What to eat and when

By Susanna Cocroft

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Title: What to eat and when


Author: Susanna Cocroft

Release date: January 25, 2024 [eBook #72779]

Language: English

Original publication: New York: The Knickerbocker Press, 1916

Credits: Bob Taylor, The Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive)


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  Transcriber’s Note
  Italic text displayed as: _italic_




[Illustration: _Susanna Cocroft._]




  What to Eat and When


  By

  Susanna Cocroft

  Author of
  “Let’s Be Healthy,” “The Woman Worth While”
  “Growth in Silence,” etc.


  _Fourth Edition_

  _With Additions and Revisions to Date_


  _Illustrated_


  G. P. Putnam’s Sons
  New York and London
  The Knickerbocker Press
  1916




  COPYRIGHT, 1916
  BY
  SUSANNA COCROFT


  The Knickerbocker Press, New York




PREFACE


THE subject of dietetics has only of late years begun to come into
its own. For centuries it was thought that the body was a thing to be
neglected and despised; that it was a clog to the soul. The teachings
of dogma and the life of the hermit and the ascetic glorified the
mortification of the body and the elevation of the soul.

The study of the functions of life and the manner in which those
functions are upheld and vivified—the development of the sciences of
Biology and Physiology—have placed the relations of the body and its
inhabitant the soul on a more consistent and rational basis. It is
coming to be recognized that the mind cannot function to its highest
efficiency in a body below par; that in order to work harmoniously
and to accomplish the most for humanity, the sound mind must dwell
in a sound body, with all of its functions active, its organs in
vigorous condition, kept so by a thorough assimilation and a forceful
circulation. These are to be secured by means of daily exercise,
abundance of fresh air, and healthful, happy, constructive thoughts.

It has been well said that the distinguishing feature between man
and other animals is the fact that he is a cooking animal. Until he
discovered fire man’s subsistence was little more than that of the
brute. Out of his discovery of the varied uses of this element came
modern civilization. Much of this advance was made possible through the
added strength of mind that was given man by a more varied diet. His
limited raw diet gave little scope to his inventive faculties. From the
discovery of the possibilities in cooked food his mind was stimulated
to research in other directions. With the lessened need for vigorous
mastication, however, the degeneration of man’s teeth began and we
are slowly learning now that exercise for the teeth and gums is as
necessary for their health as it is for the rest of the body.

Dietetics is, in itself, both an Art and a Science. Food can be
prepared so tastefully and its appearance made so pleasing as to become
a fit subject for a painter. But the selection of food that shall give
the body all the elements it needs in its work of growth and repair,
with the greatest economy of effort, of purse, of time, and of energy,
needs the trained judgment, the knowledge of comparative values and of
chemical combinations possessed by a scientist. This is especially true
from the fact that so many bodily ills result from a faulty digestion,
due either to the food itself or to the condition of the organs which
must handle the food.

The subject is so vast and its ramifications so many that all
the resources of chemistry own themselves baffled at some of its
intricacies. However, an intelligent working knowledge of the
processes undergone by food in its progress through the body, and its
transformation into vital force, can be attained by anyone.

This book is the outcome of years of experience in correcting bodily
ills caused by wrong hygienic habits. It has been written out of a
sincere desire to awaken the every-day individual to the important
relation that food bears to his well-being.

Much has been written on this subject by medical men for the medical
profession, in language too technical for the layman. It is believed
that in this book the layman will find a fund of information hitherto
not available to him, in language stripped of technicalities, plain and
easily understood. I have tried to make it logical and interesting.

When the American people become convinced that a thing is needed they
generally “go after” it, and sooner or later the desired thing is
attained. When they arouse themselves to see that the food they eat is
pure, well prepared, and taken into digestive systems vigorous by means
of proper exercise and fresh air, a new and far more virile race will
be the outcome.

Acknowledgment is here made of the valuable assistance of Winfield S.
Hall, Ph.D., M.D., Professor of Physiology in the Northwestern Medical
School, Lecturer, and Author of _Nutrition and Dietetics_; of Alida
Frances Pattee, late Instructor in Dietetics, Bellevue Training School
for Nurses, Bellevue Hospital, New York City, Author of _Practical
Dietetics_.

The tables of Food Values and the classification of foods are kindly
furnished by Dr. Hall and used by the courtesy of his publishers,
while a few of the recipes are generously furnished by Miss Pattee.
Recognition is also made of the good work of Miss Helen Hammel, former
dietitian in Wesley Hospital, Chicago, in the preparation of some of
the recipes.

  THE AUTHOR.




INTRODUCTION


The problem of proper nutrition for the body is as vital as any study
affecting the morals, health, and consequent power of a nation, since
on the quality and quantity of food they assimilate, depend the
sustenance, health, and strength of its citizens.

The food eaten by a nation largely determines the character of that
nation.

No subject is so vital to the individual, to the family, the community,
the nation, as health. No education is so vital as a knowledge of
foods, sanitation, hygiene.

Health is the basis of happiness and the attainment of happiness is
man’s chief pursuit. The very foundation of national life is the
education of its citizens in its preservation. The nation seeks
prosperity and happiness—yet true prosperity is based on these
fundamentals.

Money can be expended for no object which will yield the nation, or the
individual, greater returns than in the acquisition of a knowledge of
how to keep well. Health specialists, in the future, will direct their
work more to the prevention than to the cure of diseases.

The strongest powers are those which most fully guard the health of
their citizens. The endurance of an army lies in the strength of the
individual soldier.

The basic work for “preparedness” is in building the bulwarks of
physical strength and endurance.

The study of life is of most vital interest. The enjoyment and
maintenance of life is inbred. It is intuitive. The infant’s first
instinct is the preservation of life; almost immediately he seeks for
nourishment.

His body is an ever awakening wonder to him. He begins his education by
testing his lungs, by studying his hands, his legs, and his flesh.

The human race spends more time in providing nourishment for the body
than in any other line of activity. Yet we are wasteful; we have not
studied to make the food yield its greatest nourishment and the body
its greatest efficiency.

Unless the system is thoroughly nourished we miss much of the physical
satisfaction of life; we miss the joys of mental development, the
inspiration of soul, the sense of growth, of freedom, of expansion, and
the self-satisfaction of accomplishing. The satisfaction resulting from
greatest usefulness and the enjoyment of the results of usefulness, the
greatest blessings and the largest measure of life come only to those
whose nutriment is proper in quantity and quality, taken properly as to
time, and is thoroughly assimilated, because both body and brain are
thereby enabled to develop most fully.

The enjoyment of vibrant life, of bodily efficiency, is far beyond the
fancied joys of the intemperate or the ascetic.

That one may thoroughly enjoy life in the freedom which comes from
perfect activity of bodily functions, it is necessary that proper
_habits_ be formed, then the energy of thought is not constantly
engaged in deciding what is best. Habit calls for no conscious
expenditure of energy.

Nutrition is a broad subject. It means not only that the foods be
supplied which contain elements required to rebuild body substance and
to create heat and energy, but it embraces, also, the ability of the
body to appropriate the foods to its needs.

The study of nutrition in its full sense, therefore, must embrace not
only foods, but anatomy and physiology (particularly of the digestive
system). A knowledge of chemistry is also necessary that we may know
the changes foods undergo in being converted into tissue, heat, and
energy.[1] This science is known as Dietetics.

Scientific research along the lines of electricity, psychology,
metaphysics, medicine, and art has been tenaciously pursued for
centuries; yet scientific study of the natural means of keeping the
body in health, that the individual may be in physical, mental, and
moral condition to enjoy and to profit by researches made in other
lines, has been neglected.

The entire framework of the body—bone, muscle, blood, brain, and
nerve—as well as the heat and the mental and physical energy necessary
for every motion is supplied from food and drink, and from the oxygen
breathed into the lungs.

We are learning that derangements of the body are largely caused by
injudicious eating, yet, vital as it is, the subject of foods, except
in recent years, has not had a place in the courses of study in our
public schools.

We have given much attention to the “pound of cure,” but insufficient
attention to the “ounce of prevention.” Man does not enjoy life to its
full, nor do his physical or mental efforts yield him his best returns
unless his system is thoroughly nourished.

Formerly, the physician gave general directions, or none at all, as to
the diet. His directions, when given, were often indefinite because the
subject was not definitely understood, due to the fact that the course
of instruction in medical colleges contained practically nothing on the
subject of foods. This study is not in the curriculum of all of our
medical colleges to-day.

Our public-school curriculum contains no more important study than that
of health and of the simple, hygienic laws which enable us to retain
it. The science of foods in their relation to health, sanitation,
and general hygiene should be among the foremost requirements of our
public-school courses of study. Mothers’ clubs will find no more
interesting or profitable study than Dietetics.

It is coming to be widely recognized that a far larger number of
diseases arise from the food habit than from the liquor habit. Many who
look with contempt or pity on the victims of alcohol, are themselves
diseased of body through the unintelligent use of food.

Habitual overeating not only produces diseases of the digestive organs,
from overwork and excessive secretory activity, but also of the
excretory and glandular system, as the kidneys and the liver, and may
give rise to functional disturbances of the heart.

Food, if taken in greater quantity than the digestive juices can
handle, either passes out of the system without being absorbed or it
ferments or decomposes, giving rise to constipation, diarrhea, or other
intestinal disturbances.

If the stomach and intestines are active and can handle the excess of
food, its absorption beyond what the system requires overloads the
blood and causes obesity or diseases of the skin and kidneys. It thus
brings about abnormal deposits as in gout, or the calculi found in the
kidney or the gall-bladder. Biliousness and congestion of the liver may
follow, with constant headache, coated tongue, foul breath, and languor
of body and of mind.

Many habitually eat too much and take too little fluid, though, due to
a greater spread of knowledge, overeating is becoming less common.

On the other hand, an insufficient or illy balanced diet will bring
in its train disorders of the system scarcely less harmful. A large
number, particularly of young girls, take insufficient food, eat
irregularly, and are undernourished.

When one does not eat sufficient food or the proper kind and variety,
the tissues of the digestive organs are undernourished and do their
work imperfectly.

The undernourished are usually those who work at high tension, those
who worry, or those who do not get bodily exercise proportionate to the
mental.

Mental workers are liable to become preoccupied and forget to take
food. Growing girls who are over-interested in studies, anxious
concerning examinations, etc., neglect their meals. Parents are often
to blame in these cases by unduly encouraging the intellectual effort.

Members of some religious sects practice undereating as a form
of asceticism; many others from poverty are unable to procure a
sufficient amount of food.

Too many, if not the majority of those concerned with the purchase
and preparation of food, understand but little of food values and
the importance of their proper combination. No matter how simple the
menu, it should embrace the elements the system needs for its complete
sustenance.

The problem of nutrition must be solved largely through chemistry.
The health and efficiency of the individual and of the nation depend
on careful study of the foods placed on the market, their chemical
components, and their possible adulteration.

Happily the United States Government, realizing that its power as
a nation depends on the strength and health of its citizens, has
established experimental and analytical food departments. As a result
of the findings of the government chemists, there was enacted in 1906,
the Food and Drugs Act, which has raised the standard of food purity,
by prescribing the conditions under which foods may be manufactured and
sold. The law compels the maker of artificially colored or preserved
food products to correctly label his goods. The national law instigated
the passage of various state laws, which have further helped to insure
a supply of pure food products; yet we need other laws which shall have
greater efficiency and wider scope.

The strength of Germany as a nation is due very largely to the
government supervision of foods manufactured and imported.

There is no more important branch of the United States Government than
that which protects the health of its citizens.

The custom among some nations of retaining a physician to _maintain_
the health of the family rather than to _regain_ it, to _avoid_ disease
rather than to _cure_ it, has its distinct advantages.

We should not be satisfied with anything less than perfect health and
we are beginning to realize that this perfect health is a possibility
for almost every individual.

In the maintenance of health, as well as in the cure of disease, diet
is often more important than drugs.

To-day, scientific knowledge of hygiene and of food values is within
the reach of all, and every mother and teacher may learn how to guard
the health of those in her charge.

It is necessary to know the comparative values of foods as nutrient
agents, in order to maintain our bodies in health and strength, and
with economy of digestive effort, as well as efficiency.

There is no study, therefore, more important than that of bodily
nutrition, which comprises not only the right proportion of food and
drink, but also the manner in which they must be prepared in order
to yield the best returns under varying conditions—age, employment,
health, and sickness.

The body is certainly a marvelous machine! It is self-building,
self-repairing, and, to a degree, self-regulating.

It appropriates to its use foodstuffs for growth and for repair.

It eliminates its waste.

It supplies the energy for rebuilding, and eliminating this waste.

It directs its own emotions.

It supplies the energy for these emotions.

It discriminates in the selection of food and casts out refuse and
foodstuffs not needed.

It forms brain cells and creates mental force with which to control the
organism.

It keeps in repair the nerves, which are the telegraph wires connecting
the brain with all parts of the body.

It converts the potential energy in the food into heat with which to
keep itself warm.

Withal it is not left entirely free to do its work automatically. It
has within it a higher intelligence, a spiritual force, which may
definitely hamper its workings by getting a wrong control of the
telegraph wires, thus interfering with the digestion, the heart action,
the lungs, and all metabolic changes. The right exercise of this higher
intelligence, in turn, depends on the condition of the body, because
when the mechanism of the body is out of repair it hampers mental and
spiritual control.

About one-third of the food eaten goes to maintain the life of the
body in its incessant work of repairing and rebuilding, the remaining
two-thirds being held in reserve for other activities.

One of the most remarkable and the least understood of any of the
assimilative and absorptive functions, is the ability shown by one part
of the body to appropriate from the foods the elements necessary for
its own rebuilding, while the same elements pass through other organs
untouched. The body has the power, also, not only to make use of the
foods, but to use up the blood tissue itself. Just how this is done is
also a mystery.

There is surely a great lesson in industry here, and one of the most
profound studies in economics, physics, and chemistry.

Habitual worriers use up force and become thin more quickly than those
whose work is muscular. Those who spend their lives fretting over
existing conditions, or worrying over things which never happen, use up
much brain force and create disagreeable conditions within, resulting
in digestive ills. These again react on the body and continue the
process of impoverishment of the tissues.

Certain it is that improper foods affect the disposition, retard the
spiritual growth, and change the current of one’s life and of the
lives about one. Therefore the intelligent care of the body—the medium
through which the soul communicates with material surroundings—is a
Christian duty.

“The priest with liver trouble and the parishioner with indigestion, do
not evidence that skilled Christian living so essential to the higher
life.”

Man has become so engrossed and hedged about with the complex demands
of social, civic, and, domestic life, all of which call for undue
energy and annoyance and lead him into careless or extravagant habits
of eating and living, that he forgets to apply the intelligence which
he puts into his business to the care of the machine which does the
work. Yet the simple laws of nature in the care of the body are plainer
and easier to follow than the complex habits which he forms.

The “simple life” embraces the habits of eating as well as the habits
of doing and of thinking.

_The whole problem of perfect health and efficient activity is in
keeping the supply of assimilated food equal to the demand, in keeping
a forceful circulation that the nourishment may freely reach all
tissues and the waste be eliminated, and in full breathing habits
that sufficient oxygen be supplied to put the waste in condition for
elimination._


FOOTNOTES:

[1] It is impossible in this book to go into the anatomy and physiology
of digestion exhaustively. The reader is respectfully referred to Miss
Cocroft’s book on _Let’s Be Healthy_. This traces the food through the
digestive canal, indicating the juices which act on it, putting it into
the state in which it can be absorbed by the body and appropriated to
its various uses.




CONTENTS


  CHAPTER I

  PURPOSES OF FOOD

                                                                    PAGE

  Production of heat and energy; derivation of food
  elements; composition of the body; building
  and repair of cells; necessity of exercise; food
  elements as used in body building                                  1-7


  CHAPTER II

  CLASSIFICATION OF FOOD ELEMENTS

  Definition of food stuffs, of foods; basis of classifications
  of foods; tabulations of classes of foods and
  foodstuffs; proteins or tissue builders; carbonaceous
  foodstuffs; carbohydrates; fat; water; mineral
  salts                                                             8-37


  CHAPTER III

  CLASSIFICATION OF FOODS

  Carbonaceous: roots and tubers, green vegetables,
  fruits; nitrogenous: flesh, fish, eggs; carbo-nitrogenous:
  cereals and cereal preparations, legumes,
  nuts, milk and milk products; table of food values              38-102


  CHAPTER IV

  HEAT AND ENERGY

  BEVERAGES AND APPETIZERS

  Tea; coffee; cocoa and chocolate; lemonade and other
  fruit drinks; effervescing waters; condiments and
  spices; vinegars; sauces; food adulteration; preservation
  of foods; heat and energy                                      103-129


  CHAPTER V

  REPAIR AND ELIMINATION OF WASTE

  (METABOLISM)

  Chemical changes in foods in body; work of assimilation;
  food reserve; digestion, its processes and
  ferments; absorption of food; economy in food;
  selection of foods for need of body; mouth and
  nasal passages                                                 130-150


  CHAPTER VI

  ORGANS AND CONDITIONS AFFECTING DIGESTION

  The liver, the muscles, the nerves, the kidneys, the skin,
  the intestines, the blood, summary of work of
  organs and tissues; season and climate; habit and
  regularity of eating; frequency of meals; exercise
  and breathing; ventilation; fatigue; sleep; influence
  of thought; the circulation; gum chewing;
  tobacco and alcohol                                            151-184


  CHAPTER VII

  COOKING

  Importance of proper cooking; purposes of cooking;
  meats; cereals and cereal products; vegetables;
  fruits                                                         185-199


  CHAPTER VIII

  FOOD REQUIREMENTS OF THE SYSTEM

  Elements determining quantity of food necessary;
  selection of dietary food required by workers at
  various occupations; average requirement; energy
  derived from various foods; mixed diet versus
  vegetarian diet                                                200-215


  CHAPTER IX

  DIETS

  Constructing balanced meals; in sedentary occupations;
  the girl or boy from thirteen to twenty-one;
  the athlete; the laboring man; condition of “age”;
  model diets; tables of use in making up a balanced
  diet                                                           216-241


  CHAPTER X

  DIET IN ABNORMAL CONDITIONS

  Importance of proper diet in conditions of disease;
  anemia: indigestion or dyspepsia; gastritis,
  dilatation of the stomach; intestinal disorders;
  constipation; derangements of the liver; gall
  stones; neuralgia; kidney derangements; excess
  of uric acid; asthma; tuberculosis; neurasthenia;
  skin diseases; when traveling; in convalescence;
  leanness; obesity                                              242-304


  CHAPTER XI

  RECIPES FOR FOODS FOR INVALIDS AND SEMI-INVALIDS

  Waters; fruit juices; liquid foods; farinaceous beverages;
  meat juices; semi-solid foods; gruels; souffles                305-319


  CHAPTER XII

  INFANT FEEDING

  Problem of correct feeding; breast feeding; wet nursing;
  contra-indications to nursing; anatomy and
  physiology of the infant; intestinal disturbance;
  times of feeding; water; normal development in
  the breast-fed; weaning; artificial feeding; bacteriology;
  composition of human milk; top-milk; top-milk
  mixture; certified milk; milk modifications;
  sterilizing and pasteurizing; comparative analysis
  of milks and infant foods; gruels; vomiting; colic;
  the stools in infancy; constipation; diarrhea;
  anemia rickets; scurvy; feeding the second year                320-356


  APPENDIX

  MEASURES AND WEIGHTS                                           357-359

  INDEX                                                          361-366




ILLUSTRATIONS


        PAGE

  SUSANNA COCROFT                _Frontispiece_

  DIAGRAMMATIC REPRESENTATION OF VILLUS      146




What to Eat and When




CHAPTER I

PURPOSES OF FOOD


The purposes of food are:

To supply the material out of which the body may rebuild the tissues.

To produce heat, and to liberate muscular and mental energy.

Every particle of body substance is constantly changing. The new
material for cells and tissues, the substance to supply the energy
needed in the metabolic work of tearing down and rebuilding, the energy
used in the digestive process of converting the food into condition
to be assimilated, and the energy used in muscular, brain, and nerve
movement must all be supplied by food.

Every effort of the brain in the process of thinking, every motion, and
every muscular movement requires energy which the food must supply.

The body is composed of a vast number of cells varying according to
the tissue or organ in which they are found. The characteristic of all
living matter is that it constantly reproduces itself. Cells perform
their appointed work, wear out, and must be replaced by new ones or
derangements follow.

The new cells constantly being formed, increase in size and in so doing
push the worn-out, dying, and dead cells out of the way. The process of
building and eliminating continues within the body and on its surface
every instant of life.

An idea of the number of dead cells constantly being thrown off from
every part of the body may be gained by noticing the amount of dead
skin cast off. The fine scales of “scarf” or “dead” skin, which we
easily rub off in a friction bath, are composed of these dead cells
which have been crowded out by the hosts of vital cells constantly
forming beneath. The process is the same in every tissue and organ. The
dead or worn-out matter within the body is burned by oxygen and put in
condition to be carried by the blood to the organs of elimination, the
kidneys, intestines, lungs, and skin.

Much waste is eliminated in liquid form through the sweat glands. It
is said that stokers throw off four pounds of water and waste a day
through the skin.

In the growing child the process of building and of eliminating is
active and rapid. In the youth it is less rapid, in the adult still
less, but unless the process is kept active, stagnation and death ensue.

_Daily exercise is necessary to keep up the body activities; yet very
few take the trouble to secure daily a complete, thorough circulation
of blood, especially through the vital organs and the deeper tissues.
Perfect circulation is the key-note of health._

Activity of any kind necessitates the expenditure of energy. The
process is a chemical one and in all chemical processes heat
is necessary to cause the decomposition of elements and their
recomposition into different substances.

Heat in its turn has two functions. It enables the chemical changes to
be carried on which fit the food for the use of the various tissues,
and it burns to an ash the worn-out products of the body’s activity,
fitting them for elimination.

It keeps the tissues flexible and the secretions fluid; coagulation
takes place when the secretions become cold.

As previously stated, food in the body, then, is needed for two
purposes:

(1) to build and maintain the cell until its work is done;

(2) to furnish the heat necessary to decompose the food into its
elements, and to produce the energy by which all the body processes are
carried on.

[Sidenote: Food Elements]

That the food may be appropriated by the body it must be not only
proper in kind and quantity, but the body must also be in condition to
digest, absorb, and assimilate it and to eliminate the waste, otherwise
the body needs are not met.

It is the nourishment which _the body assimilates and appropriates to
its needs_ which counts in food economy, _not necessarily the amount
consumed_.

Therefore if the food is to economically serve its purpose, the body
must be in a condition to digest and assimilate it—_this condition
depends largely on perfect circulation, correct position of organs, and
correct breathing habits_.

Of the fifteen to twenty substances contained in foods and comprised in
the body, the principal ones are oxygen, hydrogen, carbon, nitrogen,
chlorin, sodium, potassium, magnesium, iron, calcium, phosphorus, and
sulphur. The differences in the forms of matter lie in the proportions
in which these elements are combined.

Those containing the largest proportion of nitrogen are called
_Nitrogenous_ foods or _Protein_—such as meat, eggs, and some
vegetables.

Those containing the largest proportion of carbon are known as
_Carbonaceous_—such as cereals, sugar, and fat.

The four food elements, indispensable to life, either of plant or
animal, are oxygen, hydrogen, carbon and nitrogen.

Carbon combined with oxygen forms carbon dioxid.

Oxygen, nitrogen, and carbon dioxid largely form the air.

Oxygen and hydrogen form water.

Calcium, iron, magnesium, sodium, and potassium are used in the
formation of the various tissues and secretions of the body.

The substances contained in living organisms are the same as those in
inorganic matter, only in different complexities as appropriated to the
needs of each organism.

The difference between living and non-living matter is in the relative
proportion and arrangement of the same elements.

Before it is fit to supply the needs of the body, the raw material must
undergo a chemical change.

It has been demonstrated by scientific investigation that no
unorganized elements, such as pure nitrogen, pure iron or magnesium,
are assimilated by the system and converted into its various
structures.

While the body needs carbon, it cannot use coal; it needs nitrogen,
yet it cannot appropriate it to rebuilding bone and muscle, until, by
chemical action with other elements, it has been converted into complex
substances called proteins.

The muscles, ligaments, and labor-performing structures contain the
largest amount of nitrogen.

The fat contains the largest amount of carbon.

The brain, the nerves, and the bones contain the largest proportion of
phosphorus compounds.

Yet, while the brain contains phosphorus, and the tissues nitrogen,
the brain cannot be built up by eating elementary phosphorus, nor the
muscles by pure nitrogen, but compounds rich in phosphorus or nitrogen
may be utilized.

Plants use the simple compounds of the earth, air, and soil, and,
within their own cells, build them up into such complex substances as
starch, sugar, protein, fat, and salts, putting them in condition for
man and other animals to appropriate to their use.

All plant life is compounded from the elements in the soil, air, and
water, by the action of the sun’s rays. The rays of heat and light
store something of their power in latent heat and energy in these plant
compounds.

The end of plant life is the completion of its compounds—when it has
matured them, the plant dies.

All organic matter is thus formed by the action of the sun’s rays on
inorganic matter.

The gluten of wheat is formed from the chemical union of nitrogen in
the air and nitrogen in the soil with other substances.

The starch of wheat and other grains is from carbon which the plant
has taken from the soil and combined with other substances.

All meats are largely derived from plants which have appropriated
the elements from the soil, water, and air. The chemical processes
of the animal convert the energy latent in the plant foods into the
more concentrated form of meat. The animal thus performs a part of
the chemical work for man—the digestive organs of one animal convert
the food contained in certain plants, into a substance more easily
assimilated by another animal.

Man would need to eat a large amount of nitrogen-containing plants in
order to get as much protein as is contained in one egg or in a piece
of lean meat the size of an egg. It is because the nitrogen is in
such condensed form in meat and eggs that one is likely to take more
than the system can handle, if he eats too freely of these two foods,
particularly of meat. We will discuss this question more fully under
“Proteins.”

Most domestic animals take their food elements from air and water, as
well as from the compounds which the plants have formed, while wild
animals and some domestic ones, such as hogs and chickens, make use of
meat as well.

The greater part of muscle, nerve, and gland is composed of _protein_.

When the muscles are exercised constantly they use up their protein and
must have it resupplied, or the muscle substance will waste. When the
muscles are exercised freely, as in the laborer, or the athlete, they
need more building material.

The skeleton is composed largely of deposited _salts_, as _calcium_.
If, therefore, the growing child be not supplied with a sufficient
amount of this substance, the bones will be weak and liable to
deformity and the teeth will be slow in coming or will be small and
malformed. Children need foods rich in lime.

The elements which supply heat and keep up muscular activity are
_starches, fats, and sugars_.

It must be apparent to every thoughtful person, that, since the nerves,
muscles, and glands are composed largely of protein and the skeleton
largely of calcium salts, in order to furnish the body with the
elements necessary for growth and repair, all of these elements, as
also the energy-producing substances, must be provided.

_Each individual, therefore, should learn how much he requires to
replace his daily waste, both for rebuilding tissue and for supplying
heat and energy._

The day laborer, though he may do more muscular work than an athlete in
training, expends scarcely any nervous energy. Therefore he needs less
protein in his diet than one does who expends both nervous and muscular
activity, as does the athlete.




CHAPTER II

CLASSIFICATION OF FOOD ELEMENTS


By foodstuffs are meant the chemical elements appropriated by the
animal for the use of the body, as previously described.

By foods are meant those articles of diet found in the market which
contain the chemical elements used by the body in various combinations.
Bread, for example, contains all of the foodstuffs and has been called
the staff of life, because it sustains life. This refers to bread made
from the whole of the grain. White bread, as commonly eaten, is not the
“staff of life.”

Foods may contain elements, not foodstuffs, and not used by the body,
but cast out as waste. Certain foods, such as sugar, corn-starch, olive
oil, and egg albumin, contain only one foodstuff, as will be noted
in the following classification, in which the foodstuffs are grouped
according to the body uses.

The classification of foods is based on the principal organic
foodstuffs they contain. The preponderance of the elements in any one
food determines its chief use in the body.

It will be remembered that the chief uses of foods are to produce heat
and energy, to build the tissue of the growing child, and to repair
the tissues in the child and the adult.

Nearly all foods are made up of a combination of substances.

The following tabulations give the classification of foods based on
their predominating elements.

Nitrogenous foods:

  Lean meat
  Eggs
  Gluten

Carbonaceous foods:

  Sugars
  Starches
  Root and tuberous vegetables
  Green vegetables
  Fruits
  Fats

Carbo-nitrogenous foods:

  Cereals
  Legumes
  Nuts
  Milk

Vegetables are mixtures of sugars and starches;

Fruits are mixtures of sugars, vegetable acids, and salts;

Milk, legumes, cereals, and nuts contain a more equal division
of sugars, fats, and proteins, and are therefore represented as
carbo-nitrogenous;

Lean meats, with the exception of shellfish, contain no starch, but all
meats contain protein, fat, and water.

                           { Water                   { Corn-Starch
              { Inorganic  { Salts         Starches  { Sago
              {                                      { Tapioca
              {
              {           Carbonaceous               { Glucose
              {           (producing     { Sugars    { Cane Sugar
              {           heat & energy) {           { Syrups
              {                          {           { Honey
  Foodstuffs  {                          {
              {                          {           { Lard
              { Organic                  { Fats      { Olive Oil
              {                          {           { Butter
              {                          {
              {                          {           { Egg Albumin
              {           Nitrogenous    { Proteins  { Gluten
              {           (for growth                { Lean Meat
              {           and repair)

In the above tabulation, examples are given of foodstuffs which are
almost pure representatives of their classes.

Corn-starch, sago, and tapioca are practically pure starch, containing
very little of any other element;

Glucose, cane sugar, syrups, and honey are almost pure sugar;

Butter, lard, and olive oil are nearly all pure fat;

Egg albumin, gluten of flour, and lean meat are almost pure protein.

As previously stated, however, no food contains but one element of
foodstuffs.


_NITROGENOUS FOODSTUFFS OR PROTEINS_

_Protein_ is a complex combination consisting of seventeen elements.
The digestive organs split up protein into these seventeen substances,
and they enter the blood thus split. When they reach the tissues, each
tissue selects the elements it needs and recombines them according to
its own peculiar functional uses.

Meat and eggs contain the complete protein.

Protein exists in all vegetables, but few vegetables contain protein
which is made up of the whole seventeen substances, hence more
vegetable food has to be eaten to secure the protein in the quantity
and combination necessary to maintain life.

Of these seventeen elements the predominating ones are nitrogen,
sulphur, and phosphates. The predominance of nitrogen has given the
proteins the name nitrogenous.

Proteins are the tissue builders.

In this connection it may be well to state that blood is a tissue; thus
meat and eggs build the blood, as well as muscle and sinew.

All nitrogenous foods contain considerable carbon—mostly in the form of
fat in the meat elements—but the carbonaceous foods contain so little
protein that the protein elements do not appreciably enter into the
nutrition.

Carbon and nitrogen in the carbo-nitrogenous foods are about equal in
proportion.

The nitrogenous or protein elements in the body constitute about
one-fifth of its weight. They form the basis of blood, lymph, muscle,
sinew, bone, skin, cartilage, and other tissues.

Worn-out body tissue is constantly being torn down and eliminated and
the protein in the foods must daily furnish material for repair, as
well as for building new tissue.

A young animal’s first need is for growth, as it has not learned to
exercise sufficiently to use much latent energy. The first food it
receives is an animal product—milk to babes and other mammals—while
the young chicken or bird is nourished by the yolk of the egg contained
within it. Sufficient yolk substance remains within the chick when it
is hatched to sustain its life for the first day or two.

Nitrogenous foods are more concentrated and contain less waste; thus a
smaller bulk is required than of vegetables and fruits. According to
recent experiments, the average adult requires from two to four ounces
of nitrogenous foods a day, to repair the waste. Happily, when more is
consumed, the system has the power up to a certain limit (depending on
the physical condition and the daily activity), to eliminate an excess.

It is needless to say that if the daily waste is not replaced,
digestion and nutrition suffer. The system must have the two to four
ounces necessary to supply the nitrogen daily excreted, or the tissues
themselves will be consumed.

The proteins, of which meat is the principal member, are classified as:

Albuminoids: albumin (white of eggs), casein (curd of milk), myosin
(the basis of lean meat and gluten of wheat);

Gelatinoids: (connective tissue of meat);

Extractives: (appetizing and flavoring elements).

If protein material is taken into the body in excess of its needs the
excess is used as fuel. While vastly more expensive, an excess of
protein is worth no more as fuel than starch is; 1 gram of protein
produces 4.1 calories of heat, no more than 1 gram of starch.

The proteins produce heat and energy when the supply of sugars,
starches, and fats is exhausted, but proteins alone form muscle and
the larger part of blood and sinew. They are, in this sense, the most
important of foods; they are also the most costly.

An excess of protein, usually eaten in the daily intake of food, then,
is of no practical use and can be eliminated with great benefit to the
pocketbook. Meat once a day is sufficient. The excessive consumption of
meat can be lessened with no lack of nutrition to the body. The trouble
is that meat is the first thing thought of for a meal; it is easily
prepared and housewives are not willing to use the thought and effort
necessary to secure a balanced meal without it.


_CARBONACEOUS FOODSTUFFS_

The carbonaceous foods are those used by the body for heat and energy
and are so named because they contain a large proportion of carbon—the
heat-producing element.

It is the carbon in wood, which, uniting with oxygen, produces heat and
light.

The carbonaceous foods are all composed of carbon, hydrogen, and
oxygen, the difference between them being in the different proportions
in which these elements are combined.

They are divided into two classes, Carbohydrates and Fats.

       *       *       *       *       *

[Sidenote: Carbohydrates]

The carbohydrates embrace the _sugars_ and _starches_ and include such
substance as the starches of vegetables and grains (notably corn, rice,
wheat, and the root vegetables), and the sugar of milk, of fruits,
vegetables, and the sap of trees. Their chief office is to create
energy.

The starches are converted into sugar, so they are together given the
one name of carbohydrate. The name means that carbon and hydrogen are
contained in them in such a proportion that when oxygen unites with
the hydrogen, water is produced and the carbon is liberated. In this
chemical process heat is produced. One gram of carbohydrate produces
4.1 calories of heat.

They are almost entirely absent from meat and eggs, the animal having
converted them into fats.

When the digestive organs are in a normal condition carbohydrates
are easily digested.[2] They do not play a large part in the growth
of the body tissues, but they are utilized by the body to spare the
consumption of the fat which is stored in the tissues as a reserve.
This explains their action in preserving but not producing fat.
When there is an excess of fat and the desire is to reduce, the
carbohydrates should be limited that the body may call on the reserve
fat for heat and energy.

Few realize that after the starches and fats have been consumed in heat
and energy the tissues are consumed.

The assimilation of the carbohydrates is almost complete, so that the
energy derived from them may be closely calculated.


_SUGAR_

There are many varieties of sugar. Those commonly used as foods are,
cane sugar (sucrose), fruit sugar (levulose), sugar of milk (lactose),
sugar of malt (maltose), sugar of grapes or corn (glucose), maple
sugar, honey, and saccharin—a coal-tar product. They are derived from
plants, from trees, and from tubers or other vegetables.

_Cane sugar_ (sucrose) is derived from the juice of the sugar cane and
from beets. One-third of the world’s supply of sugar is derived from
the sugar cane and two-thirds from beets. From two to ten per cent. of
sucrose may be obtained from the maple tree. It is also found in the
sugar pea.

All sugars are carbohydrates—carbon, hydrogen, and oxygen—the oxygen
and hydrogen being in the proportions which form water (two atoms of
hydrogen and one of oxygen).

_Brown sugar_ is granulated sugar in an early stage of refinement.

_Maple sugar_ is obtained by boiling down the sap of the maple tree.
It is often adulterated with other sugars or with glucose from
corn, because they are cheaper. This adulteration does not make it
unwholesome, but causes it to lose its distinct maple taste.

The nutritive value of sugar is said to be about ninety-five per cent.

_Glucose_ was formerly derived almost entirely from grapes. Later the
process was discovered by which the starch in corn was converted into
glucose. It is produced so much more cheaply from corn that this is now
the chief source of supply.

Glucose is also found in most of the fruits, in combination with other
sugars. It needs little change to be absorbed by the system and quickly
overloads the digestive apparatus if much of it is eaten.

It is pure, wholesome, and cheap, and for this reason it is often
combined with other sugars. It is not so sweet as cane sugar, though
just as nutritious. Many of the syrups on the market are made from it.

Candy is often made from glucose instead of from molasses or cane sugar.

Much candy, unless one is actively exercising, tends to produce
indigestion.

While glucose is wholesome, it ferments readily.

Before sugar can be used by the system, it is changed into the easily
absorbed form of the sugar in grapes, by a ferment in the small
intestine. Hence digested sugar in the body is called grape sugar.

_Milk sugar_ needs less chemical change than other sugars and is taken
almost at once into the circulation. It is contained in the natural
food for the infant.

The digested sugar (grape sugar) is further changed in the body into
glycogen. When an excess of sugar or starch is consumed, it is stored
within the body as glycogen, until required.

Sugar is perhaps a better food than starch, because less force is
required for its digestion and it is easily assimilated, being more
readily converted into dextrose than are starches.[3] Moreover it
furnishes the heat and energy needed by those having small power to
digest starch.

Sugar is soon oxidized, and, for this reason may be eaten by those who
need to use an extra amount of muscular strength, or to get strength
quickly. It yields heat and energy within thirty minutes after eating,
and in times of great exertion or exhausting labor, the rapidity with
which it is assimilated gives it advantage over starch. Because it is
so quickly converted into energy it is valuable for children at active
play.

Experiments with soldiers on forced marches, and in Arctic
explorations, have shown the value of sugar as a food, in enabling the
men to withstand hunger, thirst, and fatigue. Taken in excess, however,
particularly by those of sedentary habits, it clogs the system as does
any other excess of material, creating difficulties for the liver and
kidneys.

During muscular activity, four times as much sugar is consumed in the
body as is ordinarily used in the body processes.

Used in limited quantities, therefore, according to the muscular
or brain power exercised, sugar is one of the best foods for the
production of energy.

When much sugar is eaten the starches and fats in the food should be
lessened to avoid overloading the system.

When eaten in excess, sugar may temporarily appear in the urine
unaltered.

It might be inferred that, as all starch must be converted to sugar
before it can be used by the body, starches might be discarded and
replaced by sugars. A small quantity of sugar, however, soon surfeits
the appetite, and if the foods were confined to those having a surplus
of sugars, sufficient food would not be eaten to supply other needs
of the body. This lack of appetite occasioned by an excess of sugar
is due, partly, to the fact that the gastric juice is not secreted so
freely when there is much sugar in the stomach.

Because of the slower secretion of gastric juice and the surfeit of
the appetite occasioned by them, sweetened foods should not be used
at the beginning of a meal, and, while a moderate amount of sugar is
desirable, a surfeit will cause indigestion. This is particularly
liable when one eats sufficient starch and sugar at a meal and then
eats candy between meals.

Sugar is so readily oxidized and supplies heat and energy so promptly,
that the fats stored in the tissues are not called on until the latent
energy in the sugar is used. The power of sugar to fatten thus lies in
sparing the use of body fat; when starch and fat are used in addition
to sugar an excess of fat quickly results. Therefore, those who wish
to reduce in flesh should eat sparingly of sugar that the starches and
fats may be used to furnish energy, but sugar should be as freely used
as the system can handle it, by those who wish to build up in flesh.

Broadly speaking, about one-fourth of a pound of sugar, daily, in
connection with other foods, is well utilized by the system, the
quantity depending on whether one leads an active or a sedentary life.

The natural flavor of fruits and grains is very largely destroyed by
sugar, which is used too freely on many articles of diet. Sugar should
never be added to fruits while cooking, if intended for immediate
use, as the acids of the fruits neutralize a portion of the sugar.
More sugar is thus used than is needed after the cooking process is
completed.

The sweet taste in all fruits and vegetables is due to the presence of
sugar. Sweet potatoes, beets, carrots, parsnips, turnips, grapes, figs,
and dates are especially rich in sugar, and when these are furnished
with a meal, in any appreciable quantity, the starches should be
restricted—notably bread, Irish potatoes, and rice.

Those who do hard work in the open air, because of the increased
oxidation, can consume larger quantities of sugar in pie or other
pastry, which ordinarily would be difficult to digest. One who lives an
indoor life should refrain from an undue indulgence in such foods.

For one who is undernourished, sugar is a desirable food, if the starch
be diminished in proportion as the amount of sugar is increased; but
the tendency in sweetening foods is to take more starch also than
the system requires, since it is the carbohydrate foods which are
ordinarily sweetened—not the proteins.

On account of their latent heat and energy, sugars are more desirable
in cold weather than in warm. For this reason Nature supplies them more
abundantly in the root vegetables, eaten more freely in cold weather.
More puddings and heavier desserts may be eaten in cold weather.

The desire of the child for sweets is a natural one, because the child
uses much energy, and sugar supplies this energy with less tax of the
digestive system. When the child begins to eat more solid foods, if
sugar is used in abundance for sweetening, he is no longer attracted by
the mild sweetness of fresh milk, and it is well not to sweeten cereals
or other foods, also to limit other sweets, when the child turns
against milk, in order to restore the taste for this valuable food.
Many authorities state that a child, up to its third year, should not
be allowed to taste artificial sweets, in order that the appetite may
not be perverted from the natural sweets of milk.

Sugar is better supplied the child in a lump or in home-made molasses
candy, rather than in the sweetening of porridge, oatmeal, or bread and
milk, etc.

Molasses is readily absorbed and is mildly laxative, and when young
children are not allowed to eat too much, it assists in keeping the
bowels open.

Sweet fruits, fully ripened, contain much sugar and should be freely
given to the child.

[Sidenote: Starch]

Starch is one of the most important carbohydrates. It is formed from
the carbon dioxid and water in the air and in the soil by the chemical
action of the sun’s rays on the cells of living plants.

As stated, corn-starch, sago, tapioca, and arrowroot are practically
pure starch. Rice is almost pure starch.

Corn-starch is obtained from young maturing corn; tapioca comes from a
tropical plant, cassava; sago from the pith of the sago palm; arrowroot
from a plant of the same name, a native of the West Indies.

Starch lacks flavor and for this reason all starchy foods are seasoned
with salt. Salt increases the activity of the saliva and pancreatic
juices.

All starches must undergo much chemical change by action of the saliva
and the intestinal juices, before they can be used by the body.

The digestion is begun by the saliva in the mouth and is continued in
the stomach, by the saliva, until the gastric secretions begin to act.

Starch is not acted on by the gastric juice but passes unchanged into
the intestines, where it is converted, by the pancreatic juice, into
dextrin, maltose, and glucose. It is thus absorbed into the blood.

After the digested starch passes into the blood it is taken to the
liver and is there changed into glycogen and is stored in reserve.
When the system needs to produce energy it is first furnished by the
glycogen. When this is exhausted the fats and proteins are used.

The _starches_ and _sugars_ then are really the energy “reserves” of
the body, any excess over the daily needs being stored until required.

Starchy foods should not be given to any one in whom, from disease or
derangement, the starch-converting ferments, ptyalin in the saliva and
pancreatin in the pancreatic juice, are lacking.

Because the child has not developed the ferment in sufficient
quantities necessary for starch digestion, starchy food must not be
given to a child under twelve to eighteen months; at least not until he
has teeth and chews his food. Then he should be given starchy food in
the form of a crust or hard cracker which he chews thoroughly and mixes
with saliva.

Potatoes or bananas which the child does not masticate, should not be
given him under the age of two years.

[Sidenote: Fat]

Fat is the most concentrated form of fuel and is readily oxidized. It
has about twice the fuel value of carbohydrates. It is almost pure
carbon, hence less chemical work is required to convert it into fuel,
but more oxygen is needed.

The average fat person does not breathe deeply and does not take in
sufficient oxygen to cause a combustion of the fat and produce energy.
He is thus inclined to be lethargic.

A pound of fat has about three times as much fuel value as a pound of
wheat flour, which consists largely of starch.

Common examples of fat are butter, cream, the fat of meat and of
nuts, and the oil of grains and seeds—notably the cocoanut, olive, and
oatmeal.

Fat forms about twenty per cent. of the weight of the normal body.

The body cannot remain in health for long unless a proper amount of
fatty food is eaten. Muscular and nerve action, and the formation of
the digestive secretions are all dependent on the energy derived from
the combustion of fat. Its use in this way spares the tissues from
destruction in the chemical processes necessary to life.

Both carbohydrates and fats are composed of carbon, hydrogen, and
oxygen, the difference being that there is less oxygen in fat. One
pound of starch requires one and one fifth pounds of oxygen for perfect
combustion, while one pound of suet requires three pounds of oxygen.
One ounce of fat yields two and one-half times as much energy as an
ounce of sugar or starch.

Fats are not digested in the stomach. The connective tissue about
the fat is dissolved here, and the fat is passed on into the small
intestine, where it is acted on by the bile and the intestinal juices.
These first change the fat into an emulsion and then into the form of
soap and glycerin. In this saponified form, it is in condition to be
absorbed and carried to the tissues, where it is assimilated and used
in energy. The commercial production of soap from oil is similar to the
chemical change in the body of fat into soap.

The supply of fat stored in the body depends on the quantity consumed
with the food, on the quantity used up in heat and energy in muscular
or mental exercise. The quantity assimilated depends somewhat on the
condition of the nerves. If the nerves are weak, they do not strongly
direct digestion and assimilation and less fat is used in the digestive
and assimilative processes; thus, in case of weak nerves more fat is
often stored in the tissues. An excess of fat often indicates sluggish
nerve activity.

Manual laborers require more fat for energy than do people whose habits
are sedentary. School-children, or children who play hard, should have
sufficient fat and sugar.

       *       *       *       *       *

_Butter and Cream._ The fat present in milk, depends of course, on the
quality of the milk. There is as much butter-fat in a glass of fresh
Jersey milk as in a glass of cream from the milk of some cows. The
cream from some Jersey cows is eighty per cent. butter-fat.

Skimmed milk contains very little fat. If milk is drunk by the adult,
as a means of storing up more fat within the body, the cream, if
assimilated, should be stirred into it.

_The Fat of Meat._ This should be thoroughly cooked. All meats in the
process of baking or frying should be covered, in order to retain the
moisture. The fat in well-roasted beef is nutritious, but _to make fat
easily digestible it should be well masticated so as to break up the
tissue fibers which surround it_.

While fried foods are difficult of digestion (see page 192) because the
surface albumin is coagulated and the hot fat forms a coating around
it, making it difficult for the digestive juices to reach the tissue,
the fat of bacon is more easily dissolved because of the delicacy
of the fibers surrounding the fat cells. If thinly sliced and fully
immersed in its own grease in the process of frying, bacon is an easily
digested fat. The process of smoking the bacon renders it easier of
digestion.

Cooked bone-marrow is an easily digested form of fat which is usually
relished by those to whom any other fat is repulsive. It is useful in
some forms of anemia, as it contains considerable iron.

Eels, salmon, and mackerel contain much fat.

The Eskimos extensively use both whale and seal oil as a food.

The yolks of eggs are also rich in fat.

_Cod-Liver Oil_, pressed from the liver of the codfish, is easily
absorbed and assimilated by some. The odor is not pleasant and a little
lemon juice, salt, baking soda, or any flavoring substance may be added
to make it palatable. The pure oil taken in this way is, perhaps,
preferable to the prepared emulsions.

_Olive Oil_ is derived from ripe olives. It is often used when
cod-liver oil is not well borne. Many take olive oil for the purpose
of rounding out the figure with fat. If the system will assimilate
fat, taken in quantities, the fat may be stored; but, as a rule, one
is underweight because of a failure to assimilate the regular diet
and overloading the digestive organs with fat will not cause a better
assimilation. If the lack of flesh is due to sluggish assimilation
exercise should always accompany a diet for the building of flesh.

Olive oil, in moderation, is a good food when much heat and energy
are required, but if one’s occupation is sedentary, much fat is not
necessary.

_Cotton-seed Oil_ is often substituted or mixed with the cheaper grades
of olive oil. It is wholesome, if fresh, but has not the pleasing
flavor of the olive.

_Nut Oils_ are good, but, with the exception of peanut butter, are
not often used. English walnuts, hickory nuts, pecans, cocoanuts, and
Brazil nuts contain much oil. Nut oils are not well borne by some,
hence nuts must be sparingly used by them. If taken they should be used
with salt, and be thoroughly masticated.

Almond oil and olive oil are used in cooking, to some extent.

       *       *       *       *       *

To summarize—digested sugar is called dextrose or glucose; digested
starch becomes first dextrin, then maltose (animal sugar); digested
protein is peptone; and digested fat is saponified fat.


_WATER_

No food element is more important for the needs of the body than water.
It is composed of oxygen and hydrogen. It forms the large part of the
blood and lymph.

The body will subsist for weeks on the food stored in its tissues; it
will even consume the tissues themselves, but it would soon burn itself
up without water, and the thirst after a few days without it almost
drives one insane.

Though it produces force only indirectly, it is entitled to be classed
as a food, because it composes about two-thirds of the weight of the
body and a large part of all the tissues and secretions. Yeo estimates
that the supply of water to the body should be averaged at half an
ounce for each pound of body weight.

It has been estimated that from four to five pints of water are
excreted each day by the body and therefore a similar amount should be
consumed daily. The average individual at normal exercise, requires
about seventy one and one half ounces of water daily, which equals
about nine glasses (one glass of water weighs one-half pound). Some of
this may be obtained from the food.

By reference to Tables I to V it will be noted that water forms a large
percentage of all food, particularly of green vegetables and fruits.

In order that the body may do efficient work in digestion and in the
distribution of the nutrient elements of the foods, and that the
evaporation from the body may be maintained, the water in the foods,
together with the beverages drunk, should consist of about seventy-five
per cent. liquid to twenty-five per cent. nutrient elements, or about
three times as much in weight as proteins, fats, and carbohydrates
combined.

Much of the water taken passes through the system without chemical
change and is constantly being thrown off by the skin, lungs, kidneys,
and intestines.

Some of the water is split up into hydrogen and oxygen to unite with
other substances in the chemical changes carried on during the process
of digestion, and some water is obtained from the food by the union of
hydrogen and oxygen liberated by the action of the digestive juices.

Few people give much thought to its resupply; yet, ignorant of
the cause, they suffer from its loss, in imperfect digestion and
assimilation, and in kidney and intestinal difficulties. If it is
withheld from the diet for a while, marked changes occur in the
structure and processes of the body. The effect is seen in the
lessening of the secretions, the increasing dryness of all the
tissues, including the nerves, and if the lack is long continued, in
progressive emaciation, weakness, and death.

Water is the heat regulator of the body, and the more energy used,
either in work or in play which results in more heat and evaporation,
the more water is required. An animal, if warm, immediately seeks water.

It is constantly being used in the body to form solutions in which the
waste products are held so that the eliminative organs may dispose of
them.

It is the chief agent in increasing the peristaltic action of both
the stomach and intestines, thus aiding in mixing the food with the
digestive juices and assisting the movement along the alimentary canal.

It increases the flow of saliva and of the digestive juices and aids
these juices in reaching every particle of food.

It dissolves the foods, and helps in the distribution of food materials
throughout the body, carrying them in the blood and the lymph from the
digestive organs to the tissues, where they are assimilated.

The blood carries the water to the various secreting and excreting
glands and its increased pressure aids both the secreting and excreting
activity. The digestive organs secrete their juices more freely,
digestion is aided, more nutriment is rendered absorbable, more carbon
dioxid is liberated, and more oxygen is taken into the blood which
thereby is made richer and more life-giving.

One engrossed in business or household cares may forget to take water
between meals. In such a case, the blood, in order to preserve its
volume, must draw the water from the tissues, which, in consequence,
become less moist. The mouth becomes dry, saliva is scanty, appetite
fails, the digestion is not so active, the digestive and other
secretions are lessened in quantity, the food in process of digestion
becomes more solid, its absorption in the intestine is more difficult,
it moves slowly along the intestinal canal, and constipation results.
The body is not so well nourished and falls a more ready prey to
disease.

The supply of fluid furnished to the kidneys is not sufficient,
the urine becomes more concentrated and irritation may result. The
foundation is thus laid for derangements of the kidney function.

_To maintain the equilibrium of the body forces, water drinking should
be established as a permanent habit and be firmly adhered to as a part
of the daily program._

Many claim that one’s thirst, as in the desire for food, is the only
safe guide to the amount and time of drinking, but these desires are
largely matters of habit, and tastes are often perverted. Unless the
condition is abnormal or the mind becomes so intensely active that one
fails to listen to the call of Nature, _the system calls for what it
has been in the habit of receiving_ and at the stated times it has been
in the habit of receiving it. It does not always call for what is good
for it.

Plants thrive after a shower because the falling water brings down
the impurities in the air which constitute plant food. Rain-water for
household use, therefore, should never be collected during the early
part of a shower or rain storm.

Spring water, from its filtration through earth rich in mineral
deposits, usually contains a certain percentage of those minerals, as
salt, sulphur, or iron, dissolved through the action of the carbon
dioxid contained in the water. Some of these springs have become
famous health resorts. The contained carbon dioxid gives spring water
its pleasant, sparkling taste. Spring water is remarkably free from
organic life.

Water as used in cities usually needs careful filtration and
purification to rid it of its contained sand and other impurities. The
housewife whose water supply is derived from rivers does this on a
small scale when she strains out the mud and sand from the water which
she is often compelled to use when the river is in flood and full of
impurities.

Drinking water should be perfectly clear and without odor. Even a small
amount of decomposing vegetable or animal matter can be detected by its
odor, if the water is confined for a short time in a bottle or closed
jar.

The health of the body depends to a large degree on the purity of the
water. Contaminated water is a menace to health.

Water which appears perfectly clear may be badly contaminated with
typhoid or other germs. For this reason no water should be used until
it has been boiled if one is not sure of its purity. Water from wells
near barns and cesspools is often impure.

“Hard” water, as derived from wells, is usually rich in calcium and
magnesium. When water contains a large percentage of these substances,
it usually causes constipation and indigestion and may aid in the
formation of gall-stones or gravel.

The kidneys are especially the great eliminators of water and aid in
maintaining the equilibrium of the blood. Except in conditions in which
they need rest, water should be freely drunk in order to stimulate them
to activity and to assist them in throwing off the body waste held in
solution.

One cannot form a better habit than that of drinking two or three
glasses of water on first arising and then exercising the stomach and
intestines by a series of movements which alternately contract and
relax the walls of those organs, causing their thorough cleansing.

This internal bath is as necessary as the cleansing of the skin. Often,
in gastritis or a catarrhal condition of the stomach, a large amount of
mucus will collect in the stomach over night, and the cleansing of the
mucous lining of the digestive tract is then most important.

If in good health, two or three glasses of cool water, vigorous
exercises for the vital organs, and deep breathing of pure air,
followed by a cold bath, will do more to keep the health, vigor, clear
skin, and sparkling eye than fortunes spent on seeking new climates,
mineral waters, or tonics.

When cool water in the morning seems to chill one, a glass of hot water
may be followed by a glass of cool.

The free drinking of water aids the activity of the skin, keeping the
tissues moist and the glands active.

Effervescing waters are usually drunk for their cooling and refreshing
effect. They should not be drunk to excess as they are usually combined
with syrups or sugar and will thus occasion derangement of digestion,
flatulence, and in some cases palpitation from the excess of gas which
presses on the diaphragm and impedes the action of the heart.

Mineral waters are drunk for the action of the salts which they contain
and are used for their laxative or their medicinal effect. Kissengen,
Hunyadi Janos, Epsom, Carlsbad, and our own Saratoga are examples of
laxative waters. These all contain sodium and magnesium sulphates and
are known as “bitter” waters.

Table waters, as Apollinaris, Vichy, or others containing carbon dioxid
are refreshing and wholesome and may be used in nausea and vomiting for
their quieting effect. Those who are unable to take milk will often
find its digestion will be aided if the milk be mixed with Vichy or
seltzer water.

When water is used as a hot drink it should be freshly drawn, brought
to a boil, and used at once. This sterilizes it and develops a better
flavor.

Cold water should be thoroughly cooled, but not iced. Water is best
cooled by placing the receptacle on ice rather than by putting ice in
the water. Impure or contaminated ice will contaminate water.

The theory has long been held that water drinking at meals is
injurious, the objection being that the food is not so thoroughly
masticated if washed down with water, and that it dilutes the digestive
juices. But this theory is now rejected by the best authorities.

_When water drinking at meals is allowed to interfere with mastication
and is used to wash down the food, the objection is well taken_, but
one need rarely drink while food is in the mouth; the water should be
taken at rest periods between mouthfuls.

_Thorough mastication and a consequent free mixing of the food with
saliva is one of the most essential steps in digestion_, and the flow
of gastric juice, as the flow of saliva, is stimulated by the water.

It is singular that the use of water at meals has long been considered
unwise when the free use of milk, which is about seven-eighths water,
has been recommended.

The copious drinking of cool water from a half hour to an hour before
a meal will cleanse the stomach and incite the flow of saliva and
gastric juice, thus aiding digestion.

Moreover, the digestive cells secrete their juices more freely and the
sucking villi absorb more readily when the stomach and intestines are
moderately full, either of food or water, and to fill the stomach with
food requires too much digestive and eliminative activity.

Water taken before meals passes through the stomach before the food,
washes away any mucus that may have collected over the mouths of the
gastric glands, stimulates them to activity, and prepares the stomach
to receive the food.

Results obtained, in building up about twenty thousand thin women, show
that the free drinking of liquid at meals has a tendency to increase
flesh. Probably one reason for this is the cleanliness and greater
freedom it gives to the absorbing and secreting cells of the mucous
lining of the digestive tract, the stronger peristalsis it occasions,
and the consequent better digestion.

When one wishes to reduce in flesh, water drinking at meals is
restricted.

If the contents of the stomach have become too concentrated or solid,
the water will render it more liquid, hence will aid the admixture with
the gastric juices and will enable it more readily to pass the pyloric
orifice.

Drinking at meals, therefore, has many more arguments in its favor than
against it.

All who have a tendency to the deposit of uric acid in the tissues, as
in gout, should drink freely of water to lessen the deposit of salts
from the blood which must maintain its proportion of fluid.

More water should be drunk if the meal consists largely of protein. The
nitrogen it contains is eliminated in a short time by the kidneys, the
amount of urine is increased, and more water must be drunk to make up
the loss.

In sickness, as in fever, the increased respiration causes a
corresponding loss of water from the skin and the lungs. If the bowels
are active as in diarrhea, much water is lost in this way. The increase
in the heat of the body also tends to dry all the secretions, hence
water must be taken to keep them in proper fluidity.

The patient is often too ill to ask for water or will forget to ask
for it. Constipation may result from this cause. It must be a part of
the nurse’s duty to see that a sufficient amount is taken. An excess
of cold water, if hastily taken, may cause cramps. If slowly sipped it
will do no harm.

Water may be given in fever in the form of lemonade; a small pinch of
soda will make it effervescent and more refreshing.

_There is no tonic like water, exercise, and fresh air._ The safe
method is not to allow the habit of drinking water with regularity to
be broken, unless for some necessary purpose, and then the habit should
be reinstated as soon as possible.

Soft water, that is, water containing no lime or other mineral, is
best. Hard water which causes any degree of curdling of soap, or a lime
crust in the bottom of a teakettle, renders digestion difficult.

Bacteria are killed and much of the mineral matter is deposited by
boiling the water. Boiled water tastes flat or insipid. It may regain
its original, fresh taste by filling a jar half full of water, and
shaking the jar so that the air passes through the water.


_SALTS_

The salts of sodium, potassium, magnesium, calcium and some other
substances, are necessary for proper bodily functioning. Taken with the
food, they pass into the tissues without change and can be recovered,
unchanged, from the tissues and the urine.

The uses of some of these substances are not thoroughly understood, but
if deprived of them, the nutrition of the body suffers.

Lime (calcium) is necessary for the bones and teeth and to preserve the
coagulability of the blood.

Sodium chlorid (common salt) aids the formation of hydrochloric acid
and the activity of the pancreatic juice.

The salts of iron are necessary for the blood.

Other salts are also needed to carry on the chemical reactions in the
digestive system.

Cereals, all vegetables, fruits, and nuts furnish both calcium salts
and sodium, potassium, and magnesium, which are the salts in the blood
and lymph. Minerals are also abundant in dried legumes (beans and peas).

Fruits and nuts contain the least amount of these salts, and meats,
vegetables, and cereals follow in the order named, cereals, that
is the whole of the grain—not the white flour—containing the most.
Any diet, therefore, which recommends the use of fruits and nuts to
the exclusion of other foods, depletes the system of some of the
body-building elements. The system may seem to thrive for a time on
such food because, perhaps, of the rest given to overworked organs,
but eventually the body lack will manifest itself; anemia may appear
or malnutrition become evident.

Milk furnishes salts in proper proportion for building the bones and
teeth of the baby; because of the lime which it contains it is a good
food for the growing child. After the child is one year old, eggs may
be added to the diet. During the first year the albumin and fats in the
egg are not well digested. It is especially essential that children
be furnished milk and eggs that they may be assured of the proper
proportion and quantity of calcium salts for growth.

Sodium chlorid (common salt) has been for ages recognized as an
important element in food, so important that in Eastern countries it is
the symbol of hospitality and friendship.

When taken in moderate quantities, salt increases the activity of the
gastric secretion and aids the appetite. When taken in excess, as many
who have formed the salt-eating habit do, it is an irritant to the
mucous membrane of the stomach and intestines and may interfere with
nutrition, causing dyspepsia, gastroenteritis or diarrhea from the
continued irritation.

The habit indulged by some of nibbling at salted nuts of various
kinds, at and between meals, may for a short time satisfy the needs
of the body for more salt than is usually taken with the food, but
such a habit persisted in will cause acidity of the stomach from
overstimulation of the hydrochloric acid producing glands; it will also
decrease the fluidity of the blood by causing the water to be drawn
from the blood for the use of the tissues. Irritative action is also
exerted on the kidney, as any excess of salt is excreted by this organ.
For this reason salt is often prohibited for those suffering from any
inflammation of the kidney, in Bright’s disease, etc.

When chemical tests show an excess of hydrochloric acid, salt should be
omitted from the diet.

A diet consisting largely of vegetables needs the addition of sodium
chlorid to supply sufficient salt for body uses; likewise more
salt than is contained in grass and fodder is needed for animals,
particularly for those producing milk. The scientific farmer salts his
cattle regularly, while wild animals travel miles and form beaten paths
to springs containing salt.

In rectal feeding, it is known that food absorbs more readily through
the large intestine if salted. It is probable that salt, in normal
proportions, also aids absorption in the stomach and small intestine.

_Potassium_ is next in importance to sodium as it constitutes the
chief salt in the muscles. It also aids the action of the digestive
secretions and the maintenance of the reaction of the urine. Potatoes
and apples are valuable foods on account of the potassium they contain.

_Calcium_, if in excess, may cause the formation of calculi, renal or
biliary. It is also found in the tartar which accumulates on the teeth,
in the hardening walls of the arteries in arteriosclerosis, etc. All
of the cabbage family are rich in calcium. Many mineral waters and the
water from many wells contain it in excess.

Those addicted to gall-stones, gravel, etc., should particularly avoid
“hard” water.

_Phosphorus_ and sulphur are obtained by the body from eggs and milk
and from such vegetables as corn, cauliflower, asparagus, and turnips.

_Iron_ is necessary in forming the pigment of the red blood corpuscles.

If, through some disturbance in digestion, absorption or assimilation,
the iron taken in the food is not utilized, or is insufficient in
amount, the blood-making organs do not receive the necessary amount
of this substance and the red corpuscles are not formed in sufficient
numbers. The blood becomes poor in hemoglobin, and the individual
becomes pale and loses vitality. This condition is known as anemia.


FOOTNOTES:

[2] For the process of digestion and the action of the digestive juices
on the various food elements, see _Let’s Be Healthy_, by Susanna
Cocroft.

[3] PUBLISHER’S NOTE: The conversion in the body of starch and sugar
into grape sugar, then into dextrose, then into glycogen, the glycogen
being again broken up into grape sugar, is fully explained in Susanna
Cocroft’s book _Let’s Be Healthy_.




CHAPTER III

CLASSIFICATION OF FOODS


In the previous chapters, we have given the classification of the
elements in foods (foodstuffs) which supply the body needs. In this
chapter the foods commonly used are classified according to the
predominance of these elements.


_CARBONACEOUS FOODS_

While all foods contain a combination of elements, some contain a
greater proportion of carbohydrates and fats, and are classed as
_carbonaceous_.

       *       *       *       *       *

[Sidenote: Roots and Tubers]

Of the carbohydrates, next in importance to the sugars and to the
starches in their purest form (cornstarch, tapioca, sago, and
arrowroot), come the roots and tubers, such as potatoes, sweet
potatoes, beets, parsnips, turnips, and onions.

The following table shows the proportion of various foodstuffs in these
vegetables. The skins of the vegetables are included.


TABLE I

ROOTS AND TUBERS

  ——————————————+—————————+—————————+—————————+—————————+—————+——————————
                |  Water  | Protein |   Fat   |Carbo-   | Ash |Food Value
  FOOD MATERIALS|per cent.|per cent.|per cent. hydrates |per  |per pound
                |         |         |         |per cent.|cent.| Calories
  ——————————————+—————————+—————————+—————————+—————————+—————+——————————
  Sweet Potatoes|  69.4   |   1.5   |   0.3   |  26.2   | 2.6 |   440
  White Potatoes|  75.0   |   2.1   |   0.2   |  22.0   | 0.7 |   295
  Parsnips      |  64.4   |   1.3   |   0.4   |  10.8   | 1.1 |   230
  Onions        |  86.0   |   1.9   |   0.1   |  11.3   | 0.7 |   225
  Beets         |  87.0   |   1.4   |   0.1   |   7.3   | 0.7 |   160
  Carrots       |  88.2   |   1.1   |   0.4   |   8.2   | 6.0 |   210
  Turnips       |  92.7   |   0.9   |   0.1   |   0.1   | 0.6 |   120
  ——————————————+—————————+—————————+—————————+—————————+—————+——————————

_Potatoes._ It will be noted from the table given above that sweet
potatoes contain a larger percentage of carbohydrates, hence they
produce more heat and energy than any other vegetable; next to the
sweet potato comes the Irish or white potato.

While the white potato contains two per cent. of protein, this is
almost all located in a very thin layer immediately beneath the skin,
so that when the potato is peeled in the ordinary way, the protein is
removed. This is true of many vegetables. They lose their distinctive
flavor, as well as their value as tissue-building foods, when the skins
are removed, especially before cooking. Many vegetables may be peeled
after being cooked and their value in nutrition is thus increased.
All tubers gain in dietetic value if they are cooked in their skins,
the thin outer covering being removed after the cooking process is
completed. The ordinary cook, however, is unwilling to take the trouble
to prepare them in this way.

In vegetables as usually prepared for the table the proportion of
carbohydrates is increased and the proportion of protein is diminished.
The skins render many of the foods unsightly, hence they are discarded
in the preparation for cooking.

When a potato is baked the outer skin is readily separated from the
less perceptible layer containing the protein. Potatoes boiled in their
skins retain the protein.

In the white potato, of the twenty-two per cent. of carbohydrates,
three and two-tenths per cent. is sugar and eighteen and eight-tenths
per cent. is starch. In the sweet potato ten and two-tenths per cent.
is sugar and sixteen per cent. is starch.

Since sugar digests more quickly than starch, the sweet potato digests
more quickly than the white. Because of the large percentage of
carbohydrates in each, it is a mistake to eat these two vegetables at
the same meal, unless the quantity of each is lessened. For the same
reason, bread and potatoes, or rice and potatoes, should not be eaten
to any extent at the same meal, unless by one who is doing heavy manual
labor, requiring much energy.

_Onions._ Only about four per cent. of the onion represents
nourishment; the eleven and three-tenths per cent. of carbohydrates
is made up of two and eight-tenths per cent. sugar and the rest of
extractives. Of the extractives the volatile oil, which causes the eyes
to water when onions are peeled, is the most important.

The onion is not, therefore, so important for its actual nourishing
qualities as for its relish and flavor, and for this it is to be
commended.

It is a diuretic, encouraging a free action of the kidneys. Because of
its diuretic value it is commonly called a healthful food. An onion and
lettuce sandwich stimulates the action of the kidneys and is a nerve
sedative.

The volatile oil makes the raw onion difficult for some to digest and,
in that case, should be omitted from the diet.

_Beets._ There is no starch in beets, their seven and three-tenths
per cent. of carbohydrates being sugar. They possess, therefore, more
nutritive value than onions, and they are easily digested. It will be
noted that it takes many beets to make a pound of sugar.

There are no more delicate or nutritious greens than the stem and leaf
of the beet. These greens contain much iron and are valuable aids in
building up the iron in the blood, thus aiding in the correction of
anemia.

_Carrots._ Carrots are valuable as food chiefly on account of their
sugar. They are somewhat more difficult of digestion than beets and
they contain more waste. They make a good side dish, boiled and served
with butter or cream.

_Turnips._ Turnips have little value as a food. Their nutriment is
in the sugar they contain. For those who enjoy the flavor they are
a relish, serving as an appetizer, and, like the onion, are to be
recommended as a side dish for this purpose.

_Parsnips._ Like carrots, parsnips are chiefly valuable for their sugar
and for the extractives which act as appetizers.

Since turnips, carrots, onions, and parsnips owe a part of their
nutritive value to the extractives which whet the appetite for other
foods, it follows that, if one does not enjoy their flavor or their
odor, these vegetables lose in value to that individual as a food.
If one does enjoy the flavor, it adds to their food value, therefore
_taste for the flavors of all foods should be cultivated_.

       *       *       *       *       *

[Sidenote: Green Vegetables]

The question may be asked with reason: “Why do we eat green
vegetables?” They contain only about four per cent. nutriment, as
will be seen in Table II, and are mostly made up of water and pulp.
It will be noted that they are distinctly lacking in protein and in
carbohydrates; hence, they have little food value.

Some of them, however, contain acids which tend to increase the
alkalinity of the blood, and salts which are needed by the system.

Their merit lies in the fact that they have distinct flavors and thus
whet the appetite. Another reason why green vegetables are thoroughly
enjoyed is because they come in the spring, when the appetite is a
little surfeited with the winter foods.

They are diuretic, helping the kidneys and the skin to rid the system
of waste.

Because of their bulk of waste they are useful in constipation as
they act as a stimulus to the peristaltic action of the bowels; thus
they are more laxative to the intestines than the root vegetables,
partly because of the salts which they contain and partly because of
the undigested vegetable fiber. This vegetable fiber, being coarse,
assists in cleansing the mucous lining of the stomach and intestines.
They are diuretic and, if for no other reason than for this cleansing
of the kidneys, and to make the stomach and intestines more efficient,
the use of green vegetables is to be commended, and it is well to eat
freely of them.


TABLE II

GREEN VEGETABLES

  —————————+—————+—————————+—————+—————————+———————+—————————+—————————
           |Water|Nitro-   | Fat |Carbo-   |Mineral|Cellulose|  Fuel
    FOOD   | per |genous   | per |hydrates |Matter |per cent.|Value per
  MATERIALS|cent.|Matter   |cent.|per cent.|  per  |         |  pound
           |     |per cent.|     |         | cent. |         |Calories
  —————————+—————+—————————+—————+—————————+———————+—————————+—————————
  Cabbage  |89.6 |  1.80   | 0.4 |  5.8    |  1.3  |   1.1   |   165
  Spinach  |90.6 |  2.50   | 0.5 |  3.8    |  1.7  |   0.9   |   120
  Vegetable|     |         |     |         |       |         |
   Marrow  |94.8 |  0.06   | 0.2 |  2.6    |  0.5  |   1.3   |   120
  Tomatoes |91.9 |  1.30   | 0.2 |  5.0    |  0.7  |   1.1   |   105
  Lettuce  |94.1 |  1.40   | 0.4 |  2.6    |  1.0  |   0.5   |   105
  Celery   |93.4 |  1.40   | 0.1 |  3.8    |  0.9  |   0.9   |    85
  Rhubarb  |94.6 |  0.70   | 0.7 |  2.3    |  0.6  |   1.1   |   105
  Water    |     |         |     |         |       |         |
   Cress   |93.1 |  0.70   | 0.5 |  8.7    |  1.3  |   0.1   |   110
  Cucumbers|95.9 |  0.80   | 0.1 |  2.1    |  0.4  |   0.5   |    10
  Asparagus|91.7 |  2.20   | 0.2 |  2.9    |  0.9  |   2.1   |   110
  Brussels |     |         |     |         |       |         |
   Sprouts |93.7 |  1.50   | 0.1 |  3.4    |  1.3  |   0.4   |    95
  Beans    |     |         |     |         |       |         |
   (string)| 8.92|  2.3    | 0.3 |  7.4    |  0.8  |   7.0   |   195
  Beans    |     |         |     |         |       |         |
   (dried) |12.6 | 22.5    | 1.8 | 59.6    |  3.5  |   0.0   |  1605
  Peas     |     |         |     |         |       |         |
   (green, |     |         |     |         |       |         |
   shelled)|74.6 |  7.0    | 0.5 | 16.9    |  1.0  |   0.0   |   465
  —————————+—————+—————————+—————+—————————+———————+—————————+—————————

In larger cities, fresh vegetables are in the markets the year around,
but if they are raised in greenhouses, or in any way forced, they lack
the flavor which comes with natural maturity and they also lack the
full amount of iron given by the rays of the sun. If raised in the
south and shipped from a distance, they are not fresh and they do not
have as good an effect on the system as when fresh and fully matured by
the sun.

_Greens_, as spinach, chard, dandelions, and beet tops, as previously
stated, contain iron and build red blood corpuscles.

_Cabbage_, of which there are many varieties, contains much sulphur. If
fermentation exists in the intestines the sulphur unites with hydrogen
causing gas of an unpleasant odor.

They promote the formation of calcium oxalate in the urine and should
be avoided as a food by any one inclined to gout, rheumatism, or
gall-stones.

Cabbage is usually not well digested by invalids.

Eaten raw, because of its bulk, it is laxative. Some dyspeptics, who
cannot digest cooked cabbage, digest raw cabbage readily.

_Celery_ is wholesome when cooked, because of the milk and butter in
which it is prepared. Eaten raw the fiber is hard for the digestive
juices to dissolve and should be thoroughly masticated. It has little
nutritive value save for its appetizing flavor.

Because of the salts, largely sulphates and phosphates, which it
contains, celery has been called a nerve food, but the proportion of
these is so small that their food value is negligible.

_Tomatoes_ are easily digested and are refreshing. They are not well
borne by some and on account of the oxalic acid they contain should not
be used by those having an excess of uric acid.

_Asparagus_, because of its delicate flavor and appearance early in
spring, is a vegetable universally liked. It is easily digested and may
be eaten by invalids; they usually greatly relish it. Its particular
food value lies in its sulphur and in its value as an appetizer.

_Rhubarb_ is one of the most wholesome of vegetables and is being much
more widely used. Thoroughly cooked it is digestible and a natural
laxative.

Its tart flavor and appearance in early spring render it a pleasant
change from the ordinary diet. Eaten in excess, like cabbage, it
produces calcium oxalate in the urine and should not be eaten in large
amounts by those inclined to gout.

All fresh vegetables should be masticated to almost a fluid
consistency; otherwise, they are difficult of digestion, containing, as
they do, so much fiber.

       *       *       *       *       *

[Sidenote: Fruits]

Technically speaking, fruits include all plant products which bear
or contain a seed. They are valuable for their acids and organic
salts—citrates, malates, or tartrates of potassium, sodium, magnesium,
and calcium.

They are composed for the most part of starch, sugar, water, and
various organic acids, cellulose, and pectin. (Pectin is the substance
which jellies under heat.) Fruits which do not contain pectin must be
combined with others which do, or with gelatin, if jelly from them is
desired.

The organic acids in fruits are readily split up in the body, and
form alkalis. For this reason acid fruits are useful in certain acid
conditions of the stomach, because they combine with the stomach acids,
liberating substances which cause an alkaline reaction.

The citrus fruits—oranges, lemons, grapefruit and limes—are rich in
citric acid.

Malic acid is found in gooseberries, peaches, pears, apples, currants,
and apricots.

Tartaric acid is prominent in grapes.

The value of fruits as a food depends largely on the amount of starch
and sugar they contain, though their agreeable odor and taste, by
furnishing variety in the diet, render them, also, of great value as
appetizers.

As a rule they contain too much water to be of great food value if
eaten alone.

The organic acids and salts contained in fruits are of value as they
stimulate the activity of the kidneys and lessen the acidity of the
urine. The urine may even be rendered alkaline by them; hence, when
a test shows evidence of too much uric acid, acid fruits are used to
neutralize the acids in the tissues, particularly the acids of the
citrus fruits.

The fruit juices are readily absorbed and the potassium calcium,
sodium, and magnesium they contain are liberated with the formation of
alkaline carbonates.

These alkalis are largely eliminated through the kidneys, which
accounts for the diuretic effect of fruits, their acids and salts
stimulating the activity of the kidneys.

The seeds in the small fruits are not digested, but they serve the
purpose of increasing intestinal peristalsis and of assisting the
movement of the contents of the intestines. The skin and the fiber of
fruits also assist the intestines in this way, just as the fiber in
vegetables does.

All acid fruits—particularly lemons, limes, grapefruit, and
oranges—stimulate the action of the skin as well as the kidneys and
whenever the kidneys and skin are not sufficiently active, these fruits
should be eaten freely.

In case of an excess of hydrochloric acid in the stomach, lemon juice
or citrus fruits are valuable about half an hour _before_ a meal,
as when taken on an empty stomach they decrease the secretion of
hydrochloric acid.

When the secretion of hydrochloric acid is limited, acids are given
_after_ a meal to supplement the deficiency, or stimulate the glands to
activity.

_Sweet_ or _bland_ fruits are those containing a lesser percentage
of acids. Among these are pears, raspberries, grapes, bananas,
blackberries, blueberries, melons, and some peaches, apples, and plums.

Of this class of fruits, dates, figs, prunes, and grapes (raisins),
furnish most nutriment, because, as will be noted by Table III, these
fruits contain a large amount of carbohydrates in the form of sugar.

The protein in these sweet fruits is largely in the seeds and, as the
seeds are not digested, they have no real food value for the individual.

Figs and prunes, peaches, apples, and berries are laxative—probably the
laxative action of figs and berries is due to the seeds, and of the
others to the salts and acids they contain, and to the cellulose or
fibrous material which furnishes bulk.


TABLE III

FRUITS

  ———————————————+—————+———————+———————+————————+—————+—————————+—————
  FOOD           |Water|Protein|Ether  |Carbo-  |Ash  |Cellulose|Acids
  MATERIALS      |per  |per    |Extract|hydrates|per  |per cent.|per
                 |cent.|cent.  |per    |per     |cent.|         |cent.
                 |     |       |cent.  |cent.   |     |         |
  ———————————————+—————+———————+———————+————————+—————+—————————+—————
  Apples         |82.50| 0.40  | 0.5   | 12.5   | 0.4 |  2.7    | 1.0
  Apricots       |85.00| 1.10  | 0.6   | 12.4   | 0.5 |  3.1    | 1.0
  Peaches        |88.80| 0.50  | 0.2   |  5.8   | 0.6 |  3.4    | 0.7
  Plums          |78.40| 1.00  | 0.2   | 14.8   | 0.5 |  4.3    | 1.0
  Cherries       |84.00| 0.80  | 0.8   | 10.0   | 0.6 |  3.8    | 1.0
  Gooseberries   |86.00| 0.40  | 0.8   |  8.9   | 0.5 |  2.7    | 1.5
  Currants       |85.20| 0.40  | 0.8   |  7.9   | 0.5 |  4.6    | 1.4
  Strawberries   |89.10| 1.00  | 0.5   |  6.3   | 0.7 |  2.2    | 1.0
  Whortleberries |76.30| 0.70  | 3.0   |  5.8   | 0.4 | 12.2    | 1.6
  Cranberries    |86.50| 0.50  | 0.7   |  3.9   | 0.2 |  6.2    | 2.2
  Oranges        |86.70| 0.90  | 0.6   |  8.7   | 0.6 |  1.5    | 1.8
  Lemons         |89.3 | 1.00  | 0.9   |  8.3   | 0.5 |  1.5    | 1.8
  Pineapples     |89.3 | 0.04  | 0.3   |  9.7   | 0.3 |  1.5    | 7.0

  Pears          |83.90| 0.40  | 0.6   | 11.5   | 0.4 |  3.1    | 0.1
  Blackberries   |88.90| 0.90  | 2.1   |  2.3   | 0.6 |  5.2    | 1.6
  Raspberries    |84.40| 1.00  | 2.1   |  5.2   | 0.6 |  7.4    | 1.4
  Mulberries     |84.70| 0.30  | 0.7   | 11.4   | 0.6 |  0.9    | 1.8
  Grapes         |79.00| 1.00  | 1.0   | 15.5   | 0.5 |  2.5    | 0.5
  Watermelons    |92.90| 0.30  | 0.1   |  6.5   | 0.2 |  1.0    | 0.5
  Bananas        |74.00| 1.50  | 0.7   | 22.9   | 0.9 |  0.2    | 0.5

  Dates, dried   | 2.08| 4.40  | 2.1   | 65.1   | 1.5 |  5.5    | 7.0
  Figs, dried    | 2.00| 5.50  | 0.9   | 62.8   | 2.3 |  7.3    | 1.2
  Prunes, dried  | 2.64| 2.40  | 0.8   | 66.2   | 1.5 |  7.3    | 2.7
  Raisins        |10.60| 2.50  | 4.7   | 74.7   | 3.1 |  1.7    | 2.7
  ———————————————+—————+———————+———————+————————+—————+—————————+—————

The astringent and acid taste of unripe fruits is due to the tannin
and the acids. Oxygen is necessary to ripen fruits and the slow
natural maturing of the fruit on the tree enables the oxygen to enter
into combination with these substances, lessening their reaction and
altering the starch into glucose or levulose.

Fruits ripened artificially lack this chemical action of sun and
oxygen, hence the decreased palatability and digestibility of fruits
so ripened. If underripe fruits are freely eaten they ferment in the
alimentary tract and this fermentation causes the colic, vomiting, and
diarrhea so often experienced. Overripe fruit, from the decomposition
products which have already begun to form and which are further
released in the stomach or bowels, may produce the same results.

Care should therefore be exercised to select thoroughly ripe fruits
which have not begun to decay.

In order to reach their destination in fair condition, outwardly, many
fruits are picked before they are ripe. Bananas are commonly picked
green, because they decay so quickly that if they were picked ripe they
would spoil before reaching the northern markets.

One test of a naturally ripened apple is to cut it with a steel
knife—if the blade turns black, or if the cut surface of the apple
turns brown in a few minutes, it should not be eaten, for it indicates
an excess of tannin. It is this tannin which gives the small boy
excruciating pains from his green apples.

It will be recalled that the tannin from the bark of trees toughens the
skin of animals and forms leather. The effect on the membrane of the
stomach and intestines, from the tannin in food, is not so pronounced,
because of the activity and resistance of living matter.

The juice of lemons and oranges is most valuable in seasickness and
scurvy, and is of benefit in nausea. A slice of lemon will often clear
a coated tongue and give a refreshing sense of cleanliness to the
mouth, especially in feverish conditions. Sour lemonade is one of the
best drinks in summer because of its thirst-allaying qualities.

Table III shows that _bananas_ contain nearly twenty-three per cent.
of carbohydrates, which, in an immature state, are largely starches.
The natural ripening process changes the starch to sugar, thus making
them more easily digested. The starch globules, when not matured on the
tree, are not easily broken and are thus difficult of digestion.

Bananas should not be given to children under two years of age because
before this age the ptyalin and pancreatin are not sufficiently
developed to digest the starch.

Many of the inhabitants of the tropics use bananas almost to the
exclusion of other food and appear well nourished. They obtain them
from the tree when the fruit has thoroughly ripened, the starch having
been transformed by Nature into an easily digested product.

The reason many find they cannot digest bananas, as purchased in our
markets, is due to the fact that the fruit is immature and unripe.

The banana meal or flour is usually thoroughly digestible, is
nourishing, and has an agreeable taste. Invalids can often take banana
meal in the form of gruel; it makes an appreciated addition to a
limited diet. Made into a porridge and eaten with cream it is valuable
in conditions of inflammation of the gastro-intestinal tract. The
addition of a few drops of lemon juice renders it palatable to those
who like an acid flavor. Children enjoy it as a variation from cereals.
It is relished by typhoid fever patients as a change from milk.

It must be carefully cooked and well prepared as, like oatmeal, it
can be spoiled by insufficient or poor cooking. Owing to the limited
demand it is not obtainable in all markets, as it has not yet become
popularized.

_Grapes_, because of their wholesome qualities, are useful to the
system, as they contain sodium, iron, magnesium, potassium, and
calcium. Because of their appetizing flavor they are universally
enjoyed, and because they are cheap are universally used. The skins and
seeds are indigestible and, if swallowed, may cause severe irritation
or obstruction of the intestines. Grapes are rich in sugar, and on this
account must not be eaten by diabetics.

Grape juice, when unfermented, is a valuable drink, in health, or for
the convalescent. It is agreeable in taste and is mildly laxative.
Added to other fruit juices, as lemon or orange, it allays thirst and
furnishes a pleasant flavor, but on account of its high percentage of
sugar does not allay thirst when used alone.

_Apples_, so universally used, are easily digestible when ripe, and may
be prepared in so many ways that they constitute a valuable addition
to the diet. Their laxative qualities, when taken on an empty stomach,
as before breakfast, or just before retiring, are well known. They are
thus valuable in constipation, and in some forms of dyspepsia may, with
benefit, be eaten raw.

Apples should be thoroughly masticated.

The apple peel contains potassium salts and should be eaten with the
fruit.

Most invalids digest apples better if they are cooked, especially
baked. Stewed apples may have the beaten white of eggs whipped into
them and invalids who revolt against eggs can take them thus prepared.

Because of the sugar necessary in cooking them they should be avoided
by diabetics, and in conditions in which there is irritation of the
gastro-intestinal tract.

_Quinces_ are indigestible when raw, but well baked and eaten with
cream are appetizing and nourishing.

_Pineapples_, if thoroughly ripe, contain a ferment which will digest
protein, rapidly softening and disintegrating the tissue of meat. Like
the pancreatic ferment it acts in both alkaline and acid mediums.
Pineapple juice, therefore, is exceedingly valuable as an addition to
the diet. The coarse fibers also have a laxative action. Care must be
taken, however, to use this fruit only when it is well ripened, as when
green, it is indigestible.

The juice of pineapple, because of the action of the ferment in
dissolving tissue, is valuable in many forms of sore throat,
particularly when accompanied by an ulcerous condition. The effort
should be made to hold it in the mouth, allowing it to trickle down the
throat by degrees.

_Dried fruits_ are less palatable than fresh. Many of them, as prunes
and raisins, are nourishing, but others, as citron, are indigestible,
and should be finely chopped if used as flavoring.

Dried or evaporated fruits, through the action of heat, either
artificial or from the rays of the sun, have lost the water they
contained, and are preserved by their own sugar.

Dried grapes, or raisins, because of their sugar, soon satiate the
appetite if eaten raw, but if cooked or added to cereals, puddings,
or breads, enhance the palatability and nourishing qualities of these
foods.

Dates and figs used in the same way, in cereals or puddings, are
equally valuable.

Dried currants are the most indigestible of the dried fruits, owing to
their large amount of skin in proportion to the nutriment.


_NITROGENOUS FOODS_

As previously stated, in a mixed diet, meat and eggs are the chief
sources of nitrogenous foods. Next to these come the legumes.

       *       *       *       *       *

[Sidenote: Meat]

Meat is composed largely of muscle fiber and contains connective tissue
and fat. It has been estimated that beef contains one-third nutritive
material, the other two-thirds being water and bone. Fat meat contains
less nitrogenous material and less water than lean meat.

Lean meat is almost entirely digested in the stomach by the gastric
juice, which changes it into peptone. It is needless to say that it
should be thoroughly masticated, that the gastric juice may promptly
act on it. If any part passes into the intestine undigested, the
process is continued by the trypsin of the pancreatic juice.

The peptone is absorbed and carried by the blood and lymph to all
tissues of the body, where it is used for growth and repair. As stated
under “Heat and Energy,” any excess of protein above that needed
for growth and repair is oxidized if sufficient oxygen is breathed,
yielding energy and heat, and the waste is eliminated through the
kidneys and the bile.

For purposes of comparison, one pound of beef has been said to equal
in nutritive value, two and one-half pints or five glasses of milk,
one-half pound (two-thirds of an ordinary baker’s loaf) of bread, and
three eggs. However, these values vary.


TABLE IV

ANIMAL FOODS

  ——————————————————+—————+———————+—————+—————————+—————+——————————
  FOOD MATERIALS    |Water|Protein|Fat  |Carbo-   |Ash  |Fuel Value
                    |per  |per    |per  |hydrates |per  |per pound
                    |cent.|cent.  |cent.|per cent.|cent.|Calories
  ——————————————————+—————+———————+—————+—————————+—————+——————————
  Beef, Fresh       | 54.0| 17.0  | 19.0|  ....   | 0.7 | 1105
    Flank           | 54.0| 17.0  | 19.0|  ....   | 0.7 | 1105
    Porterhouse     | 52.4| 19.1  | 17.9|  ....   | 0.8 | 1100
    Sirloin steak   | 54.0| 16.5  | 16.1|  ....   | 0.9 |  975
    Round           | 60.7| 19.0  | 12.8|  ....   | 1.0 |  890
    Rump            | 45.0| 13.8  | 20.2|  ....   | 0.7 | 1090
    Corned beef     | 49.2| 14.3  | 23.8|  ....   | 4.6 | 1245
                    |     |       |     |         |     |
  Veal:             |     |       |     |         |     |
    Leg cutlets     | 68.3| 20.1  |  7.5|  ....   | 1.0 |  695
    Fore quarter    | 54.2| 15.1  |  6.0|  ....   | 0.7 |  535
                    |     |       |     |         |     |
  Mutton:           |     |       |     |         |     |
    Leg, hind       | 51.2| 15.1  | 14.7|  ....   | 0.8 |  890
    Loin chops      | 42.0| 13.5  | 28.3|  ....   | 0.7 | 1415
    Lamb            | 49.2| 15.6  | 16.3|  ....   | 0.85|  967
                    |     |       |     |         |     |
  Ham:              |     |       |     |         |     |
    Loin chops      | 41.8| 13.4  | 24.2|  ....   | 0.8 | 1245
    Ham, smoked     | 34.8| 14.2  | 33.4|  ....   | 4.2 | 1635
                    |     |       |     |         |     |
  Sausage:          |     |       |     |         |     |
    Frankfurter     | 57.2| 19.6  | 18.6|   1.1   | 3.4 | 1155
                    |     |       |     |         |     |
  Poultry:          |     |       |     |         |     |
    Fowls           | 47.1| 13.7  | 12.3|  ....   | 0.7 |  765
    Goose           | 38.5| 13.4  | 29.8|  ....   | 0.7 | 1475
    Turkey          | 42.4| 16.1  | 18.4|  ....   | 0.8 | 1060
                    |     |       |     |         |     |
  Animal Viscera:   |     |       |     |         |     |
    Liver (sheep)   | 61.2| 23.1  |  9.0|   5.0   | ....| ....
    Sweetbreads     | 70.9| 16.8  | 12.1|  ....   | 1.6 | ....
    Tongue, smoked  |     |       |     |         |     |
     and salted     | 35.7| 24.3  | 31.6|  ....   | 8.5 | ....
                    |     |       |     |         |     |
  Brain:            | 80.6|  8.8  |  9.3|  ....   | 1.1 | ....
                    |     |       |     |         |     |
  Fresh Fish:       |     |       |     |         |     |
    Bass large-     |     |       |     |         |     |
     mouthed|       |     |       |     |         |
     Black, dressed | 41.9| 10.3  |  0.5|  ....   | 0.6 |  215
    Cod steaks      | 72.4| 16.9  |  0.5|  ....   | 1.0 |  335
    Shad roe        | 71.2| 23.4  |  3.8|  ....   | 1.6 |  595
    Whitefish,      | 46.1| 10.2  |  1.3|  ....   | 0.7 |  245
     dressed        |     |       |     |         |     |
  Preserved Fish:   |     |       |     |         |     |
   Halibut, salted, |     |       |     |         |     |
   smoked and dried | 46.0| 19.1  | 14.0|  ....   | 1.9 |  945
   Sardines, canned | 53.6| 24.0  | 12.1|  ....   | 5.3 |  955
   Salmon, canned   | 59.3| 19.3  | 15.3|  ....   | 1.2 | 1005
                    |     |       |     |         |     |
  Mollusks:         |     |       |     |         |     |
   Oysters, solid   | 88.3|  6.1  |  1.4|   3.3   | 0.9 |  235
   Round clams      |     |       |     |         |     |
    removed from    | 80.8| 10.6  |  1.1|   5.1   | 2.3 |  340
    shell           |     |       |     |         |     |
   Mussels          | 42.7|  4.4  |  0.5|   2.1   | 1.0 |  140
                    |     |       |     |         |     |
  Crustaceans:      |     |       |     |         |     |
   Lobster, in shell| 31.1|  5.5  |  0.7|  ....   | 0.6 |  130
   Crab, in shell   | 34.1|  7.3  |  0.9|   0.5   | 1.4 |  185
   Shrimp, canned   | 70.8| 25.4  |  1.0|   0.2   | 2.6 |  520
   Terrapin, turtle,| 17.4|  4.2  |  0.7|  ....   | 0.2 |  105
     etc.           |     |       |     |         |     |
  ——————————————————+—————+———————+—————+—————————+—————+——————————

The amount of fat in meat varies from two to forty per cent., according
to the animal and to its condition at the time of killing.

The best meats are from young animals which have been kept fat and have
not been subjected to any work to toughen the muscles.

It is possible to combine the fat and the lean of meat so as to meet
the requirements of the body without waste. About ninety-seven per
cent. of meat is assimilated by the system, while a large part of the
vegetable matter consumed is excreted as refuse.

The compounds contained in animal foods are much like those of the
body, therefore they require comparatively little digestion to prepare
them for assimilation—this work having been done by the animal—while
the vegetable compounds require much change by the digestive system
before they can be used in the body.

The proportion of _albuminoids_, _gelatinoids_, and _extractives_ in
meat vary with different meats and with different cuts of the same meat.

The _albuminoids_ of meat include the meat tissue, or the muscle cells.
These constitute by far the greater part of the meat.

The _gelatinoids_ are derived from the connective tissue forming the
sheath of the muscle and of bundles of muscles, the skin, tendons,
and the casing of bone. Gelatins are made from these and, if pure and
prepared in a cleanly manner, they are wholesome.

Gelatin is distinguishable in rich meat soups, which jelly when cool.

The gelatinoids alone have not a large nutritive value; they serve to
spare the albumin from being used, though they cannot replace albumin
in the diet. They also, to some extent, keep the muscles from being
consumed when starches, sugars, and fats are lacking.

The _extractives_ are found most abundantly in the flesh of animals and
birds noted for their muscular activity, as in game. Some of them exert
a stimulant action on the nervous system and others are appetizers,
giving to cooked meats, broths, etc., their pleasing flavor. In case
of anemia, in which it is necessary to build red blood corpuscles, the
blood of beef, the thought of which is usually repellent, may be made
very palatable if it is heated sufficiently to bring out the flavor of
the extractives, and then seasoned.

Unless the beef extracts on the market contain the blood tissue, in
addition to the extractives, they are not particularly nourishing and
are only valuable in soups, etc., as appetizers.

Soups for nourishment should be made by cooking the bones, connective
tissue, and a part of the meat. Bones and connective tissue alone make
an appetizing soup, but it contains little nutriment.

One reason why meat soups should constitute the first course at dinner
is because the extractives stimulate the appetite and start the flow of
gastric juices. Bouillons contain no nourishment, but they may be used
as stimulant restoratives to the muscles, or as a basis for vegetables,
rice, or barley to give them flavor.

Roasted flesh seems to be more completely digested than boiled meat;
raw meat is more easily digested than cooked; rare meat is more easily
digested than that thoroughly cooked.

Roasted young chicken and veal are tender, easily masticated, and
easily and rapidly digested in the stomach. This is one reason why the
white meats are considered a good diet for the invalid, though veal is
usually avoided in cases of dyspepsia, as, if too young, it may cause
diarrhea; if too old, it is less digestible than beef.

Fat meats remain in the stomach a much longer time than lean meats;
thus, gastric digestion of pork, which usually contains much fat, is
especially difficult, requiring from three and one-half to four hours
(see page 22).

Preserved and canned meats should be eaten with the utmost caution,
care being taken to know that they are put up by firms which use
extreme care in their preparation. Inferior meat is sometimes used in
the preparation of these foods. If meats are not fresh and the canning
not carefully done, they may become putrid after being put up.

_Fish_ and _sea foods_ are, many of them, rich in protein, as noted in
Table IV. They should never be used unless absolutely fresh.

The idea is prevalent that fish is a brain food. Fish is easily
digested and builds brain as well as other tissue, but no more readily
than beef does, or any easily digested, absorbed and assimilated food
which contains a goodly proportion of protein.

_Lobsters_ are difficult of digestion and contain little nutrition, so
are not valuable as a food, though they are relished by many on account
of their flavor.

_Oysters_, raw, are easier to digest than when cooked. Oysters should
not be eaten during the spawning season from May to September.

_Mussels_ are nutritious when well prepared and are rapidly gaining in
popularity.

_Clams_ furnish a valuable and nutritious food when prepared in chowder
form. Clam broth will often be retained on an irritable stomach when
other food is rejected by it.

Care should be taken to ascertain the method of their production as
typhoid fever has been contracted from eating shell fish whose feeding
beds were near or in polluted water.

       *       *       *       *       *

[Sidenote: Eggs]

Eggs are excellent articles of food for nutrition and for tissue
building. They have practically the same value in the diet as meat, and
make a very good substitute for meat. Egg yolk in abundance is often
prescribed when it is necessary to supply a very nutritious and easily
assimilated diet.

Eggs consist chiefly of two nutrients—protein and fat (ten per cent.).
Because they contain so large a proportion of protein they are
classified as nitrogenous foods.

The yolk, which is about one-third fat, contains iron, sulphur,
potassium, calcium, magnesium, and phosphorus. The white contains some
fat and phosphorus. The white and the yolk contain equal quantities of
protein. The white of the egg is almost pure albumin.

The dark stain made by eggs on silver is due to the sulphur.

The iron in the yolk is a valuable assistant in building red blood
corpuscles.

Eggs, in common with other proteins, are changed, mostly in the
stomach, into peptone. That not digested in the stomach, as is the case
with other proteins, is changed in the intestine.

If the egg is old, or if its absorption is delayed in the intestine, it
decomposes, producing gas, and may cause intestinal disorder. For this
reason no stale egg should ever be served, especially to an invalid.

One reason why eggs disagree with some is because too much fat is eaten
at the same time. Egg yolk contains fat and if much extra fat is eaten
indigestion and fermentation in the intestine may result. This is
particularly true in those who digest fat with difficulty.

When eggs seem to disagree or the system does not assimilate them well
on account of the fat in the yolk, and eggs are desirable to supply the
protein in the diet, the whites, which contain practically no fat, may
be used. They should be well beaten and if digestion is weak they may
be mixed with fruit juices.

The citric acid in lemons and oranges partially digests the egg, the
gastric juice quickly changing it to peptone.

One method of preparing eggs, which is especially valuable for those
having delicate stomachs, is in egg lemonade or orangeade. Thoroughly
beat the egg, add the juice of half a lemon or orange, sugar to taste,
and fill the glass with water.

Grape juice, cream, and cocoa, if assimilated, may be used in place of
lemon or orange, in order to give variety when it is necessary to use
eggs freely.

Eggnog is another means of taking raw eggs.

One method of testing the freshness of eggs is to drop them into a
strong, salt brine made by adding two ounces of salt to a pint of
water. A fresh egg will at once sink to the bottom. If the egg is three
days old the surface of the shell will be even with the surface of the
water and an egg two weeks old will float mostly above the surface.

The opinion is prevalent that a hard-boiled egg is difficult of
digestion, but this depends entirely on the mastication. If it is
masticated so that it is a pulp before being swallowed, a hard-boiled
egg is readily digested.

A soft-boiled egg should not be boiled longer than three or four
minutes, or better, should be put into warm water, be allowed to come
to a boil, then set off the fire and the egg be allowed to remain in
the water for ten minutes. This method cooks the egg through more
evenly.

Another method of cooking the yolk evenly with the white is to put the
egg in cold water, let the water come to a boil, and again immerse the
egg in cold water. The immersing in cold water after boiling makes
hard-boiled eggs peel readily.


_CARBO-NITROGENOUS FOODS_

Under this class come cereals, legumes, nuts, milk, and milk products.
In these foods the nitrogenous and carbonaceous elements are more
evenly proportioned than in either the carbonaceous or nitrogenous
groups. The different food elements in this group are so evenly divided
that one could live for a considerable length of time on any one food.
Some animals build flesh from nuts alone, while the herbivorous animals
live on cereals and plants.

       *       *       *       *       *

[Sidenote: Cereals]

Under cereals, used by man for food, come wheat, oats, rye, barley,
rice, and corn. As will be noted by Table V, cereals contain a large
proportion of starch and are therefore used largely for heat and
energy. Rice contains the largest proportion and next to rice, wheat
flour.


TABLE V

CEREALS

  —————————————————+—————+———————+—————+—————————+—————————+——————
                   |     |       |     | _Carbohydrates_   |
                   |     |       |     +—————————+—————————+
  FOOD MATERIALS   |Water|Protein|Fat  |Starch,  |Crude    | Ash
                   |per  |per    |per  | etc.    |fiber    | per
                   |cent.|cent.  |cent.|per cent.|per cent.| cent.
  —————————————————+—————+———————+—————+—————————+—————————+——————
  Wheat            |10.4 |  12.1 |  2.1|  71.6   |  1.8    | 1.9
  Rice             |12.4 |   7.4 |  0.4|  79.2   |  0.2    | 0.4
  Oats             |11.0 |  11.8 |  5.0|  59.7   |  9.5    | 3.0
  Rye              |11.6 |  10.6 |  1.7|  72.0   |  1.7    | 1.9
  Breads and       |     |       |     |         |         |
   Crackers:       |     |       |     |         |         |
    Wheat bread    |32.5 |   8.8 |  1.9|  55.8   | ....    | 1.0
    Graham bread   |34.2 |   9.5 |  1.4|  53.3   | ....    | 1.6
    Rye bread      |30.0 |   3.4 |  0.5|  59.7   | ....    | 1.4
   Soda crackers   | 8.0 |  10.3 |  9.4|  70.5   | ....    | 1.8
   Graham crackers | 5.0 |   9.8 | 13.5|  69.7   | ....    | 2.0
   Oatmeal crackers| 4.9 |  10.4 | 13.7|  69.6   | ....    | 1.4
   Oyster crackers | 3.8 |  11.3 |  4.8|  77.5   | ....    | 2.6
   Macaroni        |13.1 |   9.0 |  0.3|  76.8   | ....    | 0.8
  Flours and Meals:|     |       |     |         |         |
   Flour, wheat    |12.5 |  11.0 |  1.0|  74.9   | ....    | 0.5
   Corn Meal       |15.0 |   9.2 |  3.8|  70.6   | ....    | 1.4
   Oatmeal         | 7.6 |  15.1 |  7.1|  68.2   | ....    | 2.0
  —————————————————+—————+———————+—————+—————————+—————————+——————

The values as given in the table refer to the whole of the grain. When
the outer coverings are removed, as in the white flour and the outer
covering of rice, the proportion of carbohydrates is increased and the
protein and ash are almost entirely eliminated.

There is no part of the world, except the Arctic regions, where cereals
are not extensively cultivated. From the oats and rye of the north, to
the rice of the hot countries, grains of some kind are staple foods.

 An idea of the importance of cereal foods in the diet may be gathered
 from the following data, based on the results obtained in dietary
 studies with a large number of American families: Vegetable foods,
 including flour, bread, and other cereal products, furnished 55 per
 cent. of the total food, 39 per cent. of the protein, 8 per cent.
 of the fat, and 95 per cent. of the carbohydrates of the diet. The
 amounts which cereal foods alone supplied were 22 per cent. of the
 total food, 31 per cent. of the protein, 7 per cent. of the fat and
 55 per cent. of the total carbohydrates—that is, about three-quarters
 of the vegetable protein, one-half of the carbohydrates, and
 seven-eighths of the vegetable fat were supplied by the cereals. Oat,
 rice, and wheat breakfast foods together furnished about 2 per cent.
 of the total food in protein, 1 per cent. of the total fat, and 4 per
 cent. of the carbohydrates of the ordinary mixed diet, as shown by the
 statistics cited. These percentage values are not high in themselves,
 but it must be remembered that they represent large quantities when we
 consider the food consumed by a family in a year.[4]

If one’s work calls for extreme muscular exertion, the cereals may be
eaten freely, but if one’s habits are sedentary, and the cereals are
used in excess, there is danger of clogging the system with too much
starch. Indeed, for one whose occupation is indoors and requires little
muscular activity, a very little cereal food, such as bread, cake,
etc., will suffice; the carbohydrates will be supplied, in sufficient
quantity, in vegetables.

Mineral matter is supplied in sufficient quantity in almost all classes
of foods.

Cereals and legumes supply nutrients at less price than any class of
foods; therefore a vegetarian diet involves less expense than the
mixed diet. An entirely vegetarian diet, however, gradually induces a
condition of muscular weakness in many people, resulting in a loss of
strength. A well-proportioned mixed diet is best to give strength and
activity of both body and mind.

Meat, eggs, and milk, which usually supply the proteins, are the most
expensive foods, and when these, for any cause, are eliminated, a large
proportion of proteins should be supplied by the legumes.

       *       *       *       *       *

[Sidenote: Wheat]

Perhaps no food is as commonly used as wheat in its various forms. It
is composed of:

1. The nitrogenous or protein compound, chiefly represented in the
cerealin and the gluten of the bran. This is removed from white flour
and from much of the so-called “whole wheat” flour.

2. The starch—the center or white part of the kernel.

3. The fats, occurring chiefly in the germ of the grain.

4. The phosphorus compounds, iron, and lime, found in the bran.

The kernel of wheat consists of the bran or covering, which surrounds
the white, pulpy mass of starch within. In the lower end of the kernel
is the germ.

_Flour._ In the old-time process of making flour the wheat was
crushed between stones and then sifted, first, through a sieve, which
separated the outer shell of the bran; then through bolting cloth,
which separated the white pulp from the inner bran coating. It was not
ground as fine as in the present process, thus the gluten, phosphorus,
and iron (all valuable substances) were, in the old process, nearly
all left out of the white flour. The second bran coating, left by the
second sifting, was not so coarse as the outer shell but coarser than
the inner. Care was not formerly observed in having the grain clean
before grinding, the bran containing chaff and dirt, so that it was
not used as food but was considered valuable for stock, and was called
“middlings.”

In the modern process of crushing the wheat between steel rollers, the
white flour of to-day contains more of the protein from the inner coat
of the bran than the white flour of the old process; hence, it is more
nutritious.

_Bran._ Objection is sometimes made to bran because the cellulose
shell is not digested, but bran contains much protein and mineral
matter and even though it is crude fiber, as previously stated, this
fiber has a value as a cleanser for the lining of the stomach and
intestines, and for increasing peristalsis, thus encouraging the flow
of digestive juices and the elimination of waste. In bread or breakfast
foods, it is desirable to retain it for its laxative effect.

Bran has three coats—the tough, glossy outside, within this a coat
containing most of the coloring matter, and a third coat, containing
a special kind of protein, known as cerealin. The two outer layers
contain phosphorus compounds, lime, and iron. All three coats contain
gluten.

_Gluten flour_ is made of the gluten of wheat. It is a valuable, easily
digested food, containing a large proportion of protein and little
starch. Gluten bread is used by those who wish to reduce in flesh and
in diabetic cases.

_Whole wheat_ flour does not contain the whole of the wheat, as the
name implies; it, however, does contain all the proteins of the
endosperm and the gluten and oil of the germ, together with all of the
starch. As a flour, therefore, it is a more balanced food than the
white flour, because it contains more nitrogenous elements.

_Graham flour_ is made from the entire wheat kernel with the exception
of the outermost scale of the bran. It contains the starch, gluten
phosphorus compounds, iron, and lime. It is the most desirable of
the flours because, containing the bran, it assists in digestion and
elimination, and the phosphorus, iron, and lime, are valuable body
builders.

_Nutri meal_ is much the same as Graham flour, the chief difference
being that the bran is ground finer. The wheat is ground between hot
rollers, the heat bringing out the nutty flavor of the bran. Bread made
from it is not only nutritious, but delicious in flavor. It contains
all of the nutrition of the wheat.

_Bread._ As must be implied from the foregoing, the nutri meal, or
graham flours are necessary for bread if it is to be used as a complete
food, the “staff of life.” The white bread is made from flour which
is almost pure starch; the lime, phosphorus compounds, and iron are
removed.

Perhaps no form of prepared food has been longer in vogue than bread.
It has been known since history began. When the entire wheat kernel is
used it probably maintains and supports life and strength better than
any single food, but bread is not the “staff of life” unless the entire
kernel is in the flour.

Children should be given Graham bread or Graham crackers containing
the whole of the grain in order to obtain the balanced food and the
nutritive materials which are not obtained in bread made of white
flour. Lime for the teeth and the growing bones is in the bran.

The more porous the bread the more easily it digests. When full of
pores, it is more readily mixed with the digestive juices.

The pores in bread are produced by the effort of the gas, released
by the yeast, to escape. When mixed with water, the flour forms a
tenacious body which, when warm, expands under the pressure of the gas
from the yeast, until the dough is full of gas-filled holes. The walls
of gluten do not allow the gas to escape, and thus the dough is made
light and porous. The more gluten the flour holds, the more water the
dough will take up and the greater will be the yield of bread; hence,
the more gluten, the more valuable the flour. If the bread is not
porous, the fermentation is not complete, and the bread is heavy.

The albumin in the walls of the expanding bubbles causes substances
which contain beaten eggs to be more porous when baked.

_Yeast_ is a plant fungus. In its feeding, the plant consumes sugar,
changing it into alcohol and carbon dioxid. If the bread contains no
sugar the yeast plant will change the starch in the flour into sugar
for its feeding.

Many housewives, realizing that the bread begins to “rise” quicker
if it contains sugar, put a little into the sponge. Unless a large
quantity of sugar is put in, the yeast will consume it and the bread
will not have an unduly sweet taste.

As the yeast causes fermentation, alcohol forms in the dough. This
is driven off in the baking. If the bread is not thoroughly baked,
fermentation continues and the bread turns sour.

Bread is not thoroughly baked until fermentation ceases. It is claimed
that fermentation does not entirely cease with one baking; this is the
basis of the theory, held by some, that bread should be twice baked.
The average housekeeper bakes an ordinary loaf one hour.

Time must be given for the products of fermentation to evaporate,
during the cooling of the bread, before it is eaten.

Hot or insufficiently cooked bread is difficult of digestion, because
it becomes more or less soggy on entering the mouth and the stomach,
and the saliva and gastric juices cannot so readily mix with it.

The best flour for bread is that made from the spring wheat, grown in
cooler climates, because it is richer in gluten than the winter wheat.
The winter wheat flour is used more for cakes and pastries.

Bread made with milk, is, of course, richer and more nutritious than
that made with water, and bread made with potato water contains more
starch; both of these retain their moisture longer than bread made
without them.

_Mold_, which sometimes forms on bread, is, like the yeast, a minute
plant. It is floating about everywhere in the air, ready to settle down
wherever it finds a suitable home. Moisture and heat favor its growth;
hence bread should be thoroughly cooled before it is put into a jar or
bread box. The bread box should be ventilated and kept in a cool place.

_Rye bread_ contains a little more starch and less protein than wheat
bread. It contains more water and holds its moisture longer.

_Biscuits._ The objection to eating hot bread does not hold for baking
powder or soda biscuits, if well cooked, because these cool more
rapidly and they do not contain the yeast plant; hence, they do not
ferment as does the bread.

_Baking powder_ is made from bicarbonate of soda (baking soda) and
cream of tartar. When these are brought in contact with moisture,
carbon dioxid is liberated, and in the effort to escape it causes the
dough to expand and become light.

Breads made with pure baking powder are wholesome and, when light, are
digestible. When made with cheap baking powder, however, in which alum
or ammonia is employed, the stomach may be irritated by the chemical
substances contained.

The reason that the cook attempts to bake her biscuits, or anything
made with baking powder, as quickly as possible after the baking powder
comes in contact with the moisture, is that the dough may have the full
effect of the expansion of the gas. If the room in which she mixes
her dough is cool, or if her biscuit dough is left in a cool place,
this is not important, as heat and moisture are both required for full
combustion. Enough baking powder biscuit dough may be mixed at one
time to provide biscuits every morning for a week, if buried in flour
immediately after mixing so that it is kept cool and from the air. A
portion may be cut off each morning and the remainder again buried in
the flour.

_Macaroni_ and _spaghetti_ are made from a special wheat flour known
as Durum. They contain about seventy-seven per cent. of starch, little
fat, and little protein. They may take the place of bread, rice, or
potato at a meal.

_Rice_ is a staple cereal in all tropical and temperate climates. It
requires special machinery to remove the husk and the dark, outer skin
of the kernel.

The polished rice commonly used, is almost pure starch, and, like white
flour, lacks the nutritive qualities contained in the husk or covering.

It is seldom eaten within three months after harvesting and it is
considered even better after two or three years. It requires thorough
cooking.

_Wild rice_ is used by the North American Indians. The seeds are
longer, thinner, and darker, than the cultivated rice. It is coming
into favor as a side dish but it is served more particularly at hotels
in soup and with game.

As previously stated, rice contains a larger proportion of starch than
any other cereal and the smallest proportion of protein. Next to rice,
in starches, comes wheat flour; yet whole wheat or graham flour contain
half as much again of protein.

Because of the quantity of starch in flour, potatoes, and rice, it is
obvious that one should not eat freely of more than one of these at the
same meal, else the digestive organs will be overworked in converting
the starch into sugar, the liver overworked in converting the sugar
into glycogen and back again into sugar, and be overloaded in storing
it up.

By far the best plan is to eat but one cereal at a meal.

Rice contains no gluten, hence it cannot be raised in bread.

Unhusked rice is called paddy. The “vitamins” of rice are in the
covering.

A German investigator, working to discover the cause of the disorder
of nutrition known as “beriberi” occurring in those who used polished
rice freely, found that in those who used _un_polished rice, from which
the outer husk had not been removed, the disease did not appear. He
gave the name of “vitamin” to the substance in the outer husk, which
prevented the disease.

While these substances were discovered while working with rice, they
have since come to include other substances which affect the nutritive
value of food. The term “vitamin” has since been given to other
apparently necessary elements in foods which seem to determine their
nutritive value to the system. These necessary elements, “vitamins,”
may be the spices and flavors used in the food, and sometimes, perhaps,
may be the flavors resulting from the action of benign bacteria, as
those which give the delicious flavor to butter and cheese.

Food, however nutritious, is lessened in its value to the system
unless it appeals to the senses by its mode of preparation, seasoning,
serving, and freshness. Sternberg insists that the senses of smell and
taste determine chemical changes in foods with greater sensitiveness
than chemical tests.

Dishes unskillfully prepared are not relished. Some chemical change has
occurred which the senses detect and these dishes are rendered less
wholesome, lacking the necessary “vitamin.” Distaste, loss of appetite,
and even nausea and vomiting may occur.

Sternberg calls attention anew to the fact that the science of cooking
is a complicated one and is a matter of taste in the widest sense of
the term, that vitamins may largely be produced in the preparation of
the food.

_Corn_ (maize) is a native of America and has been one of the most
extensively used cereals.

The chief products of corn are hominy, corn meal, cracked corn, samp,
glucose, corn-starch and laundry starch. Alcohol is also made from it.

Corn bread and corn-meal mush were important foods with the early
settlers, partly because they are nutritious and partly because the
corn meal was easily prepared at the mill and was cheap.

The germ of the corn is larger in proportion than the germs of other
grains, and it contains much fat; therefore it is heating. For this
reason, it is strange that corn bread is so largely used by inhabitants
of the southern states. It is a more appropriate food for winter in
cold climates.

Because of the fat in the germ, corn meal readily turns rancid, and,
on this account, the germ is separated and omitted from many corn-meal
preparations.

_Hulled corn_, sometimes called lye hominy, is one of the old-fashioned
ways of using corn. In its preparation, the skin is loosened by
steeping the corn in a weak solution of lye, which gives it a peculiar
flavor, pleasing to many.

_Corn-meal mush_ is a valuable breakfast food if eaten with milk. If
fried it should be covered with flour or dry corn meal and fried in
deep fat, so that it does not soak up the fat.

_Popcorn._ The bursting of the shell in popping corn is due to the
expansion of the moisture in the starch, occasioned by the heat.

_Green sweet corn_ does not contain the same proportion of starch as
corn meal, it being, in its tender state, mostly water. It is laxative,
because it is eaten with the coarse hull, which causes more rapid
peristalsis of the intestines. It should be well masticated to break
the covering of the husk; the digestive juices cannot penetrate the
hard covering.

       *       *       *       *       *

[Sidenote: Breakfast Foods]

The claims made for various advertised breakfast foods would be
amusing if they were not intended to mislead. Nearly all of them have
sufficient merit to sell them if the advertiser confines himself
strictly to the truth, but the ever pertinent desire to excel, which is
one great incentive to progress, leads to exaggeration. For example:
the claim is sometimes made that they contain more nutriment than the
same quantity of beef. Reference to Table V does not bear out such a
statement. They contain more starch but less protein.

It is also claimed by some advertisers that breakfast foods are brain
and nerve foods. The idea that certain foods are brain and nerve foods
is erroneous, except that any tissue-building food (protein) builds
nerve and brain tissue as it builds any other tissue, and the foods
which produce heat and energy for other tissues produce the same for
brain and nerve.

The grains commonly used for breakfast foods are corn, oats, rice, and
wheat. Barley, and wild rice, millet and buckwheat are used in some
sections, but not enough to warrant discussion here.

Barley is used chiefly for making malt and in the form of pearled
barley is used in soups.

Table VI, from one of the bulletins published by the United States
Department of Agriculture, is interesting from an economical standpoint.


TABLE VI

COMPARATIVE COST OF DIGESTIBLE NUTRIENTS AND AVAILABLE ENERGY IN
DIFFERENT CEREAL BREAKFAST FOODS

  ——————————————————————+—————+——————————+—————————+
                        |     |          |Cost of  |
                        |Price|Cost of   |1000     |
    FOOD MATERIALS      |per  |one pound |calories |
                        |pound|of protein|of energy|
                        |     |          |         |
  ——————————————————————+—————+——————————+—————————+
  Oat preparations:     |     |          |         |
    Oatmeal, raw        |  3  | 0.24     | 1.7     |
      ”                 |  4  | 0.32     | 2.3     |
    Rolled oats, steam  |     |          |         |
      cooked            |  6  | 0.48     | 3.4     |
                        |     |          |         |
  Wheat preparations:   |     |          |         |
    Flour, Graham       |  4  | 0.40     | 2.6     |
    Flour, entire-wheat |  5  | 0.46     | 3.1     |
    Flour, patent       |  3.5| 0.35     | 2.1     |
    Farina              | 10  | 1.12     | 6.2     |
    Flaked              | 15  | 1.69     |  9.3    |
    Shredded            | 12.5| 1.62     |  8.2    |
    Parched & ground    |  7.5| 0.88     |  4.9    |
    Malted, cooked and  |     |          |         |
      crushed           | 13  | 1.43     |  8.5    |
    Flaked and malted   | 11  | 1.21     |  7.2    |
                        |     |          |         |
  Barley preparations:  |     |          |         |
    Pearled barley      |  7  | 1.06     |  4.6    |
    Flaked, steam       |     |          |         |
      cooked            | 15  | 1.83     |  9.6    |
                        |     |          |         |
  Corn preparations:    |     |          |         |
    Corn meal, granular |  3  | 0.44     |  1.8    |
    Hominy              |  4  | 0.62     |  2.4    |
    Samp                |  5  | 0.78     |  3.0    |
    Flaked & parched    | 13  | 1.73     |  7.5    |
                        |     |          |         |
  Rice preparations:    |     |          |         |
    Rice, polished      |  8  | 1.48     |  4.7    |
    Flaked, steam       |     |          |         |
      cooked            | 15  | 2.31     |  9.8    |
                        |     |          |         |
  Miscellaneous foods   |     |          |         |
      for comparison:   |     |          |         |
    Bread, white        |  6  | 0.74     |  5.0    |
      ”                 |  5  | 0.62     |  4.2    |
    Crackers            | 10  | 1.10     |  5.3    |
    Macaroni            | 12.5| 1.08     |  7.5    |
    Beans, dried        |  5  | 0.28     |  3.5    |
    Peas, dried         |  5  | 0.26     |  3.4    |
    Milk                |  3  | 0.94     |  9.7    |
      ”                 |  3.5| 1.09     | 11.3    |
    Sugar               |  5  | ...      |  2.8    |
      ”                 |  6  | ...      |  3.4    |
  ——————————————————————+—————+——————————+—————————+

  ——————————————————————+————————————————————————————————————————
                        |       Amount for 10 cents
                        |—————————+———————+—————+————————+———————
    FOOD MATERIALS      |Total    |Protein|Fat  |Carbo-  | Energy
                        |weight of|       |     |hydrates|
                        |material |       |     |        |
  ——————————————————————+—————————+———————+—————+————————+———————
  Oat preparations:     |         |       |     |        |
    Oatmeal, raw        | 3.33    | 0.42  | 0.22|  2.18  | 5884
      ”                 | 2.50    | 0.31  | 0.16|  1.64  | 4418
    Rolled oats, steam  |         |       |     |        |
      cooked            | 1.67    | 0.21  | 0.11|  1.08  | 2938
                        |         |       |     |        |
  Wheat preparations:   |         |       |     |        |
    Flour, Graham       | 2.50    | 0.25  | 0.01|  1.61  | 3790
    Flour, entire-wheat | 2.00    | 0.22  | 0.03|  1.36  | 3188
    Flour, patent       | 2.86    | 0.29  | 0.03|  2.10  | 4700
    Farina              | 1.00    | 0.09  | 0.01|  0.73  | 1609
    Flaked              | 0.67    | 0.06  | 0.01| 0.46   | 1005
    Shredded            | 0.80    | 0.06  | 0.01| 0.57   | 1217
    Parched & ground    | 1.33    | 0.11  | 0.02| 0.94   | 2050
    Malted, cooked and  |         |       |     |        |
      crushed           | 0.77    | 0.07  | 0.01| 0.53   | 1175
    Flaked and malted   | 0.91    | 0.08  | 0.01| 0.62   | 1389
                        |         |       |     |        |
  Barley preparations:  |         |       |     |        |
    Pearled barley      | 1.43    | 0.09  | 0.01| 1.04   | 2165
    Flaked, steam       |         |       |     |        |
      cooked            | 0.67    | 0.05  | ... | 0.50   | 1051
                        |         |       |     |        |
  Corn preparations:    |         |       |     |        |
    Corn meal, granular | 3.33    | 0.23  | 0.06| 2.48   | 5534
    Hominy              | 2.50    | 0.16  | 0.01| 1.97   | 4178
    Samp                | 2.00    | 0.13  | 0.01| 1.57   | 3342
    Flaked & parched    | 0.77    | 0.06  | 0.01| 0.60   | 1335
                        |         |       |     |        |
  Rice preparations:    |         |       |     |        |
    Rice, polished      | 1.25    | 0.07  | ... | 0.94   | 1855
    Flaked, steam       |         |       |     |        |
      cooked            | 0.67    | 0.04  | ... | 0.51   | 1026
                        |         |       |     |        |
  Miscellaneous foods   |         |       |     |        |
      for comparison:   |         |       |     |        |
    Bread, white        | 1.67    | 0.14  | 0.02| 0.87   | 2009
      ”                 | 2.00    | 0.16  | 0.02| 1.04   | 2406
    Crackers            | 1.00    | 0.09  | 0.08| 0.71   | 1905
    Macaroni            | 0.80    | 0.09  | 0.01| 0.58   | 1328
    Beans, dried        | 2.00    | 0.35  | 0.03| 1.16   | 2868
    Peas, dried         | 2.00    | 0.38  | 0.02| 1.20   | 2974
    Milk                | 3.33    | 0.11  | 0.13| 0.17   | 1030
      ”                 | 2.86    | 0.09  | 0.11| 0.14   |  885
    Sugar               | 2.00    | ...   | ... | 2.00   | 3515
      ”                 | 1.67    | ...   | ... | 1.67   | 2940
  ——————————————————————+—————————+———————+—————+————————+———————


The less expensive breakfast foods, such as oatmeal and corn meal,
are as economical as flour, and, as they supply heat and energy in
abundance, as shown by Table VI, they should be supplied in the diet
in proportion to the energy required. They are easily prepared for
porridge, requiring simply to be boiled in water, with a little salt.

For invalids, children, and old people, breakfast foods prepared in
gruels and porridges are valuable as they are easily digested. All
should be thoroughly cooked so as to break the cell-walls inclosing the
starch granules.

_Oatmeal_ is the most nutritious cereal. The oat contains more fat
than other grains and a larger proportion of protein. It, therefore,
contains the proportion of nutrient elements best adapted to sustain
life.

On account of the fat, oats are especially well adapted for a breakfast
food in winter. Another advantage oatmeal, or rolled oats, have as a
breakfast food is in their laxative tendency, due to the coarse shell
of the kernel.

Oat breakfast foods keep longer than the foods made from wheat and rice.

There are no malts, or any mixtures in the oat preparations.

The difference between the various oatmeal breakfast foods is in their
manner of preparation. They all contain the entire grain, with the
exception of the husk. They are simply the ground or crushed oat. In
preparing the oats before grinding, the outer hull is removed, the
fuzzy coating of the berry itself is scoured off, the ends of the
berry, particularly the end containing the germ, which is usually the
place of deposit for insect eggs, is scoured, and the bitter tip end of
the oat berry is likewise removed.

_Rolled oats_ consist of the whole berry of the oat, ground into
a coarse meal, either between millstones, or, in the case of the
so-called “steel cut” oatmeal, cut with sharp steel knives across the
sections of the whole oat groat.

_Quaker Oats_ consist of the whole groats, which, after steaming in
order to soften, have been passed between hot steel rolls, somewhat
like a mangle in a laundry, and crushed into large, thin, partially
cooked flakes. The oats are then further cooked by an open pan-drying
process. This roasting process insures that all germ life is
exterminated, renders the product capable of quicker preparation for
the table, and causes the oil cells to release their contents, thereby
producing what is termed the “nut flavor,” which is not present in the
old-fashioned type of oat product.

Both Rolled Oats and Quaker Oats are now partially cooked in their
preparation, but the starch cells must be thoroughly broken and they
should be cooked at least forty-five minutes in a double boiler; or, a
good way to prepare the porridge is to bring it to the boiling point at
night, let it stand covered over night and then cook it from twenty to
thirty minutes in the morning. Another method of cooking is to bring
the porridge to the boiling point and then place it in a fireless
cooker over night.

The great fault in the preparation of any breakfast food is in not
cooking it sufficiently to break the starch cells.

_Puffed Rice_ is made from a good quality of finished rice. The process
is a peculiar one, the outer covering or bran, is removed and then
the product is literally “shot from guns”; that is, a quantity of
the rice is placed in metal retorts, revolved slowly in an oven, at
high temperature, until the pressure of steam, as shown by a gauge on
the gun, indicates that the steam, generated slowly by the moisture
within the grain itself, has thoroughly softened the starch cells. The
gun retort is pointed into a wire cage and the cap which closes one
end is removed, permitting an inrush of cold air. This cold air, on
striking the hot steam, causes expansion, which amounts practically to
an explosion. The expansion of steam within each starch cell completely
shatters the cell, causing the grain to expand to eight times its
original size. It rushes out of the gun and into the cage with great
force, after which it is screened to remove all scorched or imperfectly
puffed grains.

This process dextrinizes a portion of the starch and also very
materially increases the amount of soluble material as against the
original proportion in the grain.

_Puffed Wheat_ is manufactured from Durum, or macaroni wheat, of the
very highest grade. This is a very hard, glutinous grain. It is pearled
in order to thoroughly clean and take off the outer covering of bran.
It then goes through a puffing process, identical with that of Puffed
Rice. The chemical changes are very similar to those of puffed rice.

Both Puffed Rice and Puffed Wheat are more digestible than in the
original grain state. They are valuable foods for invalids.

_Stale Bread._ A food which tastes much like a prepared breakfast food,
but is cheaper, may be made by dipping stale bread into molasses and
water, drying it in the oven for several hours, and then crushing it.
It is then ready to serve with cream. This is a palatable way to use up
stale bread.

_Crackers and Milk or Bread and Milk._ As noted by Table VI, crackers
are similar to breakfast food in nutrient elements, and with milk make
a good food for breakfast, or a good luncheon. Business men, and
others who eat hurriedly and return immediately to work, will do well
to substitute crackers and milk, or bread and milk, for the piece of
pie which often constitutes a busy man’s lunch.

_Cracked Wheat._ In America wheat is seldom used whole. In England the
whole grain, with the bran left on, is slightly crushed and served as
cracked wheat or wheat grits.

Wheat is also rolled, or flaked, or shredded. The majority of wheat
breakfast foods contain a part of the middlings and many of them bran.
Farina and gluten preparations do not contain these, however.

The preparations of the various breakfast foods are a secret of the
manufacturers. The ready-to-eat brands are cooked, then they are either
rolled or shredded, the shredding requiring special machinery to
tear the steamed kernels; later they are dried, and, finally packed,
sometimes in small biscuits. Many preparations are baked after being
steamed, which turns them darker and makes them more crisp. Some
preparations are steamed, then run through rollers, while still wet,
and pressed into flakes or crackers.

_Predigested Foods._ It is claimed that some foods are “partly digested
and thus valuable for those with weak stomachs,” but breakfast foods
are largely starch and the starch is not digested by the gastric juice.
It is digested by saliva and the ferments in the small intestine. These
change the starch into dextrin and maltose.

Experiments with “predigested” foods do not show a larger proportion
of dextrin (digested starch), however, than would naturally be
produced by the heating of the starch when these foods are cooked at
home. The natural cooking makes starch more or less soluble, or at
least gelatinized. As a result of these experiments therefore, the
“predigested” argument is not of much weight.

Predigested foods, except in cases in which the patient is so weak as
to be under the direction of a physician, are not desirable. Nature
requires every organ to do the work intended for it, in order to keep
up its strength, just as she requires exercise for the arms or legs
to keep them strong. If an organ is weak, the _cause_ must be found
and corrected—perhaps the stomach or intestines need more blood,
which should be supplied through exercise; or perhaps the nerves need
relaxation; or the stomach less food; or food at more regular intervals.

Another argument against predigested foods lies in the fact that the
chewing of coarse food is necessary to keep the teeth strong. For this
strengthening of the teeth, children should be given dry crackers or
dry toast each day.

Dogs and wild animals which chew bones and hard substances do not have
pyorrhea, but lap-dogs and animals in the zoos, fed on bread and meat
without bones, suffer from this disease.

In the so-called “predigested” or “malted” preparations, malt is added
while they are being cooked.

_Malt_ is a ferment made from some grain, usually from barley, the
grain being allowed to germinate until the ferment diastase is
developed.

There is no doubt that a number of foods containing malt are valuable
to assist in converting starch into dextrin or sugar, just as pepsin is
an aid in the digestion of protein; but eaten indiscriminately, there
can be no question that it is more important for the teeth, stomach,
and intestines to perform their natural work and thus keep their
strength through normal exercise.

While they are not “predigested,” as claimed, these foods are, as a
rule, wholesome and nutritious. They are cleanly, and made from good,
sound grain, and they contain no harmful ingredients. Some contain
“middlings,” molasses, glucose, and similar materials, but these are in
no way injurious and have value as foods.

The dry, crisp, ready-to-eat foods are especially advantageous because
of the mastication they require. This insures plenty of saliva being
mixed with them to aid in digestion. A dish of such dry breakfast food,
well masticated, together with an egg, to furnish a larger proportion
of protein, makes a wholesome breakfast.

       *       *       *       *       *

[Sidenote: Cereal Coffees]

According to investigations made by the United States Agriculture
Experiment Station, cereal coffees are made of parched grains. A few
contain a little true coffee, but for the most part they are made of
parched wheat, barley, etc., or of grain mixed with wheat middlings,
pea hulls, or corn cobs. There is no objection to any of these mixtures
providing they are clean. The cereal coffees, as seen by Table VII,
contain no more nourishment than the true coffee, but they are probably
more easily digested; only a very little of the soluble starch passes
into the water unless the kernel is ground. Coffee and tea are not
taken for their nutrition, but for their stimulating effect on the
nerves; and, if stimulation is desired, the cereal coffees fall short.


TABLE VII

COMPOSITION OF CEREAL-COFFEE INFUSION AND OTHER BEVERAGES

  ———————————————————————————————+—————+———————+————+————————+—————————
                                 |Water|Protein|Fat |Carbo-  |Fuel
    KIND OF BEVERAGE             |     |       |    |hydrates|Value per
                                 |     |       |    |        |pound
  ———————————————————————————————+—————+———————+————+————————+—————————
  Commercial cereal coffee (0.5  |     |       |    |        |
    ounce to 1 pint water)       | 98.2| 0.2   | ...| 1.4    |  30
                                 |     |       |    |        |
  Parched corn coffee (1.6       |     |       |    |        |
    ounces to 1 pint water)      | 99.5| 0.2   | ...| 0.5    |  13
                                 |     |       |    |        |
  Oatmeal water (1 ounce to 1    |     |       |    |        |
    pint water)                  | 99.7| 0.3   | ...| 0.3    |  11
                                 |     |       |    |        |
  Coffee (1 ounce to 1 pint      |     |       |    |        |
    water)                       | 98.9| 0.2   | ...| 0.7    |  16
                                 |     |       |    |        |
  Tea (0.5 ounce to 1 pint water)| 99.5| 0.2   | ...| 0.6    |  15
                                 |     |       |    |        |
  Chocolate (0.5 ounce to 1 pint |     |       |    |        |
    milk)                        | 84.5| 3.8   | 4.7| 6.0    | 365
                                 |     |       |    |        |
  Cocoa (0.5 ounce to 1 pint     |     |       |    |        |
    water)                       | 97.1| 0.6   | 0.9| 1.1    |  65
                                 |     |       |    |        |
  Skimmed milk                   | 88.8| 4.0   | 1.8| 5.4    | 170
  ———————————————————————————————+—————+———————+————+————————+—————————

By reference to Table VII it will be seen that cocoa and skimmed milk
contain much more nutrition than any of the coffees. The chief value of
cereal coffees is that they furnish a _warm_ drink with the meal. They
should not be too hot.

Barley or wheat, mixed with a little molasses, parched in the oven, and
then ground, makes a mixture similar to the cereal coffee.

The old-fashioned crust coffee is just as nutritious as any of the
coffees and has the advantage of being cheaper.

Barley water and oat water, made by boiling the ground kernel
thoroughly and then straining, are nourishing foods for invalids
and children. They are often used as drinks by athletes and manual
laborers, as they have the advantage of both quenching thirst and
supplying energy.

Gruels are made in the same way, only strained through a sieve. This
process allows more of the starch to pass with the water.

       *       *       *       *       *

[Sidenote: Legumes]

The legumes are the seeds of peas, beans, lentils, and peanuts.


TABLE VIII

LEGUMES

  ——————————————————————+—————+———————+—————+—————————+—————+——————————
  FOOD MATERIALS        |Water|Protein|Fat  |Carbo-   |Ash  |Fuel Value
                        |per  |per    |per  |hydrates |per  |per pound
                        |cent.|cent.  |cent.|per cent.|cent.|Calories
  ——————————————————————+—————+———————+—————+—————————+—————+——————————
  Dried Legumes:        |     |       |     |         |     |
    Navy beans          | 12.6| 22.5  |  1.8| 59.6    | 3.5 | 1605
    Dried peas          |  9.5| 24.6  |  1.0| 62.0    | 2.9 | 1655
    Lentils             |  8.4| 25.7  |  1.0| 59.2    | 5.7 | 1620
    Lima beans          | 10.4| 18.1  |  1.5| 65.9    | 4.1 | 1625
    Peanuts             |  9.2| 25.8  | 38.6| 24.4    | 2.0 | 2560
    Peanut butter       |  2.1| 29.3  | 46.5| 17.1    | 5.0 | 2825
                        |     |       |     |         |     |
  Fresh Legumes:        |     |       |     |         |     |
    Canned peas         | 85.3|  3.6  |  0.2|  9.8    | 1.1 |  255
    Canned lima beans   | 79.5|  4.0  |  0.3| 14.6    | 1.6 |  360
    Canned string beans | 93.7|  1.1  |  0.1|  3.8    | 1.3 |   95
    Canned baked beans  | 68.9|  6.9  |  2.5| 19.6    | 2.1 |  600
    String beans        | 89.2|  2.3  |  0.3|  7.4    | 0.8 |  195
    Shelled peas        | 74.6|  7.0  |  0.5| 16.9    | 1.0 |  465
  ——————————————————————+—————+———————+—————+—————————+—————+——————————

Like the cereals, they are seeds, yet they contain a very much larger
proportion of protein and may be substituted for meat or eggs in a
diet. In all vegetarian diets, under normal conditions, the legumes
should be used freely to replace meats.

All legumes must be thoroughly cooked and thoroughly masticated.
Because the protein in these foods is less digestible than that in
meat or eggs, particularly if they are not thoroughly masticated,
they are better adapted for the use of those who do manual labor.
Soldiers in battle, day laborers, and others whose work calls for hard
physical exercise, can digest legumes more easily than can those whose
occupation is more sedentary.

If not thoroughly masticated legumes usually produce intestinal
fermentation with consequent production of gas. For this reason they
occasion distress in those who partake of them too freely and with
insufficient preparation by cooking.

The protein of the legumes is of the same nature as the casein of milk.
It has been called vegetable casein.

_Peanuts._ While an underground vegetable, grown like potatoes, peanuts
resemble nuts, inasmuch as they contain so much fat. The extracted oil
is used in several commercial products.

Like other legumes, they require cooking. They are roasted because this
develops the flavor.

Because they contain a more balanced proportion of proteins,
carbohydrates, and fats, they will sustain life for some time without
other food, as they provide rebuilding material, energy, and heat. Used
alone, however, there is no counteracting acid, and it is better to add
some fruit, such as apples, or apples and dates. For this reason lemon
juice is mixed with peanut butter.

In eating peanuts it is imperative that they be masticated _until they
are a pulp_, otherwise they are very difficult of digestion. The pain
which many people experience after eating peanuts is probably due to
eating too large a quantity and not fully masticating them, forgetting
that they are a very rich, highly concentrated food.

The habit of eating peanuts between meals and then eating a hearty meal
is likely to overload the digestive organs.

Both peanuts and peanut butter contain over twenty-five per cent. of
protein and about thirty-nine per cent. of fat; therefore they yield
much heat and energy.

Peanuts have been made into a flour; they are also to be had in the
form of grits which are cooked like oatmeal. When nuts or peanuts are
used as an after-dinner relish the quantity of meat should be cut down.

Their popularity is evidenced by the fact that between 4,000,000 and
5,000,000 bushels are raised annually in America.

_Peanut Butter._ While peanut butter contains 46.5 per cent. fat, it
contains only seventeen per cent. carbohydrates. Since sugars and
starches are protections to fat, being used for energy before the
fats are consumed, if these sugars and starches are not supplied in
other food, the fats in the peanut butter are consumed for energy. If
starches _are_ consumed in other foods, it is clear that one who wishes
to reduce in flesh should avoid peanut butter, as well as other fats.

Peanut butter is more easily digested than the roasted peanut, unless
the latter is chewed to a pulp. It can be made at home by grinding the
peanuts in a meat grinder, and then further mashing with a rolling pin
or a wooden potato masher. A little lemon juice mixed with the peanut
butter makes it not only more palatable, but more easily digested. A
peanut butter sandwich is quite as nourishing as a meat sandwich.

_Shelled Peas._ Shelled peas were used in Europe as far back as in the
Middle Ages, and there, to-day, the dried or “split” pea is used quite
as extensively as the dried bean. In America, peas are used almost
entirely in the green stage, fresh, or canned.

As seen by Table VIII, the green, shelled pea contains seven per cent.
of protein and sixteen per cent. of sugar and starch, while the dry
or “split” pea contains over 24.5 per cent. of protein and sixty-two
per cent. of sugar and starch, the difference being in the amount of
water contained in the shelled peas. Canned peas contain even a larger
percentage of water.

A variety of the pea is now being cultivated, in which, like the string
bean, the pod is used as a food. They are sweet and delicious.

Dried peas are used in this country mostly in purées.

_Beans._ Baked navy beans may well be substituted on a menu for meat,
containing, as they do, 22.5 per cent. of protein. It is needless to
state that beans and lean meat or eggs should not be served at the
same meal. Beans have the advantage of being cheaper than meat, yet,
as stated above, the protein in the legumes is less easily digested
than the protein of meat or eggs. They must be thoroughly cooked and
thoroughly masticated.

There is but a small percentage of fat in dried beans; for this reason
they are usually baked with a piece of pork. They make a very complete,
perhaps the most complete food, containing nutrient elements in about
the proper proportions.

A bean biscuit is used for the sustenance of soldiers on a march; it
gives a complete food in condensed form.

In baking dried beans or peas, soft or distilled water should be
used, as the lime of hard water makes the shell almost indigestible.
Parboiling the beans for fifteen minutes in two quarts of water with
a quarter of a teaspoon of baking soda softens the shell, making them
easier to digest.

_String Beans._ The string bean contains very little nutrition, as
shown by Table VIII. The pod and the bean, at this unripe stage,
contain nearly ninety per cent. water. Their chief value as a food
consists in their appetizing quality to those who are fond of them,
thus stimulating the flow of gastric juice.

Like all green vegetables they stimulate the action of the kidneys. All
green vegetables are particularly valuable to those who drink little
water.

The dried _Lima_ bean, used during the winter, may be boiled or baked.
If old, they are practically indigestible.

_Kidney Beans_ contain much water but are more nutritious than the
string bean.

_Soy Bean._ In China and Japan this bean is used extensively. Being
rich in protein, used with rice it makes a well-balanced diet.

The soy bean is made into various preparations, one of the most
important being _shoyo_, which has been introduced into other
countries. To make it, the soy bean is cooked and mixed with roasted
wheat flour and salt; into this is put a special ferment. It is then
allowed to stand for an extended time in casks. The result is a thick,
brown liquid with a pungent, agreeable taste. It is very nourishing.

A kind of cheese is also made by boiling the soy bean for several
hours, wrapping the hot mass in bundles of straw, and putting it in a
tightly closed cellar for twenty-four hours.

_Lentils_ are not commonly used in this country, but they were one of
the earliest vegetables to be cultivated in Asia and the Mediterranean
countries. They are usually imported and may be obtained in the
markets. They are used like dried peas and are fully as nourishing, but
the flavor of the lentil is pronounced and they are not so agreeable to
the average person as peas or beans.

       *       *       *       *       *

[Sidenote: Nuts]

Nuts are classed with the carbo-nitrogenous foods, because of the more
nearly equal proportion of proteins and carbonaceous substances.


TABLE IX

NUTS

  ——————————————————+—————+———————+—————+—————————+——————+——————————
    FOOD MATERIALS  |Water|Protein|Fat  |Carbohy- | Ash  |Fuel Value
                    |per  |per    |per  | drates  | per  |per pound
                    |cent.|cent.  |cent.|per cent.| cent.| Calories.
  ——————————————————+—————+———————+—————+—————————+——————+——————————
  Almonds           | 4.8 | 21.0  |54.90|   17.3  |  2.0 |   3030
  Brazil nuts       | 5.3 | 17.0  |66.80|    7.0  |  3.9 |   3329
  Filberts          | 3.7 | 15.6  |65.30|   13.0  |  2.4 |   3342
  Hickory nuts      | 3.7 | 15.4  |67.40|   11.4  |  2.1 |   3495
  Pecans            | 3.0 | 16.7  |71.20|   13.3  |  1.5 |   3633
  English walnuts   | 2.8 | 16.7  |64.40|   14.8  |  1.3 |   3305
  Chestnuts, fresh  |45.0 |  6.2  | 5.40|   42.1  |  1.3 |   1125
  Walnuts, black    | 2.5 | 27.6  |56.30|   11.7  |  1.9 |   3105
  Cocoanut, shredded| 3.5 |  6.3  |57.30|   31.6  |  1.3 |   3125
  Peanuts, roasted  | 1.6 | 30.5  |49.20|   16.2  |  2.5 |   3177
  ——————————————————+—————+———————+—————+—————————+——————+——————————

It will be noted, by reference to Table IX that nuts contain a much
larger proportion of fats and less starch than the legumes. Chestnuts
contain the largest amount of starch, and pecans the most fat.

Peanuts are classed here with nuts because of their similar use in the
diet. Their comparative richness in protein will be noted.

Nuts are a valuable food, but they should be made a part of a meal and
may well take the place of meat rather than eaten as a dessert, because
of the large percentage of protein. They are too rich to be eaten as a
relish at the end of a meal, if one has eaten as much other food as the
system requires.

In planning a meal, if the dietary is rich in starches and lacking in
protein, a side dish of nuts may be served.

Too great stress cannot be laid on the importance of the thorough
mastication of nuts; otherwise they are difficult of digestion. When
thoroughly chewed, however, they are as easily digested as cereals or
legumes. If ground fine in a meat grinder or rubbed through a sieve,
they digest more readily, but this grinding does not take the place
of the grinding with the teeth and the mixture with the saliva. They
are best chopped for salads, cake, or croquettes. When ground the oil
extracted makes them pasty and not appetizing in appearance for use in
salads or cake.

       *       *       *       *       *

[Sidenote: Milk]

Milk is a perfect food for the infant because it contains the elements
in proper proportions to sustain life and growth, though, alone, it
is insufficient for the nourishment of healthy adults. The adult, in
order to get sufficient nutriment, would be compelled to take a larger
proportion of water than necessary, the proportion of water required
by the system being about sixty-seven per cent., while milk contains
eighty-seven per cent.

In many diseases, however, a whole or partial milk diet is desirable,
especially in any inflammatory condition of the gastro-intestinal tract.


TABLE X

MILK AND MILK PRODUCTS

  ———————————————+———————+—————————+——————+———————+———————+————————————
  FOOD MATERIALS | Water | Protein | Fats | Sugar | Salts | Lactic Acid
  ———————————————+———————+—————————+——————+———————+———————+————————————
  Milk           | 86.8  |  4.0    |  3.7 | 4.8   | 0.7   | ....
  Skimmed milk   | 88.0  |  4.0    |  1.8 | 5.4   | 0.8   | ....
  Buttermilk     | 90.6  |  3.8    |  1.2 | 3.3   | 0.6   | 0.3
  Cream          | 66.0  |  2.7    | 26.7 | 2.8   | 1.8   | ....
  Cheese         | 36.8  | 33.5    | 24.3 | ....  | 5.4   | ....
  Butter         |  6.0  |  0.3    | 91.0 | ....  | 2.7   | ....
  ———————————————+———————+—————————+——————+———————+———————+————————————

The milk of the cow is not perfectly adapted for the young child—it is
lacking in the proper proportion of sugar, and when fed to the infant
it must be modified. Mother’s milk is not only richer in sugar than
cow’s milk, but it contains about half as much casein. The calf needs
more albumin than the baby does because it grows faster. Human milk is
also richer in fat.

An all-milk diet may be followed when it is desirable to gain in
weight. Such a diet should be accompanied by exercises for the vital
organs and by deep breathing, but experiments have shown that healthy
digestive organs do their work better when a part of the food is solid.

A milk and cream diet of about three quarts milk and one quart cream
with the addition of one to two eggs a day will keep up the strength of
one in bed, but is not sufficient for one who is active.

In order for an adult to obtain the proper quantity of carbohydrates
and fat, from an all-milk diet, it is necessary for him to drink from
four to five quarts of milk a day (sixteen to twenty glasses). It is
usually said that on an all-milk diet an active person requires as many
quarts as he is feet tall.

Young babies on mother’s milk are almost always fat, because of the
larger proportion of sugar and fat in the mother’s milk.

Reference to Table X shows that the thirteen per cent. of solids are
about equally divided between fat, sugar, and protein. The sugar is
lactose. It supplies heat to the infant before it can exercise its
muscles vigorously. The protein is casein.

There is no starch in milk. The digestive ferment, which acts on
starch, has not developed in the young babe and it cannot digest starch.

The salts promote the growth of bone.

The fat in milk is in small emulsified droplets within a thin
albuminous sheath. When allowed to stand in a cool place it rises to
the top.

Besides casein, milk contains a certain amount of albumin—about
one-seventh of the total amount—called lactalbumin. It maintains the
fat in milk in emulsified form.

In young babes the milk is curdled in the stomach, or the casein
separated from the water and sugar, not by hydrochloric acid, but by
a ferment in the gastric juice, known as rennin. Rennin, or rennet,
from the stomachs of calves, is used in cheese and butter factories to
coagulate the casein. This with other chemicals so hardens the casein
that it is used in the manufacture of buttons.

_Preserving milk._ If milk could be kept free from bacteria, it would
keep sweet almost indefinitely. At the Paris Exposition, milk from
several American dairies was kept sweet for two weeks, without any
preservative except cleanliness and a temperature of about forty
degrees. The United States Bureau of Animal Industry states that milk
may be kept sweet for seven weeks without the use of chemicals.

The importance of absolute cleanliness in the preparation and marketing
of this important article of food is being recognized both by the
producer and the consumer, and careful inspection has done away with
many abuses. In the absence of an efficient health department, the
consumer should ascertain in every case how the milk he uses is handled
at every stage before it reaches him. Care in this regard may safeguard
his family from disease and save him many dollars.

The best method for the housewife to follow is to keep the milk clean,
cool, and away from other foods, as milk will absorb a bad odor or
flavor from any stale food or odorous vegetables, from fresh paint, or
other substances.

Milk must never be left exposed in a sick room or in a refrigerator
unless the waste pipe and the ice chamber are kept scrupulously clean.

_Milk Tests._ In testing the value of milk, or the value of a cow,
butter makers and farmers gauge it by the amount of butter fat in the
milk, while the cheese maker tests the milk for the proportion of
protein (casein). The amount of butter fat depends on the feed and
water, and on the breed. If the total nutrient elements fall below
twelve per cent., it is safe to assume that the milk has been watered.

In cheese and butter there is no sugar; it remains in the buttermilk
and the whey, both of which the farmer takes home from the factories to
fatten his hogs.

_Pasteurized Milk._ In pasteurizing milk the aim is to destroy as many
of the bacteria as possible without causing any chemical changes or
without changing the flavor. One can pasteurize milk at home by placing
it in an air-tight bottle, immersing the bottle to the neck in hot
water, heating the water to 167 F. for twenty minutes, and then quickly
cooling the milk to 50 F. by immersing the bottle in cold water. The
rapid cooling lessens the cooked taste. The best dairies pasteurize the
milk before it is marketed.

_Sterilized Milk._ Milk is sterilized to destroy all bacteria, by
heating it to 212 F. Sterilized milk remains sweet longer than
pasteurized milk, but more chemical changes are produced and the flavor
is changed, resembling that of boiled milk.

Formerly borax, boric acid, salicylic acid, formalin, and saltpeter
were used to keep the milk sweet, but this adulteration is now
forbidden by the pure-food laws.

_Malted milk_ is a dry, soluble food product in powder form, derived
from malted barley, wheat flour (dextrin), and cow’s milk, containing
the full amount of cream.

The process of the extraction from the cereals is conducted at
elevated temperatures so as to allow the active agents (enzymes) of
the barley malt to effect the conversion of the vegetable protein and
starches. The filtered extract, containing the derivatives of the malt,
wheat, and the full-cream cow’s milk, is then evaporated to dryness
_in vacuo_, the temperature being controlled so as to obviate any
alteration of the natural constituents of the ingredients and so as to
preserve their full physiological values. The strictest precautions are
observed to insure the purity of the product. It contains:

  Fats                             8.75
  Proteins                        16.35
  Dextrin                         18.80
  Lactose and Maltose             49.15
    (Total Soluble Carbohydrates) 67.95
  Inorganic Salts                  3.86
  Moisture                         3.06

Malted milk is free from germs. The starches and sugars are converted
in the process of manufacture into maltose, dextrin, and lactose. The
fats are in an absorbable condition, and it contains a high percentage
of proteins derived from both the milk and the grains, as well as a
marked percentage of mineral salts. It is readily soluble in water and
is easily digested.

The hydrochloric acid of the stomach coagulates or curds milk much as
it is curded by many fruit and vegetable acids, such as those in lemons
or tomatoes. Thus the milk forms into curds immediately on entering
the stomach, the casein being at once precipitated by the rennin. This
is the chief reason why it should be drunk slowly, otherwise too large
curds will form, causing distress from pressure.

       *       *       *       *       *

[Sidenote: Digestion of Milk]

A part of the digestion of the casein is performed by pepsin in the
stomach and a part by the trypsin of the pancreatic juice.

The larger part of the digestion of the milk sugar or lactose, is
performed by the pancreatic juice; although it is partly acted on by
the saliva. Usually, however, the saliva is given little chance to
become mixed with the milk, unless it is taken slowly and mixed with
saliva by chewing movements. This is one reason why children should be
given milk in which bread has been broken, rather than a piece of bread
and a glass of milk. By swallowing the milk slowly, smaller curds are
formed in the stomach and the milk is more thoroughly digested.

The salts of milk, to a large extent, the water, and perhaps a portion
of the sugar are absorbed in the stomach.

When the fat (cream) is removed milk digests more readily, so that in
cases in which the stomach is delicate, _skimmed milk, clabbered milk,
or buttermilk_ are often prescribed instead of sweet milk.

Boiled milk is also more readily digested by some; the lactalbumin is
separated and rises to the top in a crinkly scum. The casein of boiled
milk is also more readily digested, forming in small flakes in the
stomach instead of in curds.

Sterilizing the milk by boiling will prevent the action of bacteria in
producing fermentation and disordered digestion, and, if relished, milk
can thus be treated. Pasteurized milk is more palatable than boiled
milk.

Milk is often better assimilated if other food is not too suddenly cut
off. When the diet is radically changed the digestive system is apt
to show derangement. Therefore when for any cause an all-milk diet is
desired, it is unwise to begin it at once, by feeding from eighteen to
twenty glasses of milk a day. This amount may be approximated within
a week’s time. The change in diet should be begun by cutting down all
meats and legumes and gradually eliminating starches. In changing
from a milk diet to a diet including more hearty foods, the transition
should also be gradual.

If a milk diet is to be followed and the milk seems to disturb the
stomach when taken in quantities, one may begin by taking it in very
small quantities every fifteen minutes for the first hour. If one’s
purpose is to gain in flesh the quantity may be increased to a glass,
and time intervals be lengthened to every hour as the stomach becomes
accustomed to caring for the milk. It should be sipped slowly and
thoroughly mixed with saliva before being swallowed. The mouth should
be carefully rinsed with equal parts of peroxide of hydrogen and water,
or listerine and hot sterile water, each time milk is taken.

Milk, in whatever form it is taken, leaves a coating on the tongue and
teeth. The heat of the mouth, especially if the patient is feverish,
quickly causes changes which give a disagreeable taste and a chance
for bacterial action. These bacterial products are carried into the
stomach and excite digestive changes through which fermentation and gas
formation appear and biliousness may result. This may be avoided if,
after taking the milk, the mouth is carefully washed and, in feverish
conditions, the tongue gently scraped or swabbed with absorbent cotton
dipped in listerine or peroxide of hydrogen. Without such cleansing of
the mouth milk may disagree.

When from two to three glasses of milk at a meal are taken, less solid
food is needed, because the required nutriment is partially supplied
by the milk. One reason why milk seems to disagree with many people,
is because they lose sight of the fact that milk is an actual food,
as well as a beverage, and they eat the usual quantity of food in
addition to the milk. As one pint, or two glasses of milk, contains
approximately the same amount of nutrition as one-third of a pound
of beef, the amount of food to be taken in addition may be readily
calculated.

The chief reason for the lessened activity of the bowels on a milk diet
is because the nourishment in milk is practically all absorbed—there
is very little residue and milk gives little rough surface to excite
peristaltic action and stimulate the walls of the intestine to activity.

The calcium, one of the constituents of milk, tends to lessen the
peristaltic action of the intestines and this is one of the causes of
constipation. Fruit and coarse bread containing much bran, should be
used with a milk diet.

Constipation may also be occasioned by drinking milk rapidly. When
the hydrochloric acid is very active coagulation may take place so
quickly as to cause hard tough curds to form; these enter the intestine
undissolved because the gastric juice can act only on the exterior
portion; the stomach retains the curds in its effort to dissolve them
and fermentation may occur, with irritation and constipation from
irregular action. In this case the constipating effect may be overcome
by taking the milk in small sips or by the addition of one part of
limewater to six parts milk. The limewater causes the curds to be
precipitated in small flakes.

Limewater may be prepared by putting a heaping teaspoon of unslaked
lime with a quart of boiled or distilled water into a corked bottle or
Mason jar. Shake thoroughly two or three times during the first hour;
then allow the lime to settle, and after twenty-four hours pour or
siphon off the clear fluid. Be careful not to allow the lime to be
poured off with the water.

Barley water or oatmeal water added to milk also prevents the formation
of large curds.

Milk may also be taken with any variety of gruel—oatmeal, sago,
arrowroot, or tapioca.

If there is much mucus in the stomach, mucous fermentation may occur in
milk because of the lack of hydrochloric acid. The partially digested
curds are tough, stringy, and slimy and the intestinal walls find no
resistance in the mass. In this case constipation may be followed by
diarrhea.

If the stomach is deficient in hydrochloric acid the juice of half an
orange or a little lemon juice may be taken a half hour before the
glass of milk.

Constipation and, later, diarrhea may also result when stomach
digestion is weak, the curds passing through the stomach and intestines
undissolved.

When there is any tendency to torpidity of the liver, daily exercise
should be directed to the liver, stomach, and intestines or milk
may cause biliousness, because the excess of fat and protein taken
overstimulates the liver, causing an excess of bile. The bile may enter
the stomach and cause nausea and vomiting. Constipation results from
the disordered digestion. This will not often occur if one exercises
daily and cuts down the quantity of solid food as the amount of liquid
is increased.

A glass of hot Vichy or Hunyadi water taken the first thing on rising,
and followed by a glass of cool water will help to relieve any
engorgement of the liver.

In case of biliousness resulting from a milk diet, abstain from all
food for twenty-four hours, cleanse the mouth as indicated above, and
drink freely of water.

When the liver is a little inactive, milk may be diluted with an
aërated water or even plain water. Daily exercise directed toward
securing a greater activity of the liver and gall-bladder should
be followed. Four tablespoonfuls of soda water, Apollinaris, or
carbonic-acid water to the glass may be used.

As noted in the preceding pages, orange and lemon juice will encourage
greater activity of the stomach and bowels.

One-third of a glass of hot Vichy water to each glass of milk renders
it easily digested and most people relish it. Unless the liver is
very inactive milk taken in this way will not constipate and exercise
directed to the liver, as previously mentioned, will help to obviate
this condition.

Skimmed milk, Kumyss, or buttermilk are easily digested and are
valuable when the digestive system is weak.

The monotony of a milk diet tends to create a distaste for milk and
the mental revolt may upset digestion and result in constipation. This
should be kept in mind and various ways of modifying the milk be used
to create variety; mental aversion and antagonism should be corrected.

When its taste is not relished milk may be made acceptable and the
stomach induced to retain it by using a variety of flavors. A drop
or two of vanilla, a trifle of cinnamon, nutmeg, salt and pepper,
chocolate, or any other flavor that is liked may be used, varying them
so as to keep from monotony.

If milk seems to produce gas in the stomach with distress and the
milk is retained too long in the stomach from the interference with
its movements caused by the gas, a teaspoonful of malt extract may be
added to each glass of milk. If the malt extract is not at hand, four
teaspoonfuls of malted milk to each glass may be used.

Equal parts of cream and hot water to which has been added a third of a
teaspoon of soda may be used, for the same purpose.

If milk disagrees because of an excess of hydrochloric acid and the
formation of hard curds, a saltspoon of salt or bicarbonate of soda may
be used, or one part of limewater to six parts of milk.

When milk seems to disagree because digestion is somewhat slow and
the milk does not offer enough bulk to excite peristaltic action, it
remains too long in the stomach and fermentation occurs. A slice of
bread, a couple of crackers, a piece of zweiback, a tablespoonful of
Nestle’s or Mellin’s food or of arrowroot gruel added to each glass, or
eaten with the milk, will give it more body and prevent the formation
of large curds.

When the stomach is excessively weak because of a lack of the digestive
juices and a consequent incomplete action of the stomach, only
predigested milk should be taken until the stomach has been brought
to a normal tone. Pepsin or pancreatin may be used for the partial
digestion. Milk so predigested must be freshly prepared each time
it is used or must be kept on ice until used. The stomach will find
practically no difficulty in assimilating milk thus prepared, and
constipation will be avoided.

_It must be remembered that milk must be sipped slowly and be well
mixed with saliva before it is swallowed._

Milk can be soured and taken separated as a variation, the curds and
whey being relished by many when properly prepared. A little sugar and
cinnamon or nutmeg sprinkled on curds or mixed with the whey make a
palatable mixture. Buttermilk or kumyss offer still other variations.

With all these means of varying the taste, appearance, or condition of
milk it is hardly possible that some way cannot be found whereby milk
may be taken and be well borne by the stomach and the full benefits
from its use be derived.

       *       *       *       *       *

[Sidenote: Cheese]

This is the casein (protein) which has been separated from milk by the
action of rennet. It is highly nutritious and many varieties are on the
market. In Europe it is largely used to take the place of meat. Cheese
contains almost as much again protein as is contained in the same
quantity of meat.

In this country more highly flavored cheeses are in demand, and when
eaten in moderate quantities they aid digestion. They are highly
concentrated food and but a small quantity should be eaten at a meal,
particularly if meat has constituted a part of the meal.

The cheeses poor in fat are more difficult to digest as they are harder
and not so easily masticated.

Contrary to the prevalent idea, a properly made Welsh rarebit is more
easily digested than uncooked cheese.

One should use judgment, in eating any highly concentrated food, not to
eat too large a quantity.

_Smierkase_, or cottage cheese, is coagulated casein. It contains
thirty-three per cent. of protein, twenty-four per cent. of fat, and
five per cent. of salts.

The thickening of the milk, or the coagulation of the casein, is like
that produced by lactic acid.

_Skimmed milk_, as shown by the table, contains the same amount of
protein as fresh milk, but more sugar and more ash, the difference
consisting almost entirely of less fat, which has been removed in the
cream.

_Buttermilk._ There is less fat, protein, sugar, or ash in buttermilk
than in skimmed milk; it is therefore less nourishing, but it requires
less digestive effort. The sugar has partially fermented and the lactic
acid is freed. It is the free lactic acid which gives the pungent taste.

Buttermilk made by lactone or Bulgarian tablets and fresh milk is as
nourishing and as desirable as that made in the process of butter
making, and it has the advantage of being fresh. When the whole milk is
used it, of course, contains the same amount of fat, protein, sugar,
and ash as the milk. It is of value in cases of poor digestion of
protein and fat, and in chronic stomach trouble. It has been claimed
that the bacilli in buttermilk made from the Bulgarian tablets prevent
putrefaction in the large intestine. This is disputed, however.

_Clabbered Milk._ The casein in clabbered milk coagulates and if kept
in a hot place the coagulation continues until the water, sugar, and
salts are separated. Clabbered or loppered milk is wholesome. It may be
sweetened or salted and flavored to taste.

_Whey_ is the watery portion of milk from which the casein has been
removed in the process of making cheese. It is a palatable drink and
may be flavored with a little nutmeg and sugar or salt. Invalids
usually relish it. Beef tea or egg yolk may be added to it.

_Milk Sugar._ Sugar made from milk is now a commercial product; it is
evaporated and transformed into a fine powder. This powder is used by
physicians and druggists in compounding powders, pills, tablets, etc.

_Junket._ The tablets used in making junket are the essence of rennet.
Milk coagulated by rennin has not the sour taste of milk coagulated by
acid. It is an admirable article of diet in many weakened conditions of
the digestive tract.

_Condensed Milk_ is made by evaporating the water until it is reduced
to about sixty-one per cent. It is then hermetically sealed. It is
convenient for use whenever fresh milk cannot be obtained, but the
process of evaporation changes its flavor so that few care for it as
a drink. It may be substituted for cream in coffee, and diluted with
three times its volume in water the proportions are again the same as
before the water was evaporated.


FOOTNOTES:

[4] Charles D. Woods, Dr. Sc., in _Cereal Breakfast Foods_.




CHAPTER IV

BEVERAGES


Beverages are used primarily to relieve thirst; they may also contain
food elements; they may be used for their effect in heat and cold,
for their flavor, which helps to increase the appetite, or for their
stimulating properties.

They are used to aid digestion and the elimination of waste, to promote
sweating, to soothe inflamed air passages or digestive membranes. They
furnish extra nutrition, stimulate nerve action, quench thirst in
fevers, warm the body when it is cold or cool it when it is hot. They
are used in health or disease, from the snows of the arctics to the
palms of the tropics. They may be alkaline or acid, mineral, medicated
or mucilaginous, effervescing or plain. The question of their utility
and preparation is important in any discussion of foods and food
products, though in themselves they are not foods.

The people of all races seemingly crave a stimulant, after bodily or
mental exertion, in fatigue, as a “bracer” in prolonged effort, as
a promoter of sociability, or as an offering of hospitality. These
stimulants are either alcoholic or non-alcoholic.

It is a notable fact that no tribe is so remote that it does not
possess some form of beverage which may be offered to friends or used
to promote feelings of conviviality; or it may be used to stir up rage
if onslaughts against neighboring tribes are contemplated. The craving
is universal and as old as the race.

Those who decry this craving when it takes the form of alcohol are
often themselves addicted to excessive drinking of non-alcoholic
stimulants.

       *       *       *       *       *

[Sidenote: Tea]

Tea is not a food—it is a stimulant. It is made by steeping the leaves
of a shrub, called Thea, which grows in the tropical regions of Asia
and adjacent islands.

Green tea differs from black in the mode of its preparation. In green
tea the leaves are steamed before they are dried.

The amount of tannin in green tea is greater than in black, hence green
tea is regarded as not so wholesome a drink as black tea.

The young tender leaves are more delicate of flavor.

Varieties of plants differ both in the amount of tannin and the
delicacy of flavor.

Tea should never be boiled or allowed to stand longer than a few
minutes; standing causes the tannin to be extracted from the leaves,
and this tannin disturbs digestion. It is the tannin extracted from the
bark of trees which toughens animal skins into leather.

The best way to make tea is to pour on boiling water and serve within
five minutes.

Because of the uncertainty as to the length of time tea may be allowed
to steep in hotel kitchens or restaurants, it is a wise custom to have
a ball of tea and a pot of hot water served that the guest may make the
tea at the table.

Tea is diuretic, stimulating the action of the kidneys. Through its
stimulant action it relieves fatigue and has been found especially
useful in Arctic explorations and for soldiers on long marches.

When taken hot it will often relieve sick headache. When taken on an
empty stomach, after a long fatiguing tramp or a prolonged “shopping”
excursion, its refreshing effect may be felt for an hour or two.

The ease of its preparation and the quickness of its effect tends to
produce the “tea habit.” When drunk to excess with meals, it causes
the precipitation of the ferments in the digestive juices, retards
digestion, and may cause constipation, particularly if taken after long
infusion.

Strong tea has an overstimulating effect on the nervous system which
reacts, producing depression and restlessness; this may lead to
insomnia, muscular twitchings, and palpitation of the heart.

Habitual users often take from ten to twenty cups of strong tea daily;
in these the evil effects of the tea habit are easily noted.

Americans, or any people whose nerves are highly stimulated, from the
stress of life, or from habitual nerve tension, should particularly
avoid all stimulating beverages.

Poor tea, because of the greater amount of tannin it contains, produces
its ill effects more quickly. From overstimulation of the nervous
system, poor tea, long stewed, has been held to be a contributing
factor in insanity.

Tea should be avoided by the dyspeptic, by those of constipated and
flatulent habit, or by the anemic.

Tannin coagulates the albumin in milk or cream and the addition of
these to tea renders it more indigestible; plain or with lemon juice
it may be well borne by those with whom it disagrees when used with
cream or sugar.

_Thein_, the active principle in tea, is chemically identical with
caffein in coffee.

       *       *       *       *       *

[Sidenote: Coffee]

Coffee is prepared from the seeds of the coffee tree. The best known
brands come from the Island of Java, Mocha, Rio de Janeiro, and Mexico.

Coffee, like tea, _is not a food_, it is a stimulant.

The active principle is caffein. This is an alkaloid and is a strong
stimulant to the central nervous system. It quickens the heart action,
and the stimulating effect is so apparent with many, that they cannot
sleep for several hours after drinking it. Others drink coffee to
quicken mental activity and to keep them awake.

It must be borne in mind, however, that there is a reactionary effect
from all stimulants, and while coffee is not intoxicating, as alcohol,
it has a similar effect on the nerves and heart.

Coffee has the redeeming feature of having a pleasing aroma, which,
because of the effect on the mind, may incite the flow of gastric
juice. Despite the fact that no morning beverage has quite the same
pleasing aroma, or pungency, ordinarily one is much better without it.

Coffee stimulates the action of the heart and for this reason it is
used in collapse to restore heart action.

It removes the sense of fatigue and is thus beneficial in some cases,
as in the army, when long marches are necessary.

It is valuable as an antidote in opium poisoning or in cases of
alcoholism.

It is given to those addicted to liquor, as a milder stimulant when
they are recovering from a spell of intoxication.

The only use of coffee as a food is that its pleasant aroma stimulates
the flow of gastric juice.

Strong coffee, particularly that which has been boiled for a long time,
retards digestion, and, if much is drunk, it will produce the same
symptoms of over stimulation of the nervous system as are manifest in
the tea habit. Heartburn, constipation, dyspepsia, and insomnia may
result.

Sometimes the habit is manifested by excessive eating of the coffee
bean. Such users show marked symptoms of nervousness; they are usually
thin and their faces are drawn and anxious.

Each person must decide for himself whether or not coffee or tea is
injurious to him and cease the habit if he finds it is interfering
with the proper functioning of the system, remembering always that the
purpose of food is to resupply body waste and produce heat and energy.

One who knows that coffee disturbs his digestion, and yet cannot break
himself from the habit of drinking it, should have sympathy for the one
who is addicted to liquor and finds it difficult to break the habit of
depending on this _so-called_ stimulant.

_Cereal Coffee_ has been discussed under the heading “Cereals.”

“Crust” coffee is made by pouring boiling water on “caramelized” bread
or bread deeply toasted, allowing it to stand ten minutes, then pouring
off the liquid, which may be sweetened to taste or mixed with cream or
milk. It is also made by using crusts of bread which have been dried in
the oven without being allowed to brown.

       *       *       *       *       *

[Sidenote: Cocoa and Chocolate]

_Cocoa and Chocolate_ are prepared from the cocoa bean.

Cocoa is from the shell of the bean and chocolate from the kernel. As
shown by Table VII, they are more nutritious than the other beverages.

Cocoa butter is the fat of the cocoa bean. It has a pleasant odor and
does not easily become rancid. Its nutritive value depends on its fat.

Most of the fat has been removed from the cocoa made for the use of
invalids, hence the nutritive value of this cocoa is lessened. The
milk and sugar used in its preparation constitute the most of its
nourishment; the cocoa simply gives a flavor.

Part of the value of chocolate is in the sugar used with it. If well
prepared it is digested with ease and forms a nutritious article of
diet. The habit of using large amounts of chocolate in candy, or as
a beverage, disorders the system because of the gastric disturbances
produced by the excess of sugar.

When food is not easily obtained, compressed cakes of chocolate may be
carried, as in traveling, for a temporary food supply.

Chocolate, as sugar, in moderation, constitutes a good food for the
growing child.

The active principle in cocoa and chocolate is _theobromin_ and, though
milder, is similar to caffein in its stimulating effect on the nervous
system.

       *       *       *       *       *

[Sidenote: Lemonade]

_Lemonade_ and other fruit drinks, particularly those made from the
citrus fruits, slake the thirst more quickly than most drinks.

All fruit drinks are diuretic, and, whenever the action of the kidneys
is sluggish, they are especially desirable.

       *       *       *       *       *

[Sidenote: Effervescing Waters]

These are made by forcing carbon dioxid, under pressure, into the
bottle. As soon as the cork is removed the escape of the gas causes
effervescence. These drinks are of no special advantage, other than
that they slake the thirst, because the amount of salts of various
minerals they contain is usually small.

When taken in excess they cause flatulence and may lead to gastric
disturbances. The indiscriminate habit of young people drinking
effervescing waters at soda fountains should be discouraged.

These waters added to milk render it more easily digested.

       *       *       *       *       *

[Sidenote: Water]

There is no beverage nor concoction devised by man equal to water. It
is to be deplored that it is not used as freely as Nature demands—from
eight to ten glasses a day.

The value of water as a food and as an aid to digestion is discussed on
page 26.


_CONDIMENTS_

Condiments are not foods. They have no nutrition in themselves, but by
their flavor they stimulate the nerves of taste, rendering the food
more appetizing and help to make the diet more varied.

They are relishes and are to be employed in this manner judiciously,
and not used generally in the diet.

Some strong condiments, as cayenne pepper, are of use in dyspeptic
conditions to stimulate the gastric mucous membrane.

They are of value in the dietary of the invalid whose appetite must
be stimulated and careful variations in flavoring will aid in varying
a diet which otherwise would be monotonous, but the excessive use
of condiments, particularly the various peppers, salt, horseradish,
ginger, vinegar, and spices, as indulged by many, so overstimulates
the gastric and intestinal membranes, as to cause catarrhal disease
and dyspepsia. They tend to weaken digestion by calling for an undue
secretion of digestive juices, which, if prolonged, tires out the
glands.

The use of salts is discussed on pages 34-37.

A reasonable amount of condiments such as pepper, salt, nutmeg, cloves,
allspice, sage, thyme, ginger, mustard, cinnamon, mace, horseradish,
vanilla, dill, etc., may be used as appetizers, because the pleasing
thought of them may incite the flow of gastric juice; but they should
not be used to excess.

The taste is undoubtedly a cultivated one, and should not be encouraged
in children. The child rarely cares for condiments and it is better
that he continue to relish his food in its natural flavor.

If beef tea, which so soon becomes distasteful to the sick, is flavored
with different savory or aromatic substances, as parsley, sage, or
mint, it is taken with greater relish.

_Mustard_, so commonly used with cold ham or other meat and in salad
dressing, is sometimes of benefit in stimulating the appetite, but when
used in large quantities, or continuously, it may irritate the stomach.
This irritant quality may be used to advantage, when it is deemed
necessary, as a counter-irritant on the skin, as in the well-known
mustard plaster. A teaspoonful of mustard to a pint of lukewarm water
is an effectual emetic in cases in which it is necessary or advisable
to empty the stomach.

_Capers_, the flower buds of a bush grown in the East, are put up in
vinegar and used in sauces for mutton.

_Cinnamon_, _nutmeg_, and _cloves_ are useful in flavoring foods; they
take the flat taste from hot water and impart a pleasant spiciness.
Many can take milk when flavored, and the slight amount necessary is in
no way injurious.

_Preserved ginger_ is of value for flavoring cereal foods and gruels
for invalids.

_Vinegar_, used in excess, reduces the alkalinity of the blood and aids
in the destruction of red blood corpuscles. It may thus produce anemia
when used in excess.

The acetic acid contained in _cider vinegar_ aids the softening of the
muscle fiber of meat and thus facilitates its digestion. Because of its
preservative qualities it is used in pickling vegetables and various
kinds of fish.

Vinegars made from grapes or other fruits are wholesome. Flavored
vinegars, as tarragon, from the herb of the same name, are useful as
appetizers.

Vinegars artificially made from commercial acids are sometimes
injurious.

_Tomato Catsup_, _Worcestershire_, and _Tabasco sauces_ are not harmful
if used moderately and with due regard to enhancing not destroying the
flavor of the food with which they are used.


_PRESERVATION OF FOODS_

This subject is of ever-growing importance. The study of the
preservation of foods has added much to the store of human knowledge.
By this means it is possible for those living in districts remote from
the supply, those who cannot afford to buy them fresh, and those who
have no cellars in which to store them, to have vegetables and fruits
at all seasons of the year.

Nutritious foods can be prepared in such small bulk and of such
excellent keeping quality that explorers, whether to the arctics or
the tropics, can be kept in first-class physical condition, enabled to
withstand fatigue, and be removed to long distances from the base of
supplies without great hardship.

The decomposition of food is occasioned by bacterial action. Air
is necessary to the growth of bacteria. If the air is excluded the
ordinary bacteria are prevented from exerting their deleterious action.

Heat, as in canning, prevents the formation of bacterial products.

Cold, in refrigeration, by inhibiting bacterial activity is also an
excellent preservative.

Other methods in use are smoking, salting, drying, sterilizing, various
antiseptics, and the exclusion of the air, as in coating eggs or meat
for transportation to other countries.

Eggs are preserved for a long period by excluding the air, which
otherwise penetrates the shell. A solution of water glass (silicate of
sodium), dry oats or salt are used for this purpose.

All food intended for preservation should be kept in a clean, cool,
dry, dark place.

Drying, cooking, and sealing from the air will preserve some meats and
fruits, while others require such preservatives as sugar, vinegar, and
salt. The preservative in cider vinegar is acetic acid, in wine vinegar
tartaric acid.

All preservatives which are actual foods, such as sugar, salt,
and vinegar, are to be recommended, but the use of antiseptic
preservatives, such as salicylic acid, formaldehyd, boracic acid, alum,
sulphur, and benzoate of soda, all of which have been used by many
canning merchants, is fraught with danger. By the efforts of the United
States Department of Agriculture the use of such preservatives has
been largely done away with by the most reliable packers and canners.
However, unscrupulous dealers may use this means of disguising fruits
and vegetables not in good condition.

There can be no doubt, that, whenever possible, the best method is for
the housewife to preserve her own food by drying, canning, preserving,
and pickling, with fruits and vegetables which she knows are fresh.
This, however, is not always practicable.

Since economy in food lies in obtaining the greatest amount of
nutriment for the least money, the preparation of simple foods in the
home, with care that no more is furnished for consumption than the
system requires, is the truest economy.

More brands of prepared food are not so much needed as purity of
elements in their natural state.

_In the effort to emphasize the importance of pure food in amount and
quality, pure air and pure water must not be overlooked. Much infection
is carried by these two elements._


_POISONING FROM FOOD_

Owing to the careful inspection given to various preparations of
foods and the education of the people on the dangers attending the
eating of underripe, overripe, or fermenting fruits and vegetables, or
decomposing canned meats or other foods, cases of poisoning from food
are not so numerous as formerly.

One still reads, however, of illnesses and even fatalities in those
who have, at some gathering, partaken of potted or canned meats, or
ice-cream made from impure milk.

Imperfect sterilization allows the micro-organisms, everywhere present
in the atmosphere, to multiply and produce their toxins.

Any food contained in a can which shows a suspicious bulging in top
or sides (not a dent caused by handling) should be unhesitatingly
rejected, for fermentation has developed gases, which, in trying to
escape, have caused the bulging. Though the practice is less common
than formerly, some grocers offer these bulging cans for sale at less
prices and they are thus purchased by those who look for bargains in
foods instead of for quality.

Sometimes the foods have not advanced to a stage in which the poisonous
products are manifested; but in the intestinal canal the germs
contained in these foods manufacture toxins which are readily absorbed
and produce the severe disturbances noted in cases of ptomain poisoning.

The liver, which has been styled the “watchdog of the body,” has a
special power to destroy many of the toxins contained in the food
material passing through it, and it is due to this fact that many
deleterious substances, taken with the food, are neutralized and their
poisons rendered harmless to the system. When the liver is disordered,
this important function may be hindered, or cease to be active.
Therefore, the importance may be readily seen of keeping the liver in
a vigorous condition by means of exercises which will send an active
circulation through it and keep the nerves controlling it in perfect
functioning order.

Ptomain poisoning results most often from tainted meat, milk, and fish.
Putrefactive processes may have begun in meat, which is thus rendered
“high,” but if it is thoroughly cooked the poisons may be made inert.
Many enjoy the flavor of such meat. The Eskimos, as is well known, will
cache a seal or other animal against a time when food is less plentiful
and after months, perhaps, will eat it with relish and without harm,
though it cannot be touched by people with less hearty appetites. Old
eggs, eaten as a luxury by the Chinese, and the fermented fish used by
other races are familiar examples of tainted foods.

The sale of “bob” veal, or the flesh of very young calves, has been
prohibited because in many people its ready decomposition causes active
diarrhea.

The process of smoking various meats affects materially only the
outside portion, the inner may furnish a suitable bed for the
development of germs. Great care should be exercised and thorough
inspection made of any meat which is eaten raw, as dried beef, or any
pork product.

Ice-cream, as made in the home, is usually innocuous, but when it is
made in factories, unless care is exercised to keep containers clean
and sterilized, the cream or milk may become infected from careless
handling, either before or after it reaches the factory—particularly
in warm weather. Toxins which cause serious and often fatal poisoning
develop. Many such cases have resulted from the free eating of infected
ice-cream at picnics or other social gatherings.

One should guard against overripe cheese, though cheese of any
kind acts as a poison with some people. Cases of severe intestinal
disturbance may occur in those who are unable to eat certain articles
of food, as strawberries, lobsters, or oysters; these attacks should be
carefully distinguished from cases of true poisoning.

Sometimes, however, particularly in the case of fish or oysters
which have been frozen, unless they are eaten immediately after they
have been thawed, toxins develop which cause severe constitutional
disturbance, particularly of the nervous system. These toxins do not
seem to affect the gastro-intestinal tract so markedly. Infected
shellfish, particularly mussels, have caused death in two hours by
their effect on the nervous system.

Many fish after being smoked are eaten raw, and if the ptomains have
begun to develop, poisoning follows.

Care must be taken in purchasing fish for the table that the flesh is
firm and the odor absolutely without taint.

Meat or fish may become toxic to the system through substances eaten by
the animal or by its own physical condition at the time it is killed.
Fish and oysters, therefore, are not eaten during the spawning season.

Cow’s milk may be made obnoxious by substances on which the cow feeds.
Wild garlic when eaten by the cow imparts a nauseous taste to the milk.

The flesh from diseased animals slaughtered and sold for food has
occasioned violent sickness. Government inspection, however, has
greatly lessened the dangers from this source.

Unripe or overripe vegetables and fruit may occasion severe vomiting
and diarrhea.

Moldy flour contains a substance which may cause poisoning.

Rye may have a parasite fungus called ergot and if flour is made
from rye contaminated with this growth, a form of poisoning called
“ergotism” may result. It takes some time and a prolonged use of the
flour to cause untoward symptoms.

Pellagra, which has been giving the southern states so much trouble,
was thought to be caused by the use of spoiled corn meal. It is now
thought to be due to the disturbed nutrition following too monotonous
and unbalanced a diet. The excessive use of corn-meal breads with their
heating qualities and the irritation of the intestinal canal may be an
accessory factor.

A food which is so universally used as milk should be surrounded with
every safeguard possible by rigid inspection from producer to consumer,
as many infective epidemics have been traced directly to a careless or
infected handler of this product. Tuberculosis and typhoid fever germs,
diphtheria and scarlet fever may all be communicated by this means.
Live typhoid bacilli have been found in acid buttermilk. Infected water
used in washing the cans will infect the milk.

Other poisoning may occur by the tin or lead in the inside of cans
being dissolved off by the acids in fruits or vegetables. This is more
likely to occur when the cans of fruit have been kept for a long time.
Housekeepers, who use tin cans, should not put up more fruit than will
supply the family for the season.

Tomatoes, asparagus, strawberries, and apricots are especially liable
to dissolve the tin from the can.

Food should be emptied from the can as soon as it is opened, as
the action of the air hastens deterioration. No cooked fruit should
be allowed to stand in a tin saucepan or other vessel. It should be
emptied as soon as the cooking process is complete.

When a can of fruit, vegetables, or meat is opened, if the interior of
the can is even partially black, it is safe to reject the contents. The
tin in the food will be absorbed in the intestinal tract and may cause
severe disturbance.

Large canners of fruit and vegetables, of the better quality, are now
coating the inside of the can with an insoluble varnish which prevents
the acids from acting on the tin.

The best canners are exceedingly careful and everything in their
factories is scrupulously clean.


_THE ADULTERATION OF FOOD_

Laws against food adulteration have been enacted, but unscrupulous
manufacturers find ways to evade them. On account of these laws,
however, the practice is less general and manufacturers are beginning
to take pride in putting up goods that pass the strictest inspection.
The people, also, are being aroused, through the efforts of the
pure-food propagandists, to the ill effects of adulterated foods both
on the body and the pocketbook and are increasingly demanding that the
foods they buy shall be pure and wholesome.

To lessen the cost of production, many foods are mixed with various
substances before being marketed in order to increase the profits
of the manufacturer or dealer. The contained substance may not be
deleterious to health, but it may lessen the value of the article as a
food.

Among foods which may be so adulterated are jellies, jams and
marmalades, catsups and pickles of all varieties, baking powder,
butter, spices, coffee, corn-starch, mincemeat, vinegar, syrups, sugar,
honey, lard, and flour.

Various adulterants which are used are: wood alcohol (a poison) in
flavoring extracts; vinegar made from various acids and colored to
imitate cider vinegar; rice flour and wheat flour used in ground
spices; kaolin and coloring matter used in candies; paraffin in gum
drops; glucose artificially flavored as maple syrup; cotton-seed oil
sold as olive oil; starch and sugar in powdered cocoa and in chocolate;
chicory, sugar, and pea meal in ground coffee; artificial coffee beans
made of starch, molasses, and chicory; alum and ammonia in baking
powders; artificial coloring of canned peas, beans, and catsups,
butter, cheese, milk, and cream.

It must be said, in justice, however, that housewives are responsible
for many of these productions. Dealers who would be glad to sell only
pure articles say that “the trade won’t have them.”

Many insist on a highly colored cheese, thinking that the color denotes
greater richness, whereas a little reasoning would show them that
the richest old cheeses are pale in color, the deeper color of the
cheese being due to the addition of coloring matter to the curd. While
the coloring matter is not deleterious, the color is no evidence of
richness.

Highly colored green pickles, beans, and peas, should not be used.
Pickles which are hard and crisp are usually made so by alum.

Brilliant red catsup is in demand, though the pure variety is known by
its darker and not so attractive hue.

High coloring in any canned fruit or vegetable is usually an indication
that dye stuffs have been used to produce it.

Fruit jams which are of nondescript color or pale when pure are colored
artificially because the ordinary purchaser demands a pretty product.

Through the vigilance of the food inspectors of the boards of health,
and because of some vigorous prosecutions, the adulteration of the
people’s food is, however, not so easy and profitable an occupation as
formerly.

The Bulletins of the Department of Agriculture furnish a mine of wealth
in the gaining of knowledge of various foods and their preparation, and
may be had free on application to this Department at Washington.


_HEAT AND ENERGY_

The second use of foods, as mentioned before, is to furnish heat
and energy for the work of the body. Heat and energy are produced
_automatically_ by the action of the heart, the movement of the
lungs in breathing, and by muscular activity through the digestion,
absorption, and assimilation of food elements, and through the activity
in tearing down and eliminating waste. They are produced _consciously_
by muscular activity in exercise.

Just as any engine requires fuel, water, and air to create the force
necessary to run the machinery, so does the human engine require fuel,
air, and water.

The fuel for an engine consists of coal, wood, or oil. As these are
brought in combination with oxygen, combustion or oxidation takes
place, liberating heat and setting the engine in motion.

The amount of energy or force given off by an engine should exactly
equal the amount of latent energy provided in the fuel. Much of this
energy is commercially lost, since much of the latent force in fuel
is not fully liberated, some passing off in the smoke, while some may
remain in the cinders.

The amount of heat and energy generated by the body equals the amount
of latent energy released by the burning of food material during
oxidation.

The carbohydrates and fats constitute the most of the fuel.

The body cells are constantly surrounded by the lymph which contains
the food material—the protein, the carbohydrate, and the fat.

The lymph carries all of the food elements, therefore the protein, the
fat, and the carbohydrate reach the tissues at the same time. If the
fat and carbohydrate predominate, their excess serves to keep a portion
of the protein away from the cells. The cells can use carbohydrate more
easily than fat, so the surplus amount of carbohydrate is first used to
produce energy. This spares the protein which is held in reserve for
tissue repair, and the fat, being least readily used, is stored.

When the carbohydrates and fats are not supplied, or when the system
fails for any reason to appropriate those eaten to its use, the protein
is used for heat and energy instead of being used for tissue building.
If the demand, either in mental or physical energy, exceeds the daily
supply for long, the body becomes lean.

In order, therefore, to maintain a perfect equilibrium the supply of
protein, carbohydrate, and fat should bear the proper relation, any
excess at one time being equalized at another. If an overhearty meal
is eaten the next should be light.

Fat is harder to burn than the starches and sugars so that they are
acted on first as an economy of effort, and the fat is held in reserve
until the carbohydrates are exhausted.

If one is cold, the quickest way to get warm is to generate more heat
within by “turning on the draught,” or, in other words, by _breathing
in more oxygen_. If cold, one should depend more on the oxygen within
than on extra clothing. So many people put on more clothing to conserve
the body heat and forget to generate more heat by arousing the fires
within. This is like covering a dying fire, instead of turning on the
draught to create more combustion.

The carbon in the body is burned by being brought into contact with
oxygen in the blood through exercise and full breathing, just as a fire
is fanned to flame by bringing oxygen in contact with the fuel, by
means of a draught of air. Keep all air away from a fire and it “dies
out,” it has exhausted the oxygen and no heat is produced; keep all air
from within the body, by cessation of breathing, and it also dies.

A room is heated with difficulty if the air in it does not contain
sufficient oxygen. Just so the body which is not constantly supplied
with pure air generates very little heat. The effect of oxygen in the
creation of heat is practically demonstrated by voluntary, rapid, deep
breathing, completely filling the lungs with air, while out in the
cold. The body will become quickly warmed on the coldest day by this
practice.

Ten to twelve deep breaths in succession “turn on the draught” inside
and create combustion (heat), just as opening the draught to a stove by
causing more air to circulate within it increases combustion or heat.

Remember that heat is the result of combustion—the more rapid the
combustion in the body, caused by oxygen breathed in through the lungs,
the greater the heat.

Just as much heat is created when fat is burned in the body as when it
is burned outside of the body.

The heat from “burning” wood is produced by the union of the oxygen
from the air with hydrogen and carbon, forming carbon dioxid and water.

The light in the burning of wood is caused by the rapid combustion.
Combustion occurs within the body more slowly, hence no light is
produced.

The exact process by which the potential energy latent in food is
converted into heat and energy is not known. It is partly released
during the digestive process, through the chemical action produced when
the elements of the food come into contact with oxygen and with the
digestive juices. This combustion gives to the digestive organs the
necessary warmth to enable them to do effective work. A certain amount
of heat is necessary for the chemical changes, and digestive juices
flow more freely when the body is warm. Heat is necessary, also, to aid
the peristaltic movements of the digestive organs.

It has been estimated that about one-sixth of the heat liberated
evaporates through the skin, the lungs, and the excreta, while
five-sixths is required to maintain the body heat.

If the digestive forces are not working perfectly and if the food
is not properly prepared, some of the fuel is not utilized. But,
in normal conditions, if the food is supplied in proportion to the
energy required, the heat and energy given off should exactly equal
the latent heat and energy consumed. If more food is taken than is
necessary to produce heat and energy, the excess of material is stored
and if the excess continues the bodily machinery may be clogged. The
relief lies in consuming the excess through exercise. More oxygen is
required to put the excess in condition for use, and the extra amount
of oxygen is gained by means of the deep breathing occasioned by
exercise.

It is to be noted, also, that no force within the body is lost. In the
very process of the removal of waste, heat and energy are created, so
that the parts no longer needed are utilized by the system, while they
are being removed from it. Here is a lesson in economy of force.

A small portion of the heat of the body is gained from the sun or from
artificial heat, but by far the greater part is generated within the
body.

As mentioned before, the fuel for the body consists of _fats, starches,
and sugars_, which, in combination with oxygen, create force.

From the foregoing, it follows that the fuel value of any food depends
on the amount of fats, starches, and sugars it contains.

The chemical combination of oxygen with food elements and with the
body tissue is known as _oxidation_. It is this chemical action of
the oxygen on the food and on the tissues which produces heat and
energy, either in muscle, gland, or nerve. This energy, in the muscle,
expresses itself in movement; in the gland, in chemical action, and in
the nervous system, by activity of brain or nerve centers. The nervous
energy is closely allied to electrical force.

Nature provides for a reserve of heat and energy, above the immediate
needs, by storing a supply of heat-producing material which is
utilized whenever the daily supply is insufficient or is lacking. Many
hibernating animals store up sufficient fat in summer to provide heat
for the entire winter. This fat would not last throughout the winter,
however, were the animal active. Many individuals carry sufficient fat
to supply all of their needs for months, even though all fat-building
elements were omitted from the diet.

The fact that more oxygen is required for combustion of fat than of
starches and sugars is important for those who wish to call on the fats
stored within the body for daily heat and energy and thus reduce in
weight.

If sufficient starches, sugars, and fats are not consumed in the body
to supply the daily heat and energy released by exercise, the body
calls on the reserve store in the tissues. If much fat or carbohydrates
are consumed in the daily food this will be oxidized before the fat
stored in the muscular tissue is called on.

The scientific reduction of weight, therefore, lies in the regulation
of the daily consumption of starches, sugars, and fats, and the
oxidation of more of these substances through an increase in the daily
exercise.

Deep breathing of pure air should accompany all exercises to supply
sufficient oxygen for combustion or oxidation.

In warm weather little fat is needed for fuel, and Nature provides
fresh green vegetables to replace the root vegetables of the cold
weather, which, consisting largely of starches and sugars, are readily
converted into heat.

In cold weather, especially in high altitudes or latitudes, more fuel
foods are required to keep the body warm and more fat is eaten.

It must be remembered that anything which creates a greater activity of
the tissues, such as muscular exercise, liberates a greater amount of
heat. The reverse is also true. A decrease in the amount of muscular
movement means a decrease in the liberation of heat. During exercise,
a large amount of carbohydrates and fats are released by the movements
and oxidized; the liberated heat is carried to all parts of the system
and the temperature is raised.

Food in the alimentary canal causes an activity in the glands of the
digestive organs maintaining their temperature.

Of course, while digestion and muscular activity are at their height,
the body temperature is highest. The temperature, as a rule, decreases
from about six at night until four or five in the morning, when it is
usually at its ebb. This is a point of importance. A degree or two of
increase in temperature, above normal, if recorded about six at night,
is not, in most conditions, considered alarming by the physician.

Anything which causes an increase in heat radiation, as perspiration,
lowers the temperature, and the open pores of the skin are valuable
aids in equalizing the body heat. A person who perspires freely does
not suffer with heat during excessive exercise, as does one whose pores
are closed.

Diuretic foods and beverages, such as water and fruits (melons, lemons,
oranges, grapefruit, etc.), which increase the activity of the skin and
the kidneys, also tend to lower the body temperature.

One ready means of regulating the body heat is the _bath_. If
one takes a hot bath, the temperature is materially raised by the
artificial heat, but there is a recompense in the increase of heat
radiation from the skin and the reaction is cooling. If one takes a
cold bath, the immediate effect is cooling, but the activity set up
within, to create a reaction, soon heats the body to a greater degree
than before the bath.

The best way to increase the evaporation and thus decrease the
temperature of the body is by a tepid shower or a tepid sponge. The
tepid water will not create a strong reaction, and it will cause a
decrease in temperature. Thus, for fever patients or on a warm day,
the tepid shower or sponge is commended; for a cold day, or for the
individual whose circulation is sluggish, the cold bath, followed by
friction, is desirable. When the vitality is low, so that reaction is
slow or chilly feelings persist, the bath must be tempered and greater
friction used.

The generation of heat is also increased by solid foods that require
more than normal activity on the part of the digestive organs. For
this reason the food given fever patients should be that most easily
digested and should be reduced in quantity. Liquid or semiliquid foods
are best.

While the elements of the food are being oxidized, the latent
(potential) energy released by the oxygen creates mental and physical
force and keeps active the metabolic changing of food into tissues and
cells, also the changing of cells and tissues into waste.

Scientists have measured the energy latent in food material, also the
amount of heat given off in the oxidation of a given quantity of waste.
The unit of measurement is the _calorie_—the amount of heat which will
raise one pound of water 4 degrees Fahrenheit.

The fuel value of any food denotes the total number of calories which
may be derived from a pound of that food if it be completely oxidized
in the body.

C. F. Langworthy gives the fuel value of proteins, fats, and
carbohydrates as follows:

  1 pound of protein yields        1860 calories
  1   ”   ”  fats       ”          4220    ”
  1   ”   ”  carbohydrates yields  1860    ”

That is, according to fuel value—the capacity of the nutrients for
yielding heat and mechanical power—a pound of the protein of lean meat
or egg albumen just about equals a pound of starch or sugar, and about
two pounds of these would about equal a pound of the fat of meat or of
the body fat.

The calculation has been made, based on experiments, that one who
does no muscular work needs only an amount of food which will produce
2700 calories. One doing light muscular work needs 3000 calories. An
individual doing moderately heavy work should take 3500 calories, while
heavy muscular work takes 4500 calories.

One hundred grams of protein food, however, gives only fifteen per
cent. of the amount of energy required. About 500 grams of carbohydrate
and 50 grams of fat are needed to make up the 3000 calories which must
be furnished by the daily supply of food for one doing light muscular
work.

The brain worker, who is using brain tissue more rapidly than the day
laborer, should have a diet equally as rich in protein, though less fat
and carbohydrates are needed.

It has been estimated that an ordinary man on full diet excretes about
twenty grams (about five-eighths of an ounce) of nitrogen a day. As
protein material contains about sixteen per cent. of nitrogen, such an
individual needs to take about 120 grams of protein a day to supply the
nitrogen needs of the body. Because of its need for protein, the body
does not store it.

A day laborer needs 0.28 of a pound of protein a day with enough fat
and carbohydrate to give a fuel value of 3500 calories. A professional
man requires 0.25 (1/4) of a pound of protein a day. Much more than
this is usually taken. This means from 1/3 to 1/2 a pound of lean meat.

_Nothing is lost in Nature’s distribution of force and energy.
Everything accomplished in life, either in the physical handling
of material, the brain work in planning the constructions, the
mental movements of thought in art, literature, or science, are all
representatives of the heat and energy released from the body, and
every man and woman should endeavor to make the body yield as large an
income as possible in the expression of this energy. In order that it
may do so, it must be used with intelligence, just as any other great
machine must be used intelligently; it must be fed, exercised, and
rested judiciously._




CHAPTER V

REPAIR AND ELIMINATION OF WASTE (METABOLISM)


The work of the body never stops. If it is to be kept in thorough
working order its tissues must be rebuilt as incessantly as they are
torn down in the process of producing heat and energy. These chemical
changes are called collectively _metabolism_.

They are divided into two groups: the chemical process of building
up complex substances from simple ones is known as _anabolism_; the
chemical process of oxidizing and breaking down the complex substances
into simple ones, so that they are in a state to be excreted, is called
_catabolism_. While the process of oxidation in catabolism is going on,
heat and energy are set free. Many of the chemical changes in the body
are catabolic in character. This work never ceases—even in sleep.

It is not enough that the proper foods be furnished the body in
kind and quantity. The essential thing is that the system be kept
in condition to _assimilate_ the foods to its needs and to promptly
eliminate the waste. Few people assimilate all of the foods eaten.

By _assimilation_ is meant the process by which foodstuffs are made
soluble and diffusible, so that they can pass into the blood; also,
the metabolic activity by which the food is converted into cells and
tissues.

Truly the body is a busy workshop. Think of the billions on billions
of cells being formed and destroyed every instant in the liberation of
heat and force! Think, also, of the necessity of perfect circulation to
bring sufficient blood to the lungs, that it may gather the oxygen and
carry it, without pausing for rest, to every tissue of the body! Even
in sleep this stream continues incessantly.

There is also a great lesson here in the law of supply and demand.
When the body is at mental or muscular work, the potential energy
liberated leaves through muscle or brain, as energy, and is expressed
in the result of the work. When the body is at rest, energy leaves it
as heat (excepting such part as is necessary to carry on metabolism,
circulation, etc.).

If much muscular energy is called for, a deep, full breath is
instinctively drawn to supply the oxygen necessary for the added force.

If strong mental work is required, attention should be given to
exercise and deep breathing, that the blood may carry off the waste
liberated by brain activity. The difficulty is that in doing close
mental work, the body is too frequently bent over a desk in such a
manner as to restrict the action of the lungs; thus, the brain worker,
in order to continue strong mental work, must often go into the open
air, as he says, “to rest his brain,” but in reality to obtain the
oxygen needed to put the waste, liberated by brain energy, in condition
to be carried away. The supply of blood has been called on for the
brain work; the poor circulation through the body has allowed an excess
of carbon dioxid to accumulate and the condition of the body designated
as “tired” has resulted. Until the necessary oxygen has been supplied,
the brain and body are not balanced, not “rested.”

In its conversion into tissue, heat, energy, and waste, the importance
of the chemical exceeds that of the mechanical action of digestion,
absorption, assimilation, and elimination; yet the chemical changes are
aided by the mechanical.

Nature provides against ignorance of the amount of supply necessary,
by enabling the system to carry off a limited amount of surplus food
above the bodily requirements. Her capacity in this regard is limited
and varies with each individual. Therefore common sense is required in
deciding for oneself the amount of food which will aid, and not hinder
Nature in her processes.

Without doubt many eat more food than the system requires, and when it
is overloaded they do not take the pains to burn up and eliminate the
excess through exercise and oxygen.

On the other hand, this theory of overeating has been so long
discussed that many have not eaten sufficient food and their bodies
are undernourished. Many, also, from lack of exercise, hence lack of
demand of the body for food, have supposed this lack of appetite to
be Nature’s call “Enough”; inertia has resulted and waste remains in
the body. They have failed to exercise sufficiently to create a demand
for food. It is thus undernourished because sufficient new building
material has not been supplied. The relief from this condition is
exercise and deep breathing so that Nature removes the waste and calls
for fresh building material.

Many others, through mental and physical activity, burn up much fuel
and the result is the body does not store up sufficient fat for a
reserve, or for beauty and comfort. The nerves require a certain amount
of fat for their protection. People of this type should take a more
full and sometimes a more varied diet, particularly more liquid, and
should not fail in daily exercise and deep breathing.

Each individual should know, approximately, the chemical constituents
and the proportion of these constituents in normal blood, because from
the elements in the blood, the tissues are constructed. If certain
elements are lacking, the foods containing these elements in largest
proportions should be supplied until the blood no longer shows the
deficiency. This is Nature’s method of correction. The variations in
the blood can be known only by chemical analyses and until physicians
have access to chemical laboratories the giving of drugs cannot be a
science.

Each meal, or each day’s food, may not contain the amount of protein or
of fuel ingredients necessary for that day’s work and resupply, but the
body is continually storing material, and this reserve is constantly
being drawn on to provide any element which may be lacking in that
day’s supply. Thus, an excess or a deficiency one day may be adjusted
the next. Healthful nourishment requires that the balance, as a whole,
be kept and that a deficiency or oversupply be not continued for too
long.

The distinct steps in anabolism and the effect of oxygen on
assimilation are discussed in the following pages.


_DIGESTION_

Any discussion of the digestibility of foods must be general, because
food which agrees with one may disagree with another, and a food which
disagrees with one at a particular time may entirely agree with him at
some other time according to the condition of his system. Therefore,
before one passes on the adaptability of a food to his system, he
should know that this food agrees or disagrees with him under various
conditions.

The chances are that the food is right but that the attitude of mind
and the condition of the body are abnormal.

The digestibility of food depends largely on the physical condition of
the individual, because the amount of digestive juices poured into the
alimentary canal is influenced by this condition, particularly by the
condition of the nerves. If sufficient juices, in proper proportions,
are not poured into the digestive tract, the foodstuffs are not made
soluble for absorption.

Digestion is practically synonymous with solution—all solid foods must
be reduced to a liquid state by means of the digestive juices and water
before they can pass through the walls of the stomach and intestines
and enter the blood.

Each individual should learn to like the foods containing the nutrient
elements which experience and blood tests have shown to be lacking in
his case.

Yet while it is true that in most cases the aversion to a particular
food is largely mental, there are kinds of food which, to certain
individuals, according to the chemical composition of the body, act as
actual poisons, _e. g._, strawberries, cheese, or coffee.

The question of likes and of dislikes in foods, is largely habit, and
one can learn to like almost any food, if one really has the desire to
do so.

When the habit has been formed of discriminating too much in the food,
of discarding this food or that, because at some time it has disagreed,
due to the particular condition at the time, the mind approaches the
table in a pessimistic attitude and the saliva and the gastric juices
are retarded in their flow.

When one is exercising freely, so that the muscular and mucous coats
of the digestive system are strong, the body will handle foods which,
during sedentary habits, it would not digest.

_Much indigestion is due to mental apathy. The mind often needs
arousing to an interest in something._

Such an individual needs to know that one of the hardest things for
the members of his family is to live day by day with one who maintains
an attitude of mental depression, and he should stir himself for “his
stomach’s sake,” as well as for the sake of his family, to a cheerful
interest in something. He should let go his grudge and ride a hobby, if
it is a cheerful one, and ride it hard.

It may be well, here, to trace, briefly, the progress of the food
through the digestive tract and the action of the juices and the
ferments on it.[5]

       *       *       *       *       *

[Sidenote: Salivary Digestion]

The food in the mouth is mixed with saliva, which begins the
dissolution of the starches.

The saliva consists of about 99.5 per cent. water and 0.5 per
cent. solids. The solids consist of ptyalin, sodium chlorid, sodium
carbonate, mucus, and epithelium. Ptyalin, the most important of these,
is the active digestive agent; the mucus lubricates the masticated
food; the sodium carbonate insures the alkalinity of the food, and the
water dissolves the food that the juices may more readily reach and act
on each particle.

The starches are the only foods whose chemical digestion is begun in
the mouth. They are first broken up by the ptyalin into dextrin and
then into the more simple sugar, known as maltose.[6]

It is important that sufficient saliva be mixed with the food through
mastication, because unless the digestion of the starches is begun by
the saliva, either in the mouth or after it is swallowed, they are
not acted on until they reach the small intestine, consequently their
digestion is unduly delayed. The pancreatic juice must then do more
than its normal work of digestion.

The saliva flows into the mouth, more or less, at all times, but more
copiously during mastication.

The movement of the jaws in chewing incites its flow and when starches
are not well digested, gum chewing, in moderation, though not a refined
habit, is beneficial.

The evident purpose of the saliva when food is not present is to keep
the lining of the mouth moist.

Salivary digestion is carried on in the stomach until the food becomes
thoroughly mixed with the gastric juice, which, being acid, inhibits
the action of the ptyalin.

The thorough and regular cleansing of the teeth is an important aid to
digestion. Food products allowed to remain about the teeth ferment,
rendering the mouth acid. When the mouth is acid, the alkaline saliva
does not secrete in sufficient amount and the mouth is more or less dry.

The mouth is acid in rheumatism and allied conditions and the saliva
may be thick and ropy so that it does not moisten the food properly.
On the other hand the flow of saliva may be too free, the ptyalin is
then too much diluted to promptly act on the food. This may result from
overstimulation of the salivary glands occasioned by the excessive
chewing of gum, or tobacco. These excesses also carry too much air into
the stomach, resulting in flatulence.

The flow of saliva is controlled, largely, by nerves centering in the
medulla oblongata. The sight of food, pleasingly served, or even the
thought of food which one likes, will increase the flow. This is one
instance of the control of thought over digestion, and the importance
of forming the habit of cultivating a taste for all kinds of food is
apparent. The stronger the relish for the food, and the more thoroughly
it is masticated and mixed with the saliva, the more perfectly will the
first step in digestion be accomplished.

Thorough mastication is important, not only because the chemical action
on the starch molecules is facilitated by the softening and mixing with
the saliva, but also because thorough mastication tends to prevent
overeating—the appetite is more quickly satisfied when the food is well
masticated.

Cool water encourages the flow of saliva and for this reason should
be drunk before meals, particularly when digestion is weak. It may be
taken at rest periods during the meal. (See page 31.)

       *       *       *       *       *

[Sidenote: The Mouth and Nasal Passages]

The relation of the mouth and nasal passages to the digestive processes
is seldom considered by the average individual. Their importance to the
growing child is being recognized by the examination of school children
which is now being made a part of the health program in many of our
cities. Their importance to the adult is no less.

Food particles allowed to remain around the teeth, or in the cavities
of decayed teeth, incite bacterial action. With the next meal these
bacteria are swallowed and cause fermentation of the food, occasioning
indigestion, and possibly, dyspepsia.

Decayed or missing teeth, swollen gums, or pyorrhea, interfere with
proper mastication of food, hence it does not receive the thorough
salivary moistening necessary; the starches pass practically unchanged
into the stomach and small intestine, overburdening these organs.

Catarrh of the nasal passages, with the constant swallowing of
germ-filled secretions, carries morbid products into the stomach,
coating the glands with mucus, often infecting them; it may also
occasion a catarrhal condition of that organ.

If, from any cause, the saliva becomes acid, dryness of the mouth
results and desire for food is lessened or absent. Diseases of the
salivary glands may render these necessary secretions unfit to perform
their work.

In illness the mouth often drops open from weakness, producing
the same condition of dryness. The mouth, in illness, is too often
neglected by those in charge of the invalid.

Adenoids and enlarged turbinates in child or adult, narrowing the nasal
passages and preventing the ingress of air, cause mouth breathing. The
air dries the membranes and the tongue becomes swollen and cracks,
interfering with proper mastication.

Adenoids should be removed, and any other condition which interferes
with the proper function of the mouth should be remedied as soon as
possible.

The mouth should be properly cleansed, the gums massaged, the teeth
thoroughly brushed, back as well as front, defective teeth repaired or
removed, abnormal growths eliminated, and the secretions kept abundant
and healthy. Food well prepared in the mouth by thorough mastication
satisfies hunger, renders more easy the work of the stomach and
intestines, and aids in the general welfare of the system.

       *       *       *       *       *

[Sidenote: Gum-chewing]

This too prevalent habit may aggravate the condition which it is
supposed to cure. A slight indigestion appearing, gum is often chewed
to cause a fuller flow of saliva to aid digestion. If gum-chewing is
indulged in to excess, however, the muscular movements overstimulate
the salivary glands, eventually weakening them. Overuse of the chewing
muscles and overexcitation of the nerves fatigue them and cause them to
weaken. The sticky gum, adhering to fillings in the teeth, loosens them
and furnishes a lodging place for food particles and bacteria.

The excess of saliva may render the gastric juice alkaline, inhibiting
its action. Excess of air swallowed with the saliva may cause
flatulence or accumulation of gas in the stomach.

Lack of poise and nerve tension is increased by excessive gum-chewing,
resulting in fatigue of the entire body. This lack of poise may
be noted in any public assembly, as the “movies,” frequented by
gum-chewers.

The habit, as generally practiced, is not an inspiring sight and should
be discouraged.

Gum-chewing in moderation, for a few minutes after a meal, may not
do harm, but its indiscriminate use is to be deplored. Thorough
mastication of food will serve to supply the necessary saliva.

Exercise directed to the stomach and a more thorough circulation
and elimination will do more for any digestive derangement than the
excessive practice of chewing gum.

       *       *       *       *       *

[Sidenote: Stomach Digestion]

As the food enters the stomach, the gastric juice pours out from the
mucous lining, very much as the saliva pours into the mouth. Like the
saliva, it consists of 99.5 per cent. water and 0.5 per cent. solids.
The solids of the gastric juice are pepsin, rennin, hydrochloric acid,
and mucus.

The _mucus_ serves to lubricate the food as in the saliva. It perhaps
also aids to prevent the digestion of the mucous lining of the stomach.

The _hydrochloric acid_ and the _pepsin_ cause the principal chemical
changes in the food while in the stomach. They act only on the
proteins. The hydrochloric acid must be present before the pepsin can
act, as only in an acid medium can pepsin dissolve the proteins. It is
also of an antiseptic nature and hinders or prevents the decomposition
of food.

The _rennin_ ferment precipitates the casein.

The only digestion of starches in the stomach is that continued by the
saliva.

Gastric juice begins to flow into the stomach soon after eating,
but normally it is not secreted in sufficient quantity to supersede
salivary digestion for from twenty to forty-five minutes.

The result of gastric digestion of proteins is their conversion, first,
into albumin, then into proteoses, and, lastly, into peptone, which is
protein in a more simple, soluble, and diffusible form. In the form of
peptone, the proteins are in condition to be absorbed.

If the food has been properly cooked and masticated, gastric digestion
will be completed in from one and one-half to three hours. If not
properly cooked and masticated, the stomach digestion may continue from
one to two hours longer. It should, however, be completed in three
hours.

It will be seen that the evening meal is ordinarily digested before
sleep, as one does not retire for from three to five hours after eating.

If, through imperfect mastication, or a disordered condition of the
stomach, the digestion is not completed in about three hours, the
food is likely to be retained in the stomach and by its weight may
cause prolapsus of that organ if the supporting tissues are weak.
Fermentation may ensue and give rise to gases which may cause acute
distress.

Animal foods, which are readily digested, remain in the stomach for
a shorter time. Meat, as a rule, is easily digested, because the
digestive juices of the animal have converted the starches and sugars.
The white meat of chicken is digested in a shorter time than the red
or the dark meat.

Corn, beets, peas, beans, etc., take about three and a half hours to
digest; baked potatoes about two and a half hours.

Raw vegetables and fruits remain about the same length of time as
potatoes.

Sugar is usually absorbed within an hour.

The cereals, if well cooked, take but two hours.

Coarse or badly masticated food, tough meats, unripe fruits, and much
fat hinder digestion.

Undigested food passing into the intestine may fail to be acted on
there and will sometimes produce diarrhea.

Fluids leave the stomach more rapidly than solids. Seven ounces of
water entirely leaves the stomach in one and one-half hours, seven
ounces of boiled milk in about two hours. Water and buttermilk almost
immediately begin to pass out of the stomach; milk begins to pass out
in about fifteen minutes.

The flow of gastric juice, as the flow of saliva, is governed by the
nerves; the sight, taste, and smell of food, and the attitude of mind
toward it, to a certain extent, regulate its flow.

After the food has accumulated, during the progress of a meal, the
stomach begins a series of wave-like movements called peristaltic
waves.[7] These waves propel the food through the length of the stomach
towards its lower opening, known as the pyloric orifice. During this
process the food is thoroughly mixed with the gastric juice.

During the early stages of digestion of solids, the sphincter muscles
of the pylorus keep the lower opening of the stomach closed, but,
as digestion progresses, the pylorus gradually relaxes to let the
digested, soluble portion of the food pass into the intestine. If the
food still remains in a solid form, by reason of being improperly
cooked or poorly masticated, as it touches the pylorus, these sphincter
muscles, almost as if they were endowed with reasoning faculties,
close, forcing the undigested mass back to be further acted on by the
gastric juice—the solid mass is not allowed to pass until dissolved.

If the individual abuses the stomach and causes it to work overtime, it
becomes exhausted and demands rest; it refuses to discharge the gastric
juice in proper proportion; the peristaltic movements are weak; and
food is not promptly or forcefully moved along the stomach and mixed
with the gastric juice. This condition is termed indigestion.

       *       *       *       *       *

[Sidenote: Intestinal Digestion]

The food passes from the stomach, through the pylorus into the small
intestine. In this condition of partial digestion it is called chyme.

The first twelve inches of the small intestine is known as the
duodenum. In the duodenum the food is acted on by the pancreatic
juice, the bile, and the intestinal juices. These juices act on
proteins, fats, and carbohydrates. The bile acts on the fats, while
the pancreatic and intestinal juices act on the proteins and the
carbohydrates. The starches, or dextrin, not fully digested by the
saliva, are changed to maltose and glucose, while the trypsin from the
pancreatic juice, together with the intestinal juices, change into
peptone the protein not fully digested in the stomach. The pancreatic
juice also digests the starch found in raw fruits and in such raw
vegetables as radishes and lettuce.

Fats are almost entirely digested in the small intestine. The presence
of fat stimulates the flow of pancreatic juice, which, in turn,
stimulates the flow of bile. For this reason, in some conditions, if
the liver is sluggish, fatty foods in moderation are desirable. When
bile is not present in sufficient amount the fatty foods ferment and
cause gases and foul odors.

The fats are absorbed almost entirely in the small intestine—mostly
in the duodenum. Some of the fat may be absorbed directly without
undergoing the process of emulsification. Some oils, as paraffin oil,
are not absorbed at all but act only as a lubricant of the intestines.

When the food enters the intestine its reaction is acid. Mixed with
the bile, pancreatic and intestinal juices, which are alkaline, its
reaction becomes alkaline.

The pancreatic juice splits up the fats into glycerin and fatty acids
and enables the bile to exert its important emulsifying power. The bile
markedly aids this action of the pancreatic juice though it has no
fat-splitting power in itself.

Steapsin, another ferment of the pancreatic juice, acts on both fats
and carbohydrates in either an acid or alkaline medium.

The sodium in the bile unites with the fatty acid, forming a soap which
coats the tiny particles of fat and emulsifies them. The bile thus aids
in the absorption of the fats. It also lubricates the intestinal mass,
facilitating its passage through the entire length of the intestines.
Thus it is a very potent agent in regulating the bowel movements.

A diminution in the flow of bile quickly expresses itself in
constipation.

Fat and protein stimulate the activity of the liver, while starches, if
taken in excess, incline to overload it.

The food is forced along the intestinal tract by peristaltic or
muscular relaxation and contraction waves, as in the stomach. As it is
so forced, the nutrient elements, after being put into condition for
absorption, are taken up through the villi of the intestinal walls by
the portal veins and the lacteals of the submucous lining.

A larger proportion of food is digested and absorbed than was formerly
supposed, and the excretions from the intestines are, in many cases,
made up almost entirely of refuse, and of the catabolic waste of the
system. In an ordinary mixed diet, it is stated that about ninety-two
per cent. of the proteins, ninety-five per cent. of the fats, and
ninety-seven per cent. of the carbohydrates are retained by the body.

_In digestion, it is of the utmost importance that the muscular,
mucous, and submucous coats, and the secreting glands of the stomach
and intestines be kept thoroughly strong and active, that the digestive
juices may be freely poured out, the nutriment be freely absorbed,
and the food be moved along the digestive tract. The strength of any
organ is gained through the nutriment in the blood; therefore, daily
exercise, which calls the blood freely to these organs is imperative.
Daily exercise should be directed to the vital organs. A walk for
exercise is not sufficient._

       *       *       *       *       *

[Sidenote: Absorption of Food]

The greater part of the food is absorbed through the intestines, yet
some proteins which have been fully digested by the gastric juice, and
certain fats, particularly the fats in milk, which are in a natural
state of emulsion, may be absorbed through the walls of the stomach.
However, the absorption through the stomach is small compared to that
through the small intestine.

[Illustration: DIAGRAMMATIC REPRESENTATION OF VILLUS.

_a_, 1, cylindrical or “sucking” cells; 2, goblet cell; 3, capillaries;
4, food particles ready for absorption by the cells; _b_, cylindrical
and goblet cells seen from above.—Adapted from LANDOIS.]

The small intestine is peculiarly fitted for absorption. Its mucous
lining is thrown up into folds to furnish a larger surface for this
purpose. The folds hold the food as it passes toward the large
intestine, until the villi have the opportunity to absorb it.

These transverse folds of the intestinal walls are called _valvulæ
conniventes_.

The villi are tiny finger-like projections of the mucous lining of the
intestines, which stand out of the lining somewhat as the nap on plush.
They have been called “sucking” villi, because during the movements of
the intestines they seem to suck in the liquid food.

As soon as the foodstuffs—proteins, carbohydrates, and fats—are put in
an absorbable state called chyle, they are very promptly taken up by
the villi.

If for any reason the chyle remains unabsorbed, it is liable to be
attacked by the bacteria always present in the intestines, and gases
form.

The peptones, sugars, and saponified fats are rapidly absorbed, while
the undigested portion, together with the unabsorbed water, the bile,
mucus, and bacterial products, are passed through the ileocecal valve
into the large intestine.

The mass passes up the ascending colon, on the right side of the
abdomen, across the transverse, and down the descending colon, on
the left side, losing, by absorption, the small amount of foodstuffs
not absorbed in the stomach and small intestine. That the large
intestine is to some extent adapted to absorption is shown by clinical
experiments with patients who cannot retain food in the stomach, the
food in such cases being given through rectal injections.

While water and salt are absorbed in both the stomach and small
intestine, the larger part of the water passes into the large
intestine, that it may assist the passage of the intestinal contents.

Water also stimulates peristaltic movements.

As the food is absorbed through the walls of the alimentary canal, it
is picked up by the rootlets of the mesenteric veins and by the lymph
channels—the latter through the abdominal cavity are called lacteals.
Nearly all of the fats are absorbed through the lacteals. The whitish
color given to the contents of the lacteals, by the saponified fats,
gives rise to the term “lacteal.”

Nearly all of the proteins and sugars pass through the mesenteric veins
and the portal veins to the liver. Here the sugars are at once attacked
by the liver cells and built up into glycogen as described on pages 151
and 159. A small portion of the proteins, however, do not go to the
liver, but are passed directly into the lymphatics and thus into the
blood stream, where they are again carried to the liver, and the urea
is separated.

       *       *       *       *       *

To sum up, the larger part of the sugars, starches, proteins, and fats
is absorbed through the small intestine, a small amount being absorbed
in the stomach and a very little through the large intestine. While
some water and salts are absorbed in the stomach and small intestine,
these are largely absorbed in the large intestine.

       *       *       *       *       *

[Sidenote: Economy in Food]

It is economy to keep the digestive organs and the circulation and
tissues strong, in order that all foods eaten may yield returns,
instead of hampering the activity of the body.

The food which furnishes the most tissue-building substance and yields
the most heat and energy, with the least refuse, is the economical
food, provided it is varied enough to meet the psychical needs as well
as the physical.

Whether or not a food is economical depends on the degree to which it
stimulates the activity of the mind as well as the body. Preparation
and serving here are as important as the material to be served.

Economy in food is a question into which many factors should enter.
A cheap food is not always an economical food. Amount and keeping
qualities, palatability, ripeness or unripeness, the age, habit, and
occupation of the partakers, all have their share in the problem.

In the selection of food for any individual, the result to be gained
from the food must be borne in mind. If one is doing heavy muscular
work, more protein to rebuild tissue, as well as more carbohydrates and
fats to produce energy, are required than if one’s habits of work are
sedentary.

In mental work, in which the brain is continually active, proteins are
required to resupply the brain tissue, but the fats and carbohydrates
may be lessened. If the brain is sufficiently active to use all of the
fuel in brain energy one does not accumulate fat.

In sedentary occupations, which do not call for hard and continuous
mental activity, the carbohydrates and fats, if taken in excess, are
stored within the system, clogging it and producing torpid liver,
constipation, and obesity.

In a study of tables of food values, in making up a dietary, the
question should be to provide the largest quantity of nutriment at the
lowest cost, with due attention to palatability and variety.

In the selection of meats, for instance, while beef steak may cost
twice as much as beef stew, it must be borne in mind that beefsteak
contains very little waste, and that it contains a large proportion of
albuminoids, or the tissue-building proteins, while, in beef stew, bone
and connective tissue predominate. A large proportion of the proteins
obtained from the beef stew are gelatinoids and extractives—not the
tissue-building albuminoids. (See page 56.)

In comparing the cheaper and the more expensive cuts in the same kind
of beefsteak, however, the cheaper cuts often yield quite as much
nutriment as the more expensive ones. Round steak is just as nourishing
as porterhouse and cheaper, if one considers the greater number of
helpings derived from a pound of round steak than from a pound of
porterhouse.

For the aged or the invalid, however, the question of preparation will
determine the relative economy.


FOOTNOTES:

[5] For a knowledge of the structure and function of the mucous lining
of the stomach and intestines, and of the tributary glands, such as
the liver and pancreas, which is important to a thorough understanding
of digestion, the reader is referred to _Let’s Be Healthy_, of this
series. In this will be found a study of the secretion of digestive
juices, the conditions favoring normal secretions, etc.

[6] Hereafter, in speaking of sugar, after it has been absorbed into
the blood, the reader will bear in mind that the term refers not only
to digested sugar, consumed as such, but also to digested starches
(maltose).

[7] See _Let’s Be Healthy_, by Susanna Cocroft.




CHAPTER VI

ORGANS AND CONDITIONS AFFECTING DIGESTION


The purpose of this chapter is to show the work of other than the
digestive organs in assimilation, construction, and elimination.

The _liver_ is commonly called the chemical workshop of the body. The
digested food is carried by the blood (portal veins) to the liver as
soon as it is absorbed from the alimentary canal. As the food materials
filter through the blood capillaries, between the liver cells, several
substances are absorbed, particularly sugar, which is changed into the
animal starch called _glycogen_. It is held in the liver for a few
hours in this form and is then redigested and gradually given to the
blood in the form of sugar.

While the conversion of the sugar is one prominent function of the
liver, it also acts on the proteins—not as they are first passed
through the liver in the blood, but as they are returned to the liver
from the muscle tissue, partly oxidized and broken up into simpler
products. The liver cells absorb and further oxidize and combine them
into nitrogenous waste, which the kidneys throw off in urea.

The liver and the spleen also dissolve the pigment or coloring matter
out of the red blood corpuscles. As these become useless, they are
broken up in the liver and the spleen. The iron is retained by the
liver cells and the remainder is thrown off in the bile.

The liver is on guard for all poisons which pass through it in the
blood. The large part of these toxic substances are absorbed through
the alimentary canal with the foodstuffs. Many of them are the result
of the fermentation of foods which are not digested so promptly or so
thoroughly as they should be, on account of an insufficient secretion
of digestive juices, or on account of a failure to secrete them in
normal proportions, due to inactivity of the stomach and intestines.

Nature thus supplies a guard to oxidize, or break down these poisons
and make them harmless, so that normally they do not affect the nerves
and the blood stream, and, through these, the entire system.

The necessity of correct habits of deep breathing will be readily seen
here, because oxygen is required to break down the poisons as well as
to oxidize the worn-out tissues.

One example of the action of the liver in rendering substances
harmless, is its oxidation of _alcohol_. From one to three ounces of
alcohol a day may be oxidized and made harmless in the liver, varying
according to the individual and to the condition, at different times,
in the same person. If the limit of one to three ounces is exceeded,
the excess is not oxidized and intoxication results. This is the reason
one may become intoxicated at one time when the same amount of liquor
would not appreciably affect one at another.

The _muscles_ play an important part in the use of foods. Most of the
heat is generated in them by the action of the oxygen in the blood
upon the sugar and fats, liberating their latent heat. This heat is
liberated during every moment of the twenty-four hours whether one is
asleep or awake. Of course, more is liberated during exercise, since
the movement of the muscles sets all tissues into activity and the
blood circulates more strongly, bringing a greater supply of oxygen to
them.

It is always well during active exercise to stop frequently and fully
inflate the _lungs_, not only to bring more oxygen to the blood, but
to change the residual air and in the inflation to exercise the lung
tissue more freely, bringing a better supply of nourishment to it. We
forget that the lung tissue as well as every other tissue of the body
needs exercise and a full supply of nourishment.

One should form the habit of breathing fully and deeply—otherwise the
liberated carbon dioxid will cause an increased pressure throughout
the blood stream, particularly about the heart and in the head. This
pressure is relieved when the excess of carbon dioxid has been thrown
off by the lungs. Much dull headache is due to the retention of carbon
dioxid resulting from shallow breathing.

Nature makes the effort to throw off this excess of carbon dioxid by
forcing one to breathe more rapidly while running or taking unusual
exercise.

A certain amount of protein is constantly oxidized in muscular action
also, being broken down into carbon dioxid, water, and a number of
nitrogenous mid-products. The carbon dioxid and water are thrown off
by the lungs, and the partially oxidized nitrogenous waste is carried
to the liver, where it is further oxidized and prepared for excretion
through the kidneys, lungs, skin, and intestines.

Through their stimulant action, the _nerves_ aid in oxidizing food
materials. During periods of rest, food materials are also stored in
the nerve cells. During nervous activity they are oxidized and carried
away through the blood and the lymph. This oxidation of the food,
stored in the nerves, creates nervous energy and heat.

The energy liberated by the nerves resembles electrical energy.

When one is continuously using an excess of nerve activity, all reserve
food material, stored in the nerve cells, is used and the nerves become
undernourished. The result is seen in neurasthenic conditions of
various kinds.

The nerves as well as other tissues require protein to renew their
substance as well as fats and carbohydrates for their energy.

The vasomotor nerves influence digestion to a marked extent by
regulating the blood pressure in the digestive organs and the
consequent rate of speed with which digestion and absorption take
place. They speed up or slow down the movements of the alimentary
canal, thus aiding and preventing the admixture of the food with the
digestive juices. By acting on the glands, they aid or prevent the
secretions from being formed and poured out. They thus materially
affect digestion.

The vasomotor nerve centers are in the medulla oblongata.

The _lungs_ absorb oxygen and eliminate carbon dioxid. They
occasionally throw off a very little organic material.

The carbon dioxid is carried to the lungs from the tissues through the
venous stream and diffused through the walls of capillaries in the
lungs. The oxygen is absorbed in the thin air sacs in the capillary
walls.

If the lungs are cramped by a faulty position of the body, by excess of
fat, or by tight clothing, they cannot expand to their fullest extent.
The blood is thus imperfectly aërated and oxygenized and is not freed
of its waste. The lung tissue is imperfectly exercised, sufficient
blood not being brought to the lung cells to insure their strength.

The cramping of the lungs is due largely to incorrect habits of
standing and sitting.

The _kidneys_ do not absorb as do the lungs, neither do they perform
any anabolic work as does the liver, nor catabolic work as the muscles,
nerves, and the liver. They simply throw off waste matter.

As the blood passes through them urea, uric acid, urates, sulphates,
and sodium phosphates pass from it and with the water are thrown from
the system; hence the kidneys are purifying organs, as are the lungs.
The blood returning from the kidneys through the veins is pure, just as
the blood in the pulmonary vein is pure, while that in the arteries to
the kidneys is impure.

Interference with the action of the kidneys results in an excess
of these substances in the blood and may produce a condition of
intoxication known as uremic poisoning.

The _skin_, by pressure on the capillaries, controls, to some extent,
their dilatation, and thus prevents an excessive loss of fluid. When a
portion of the skin is removed by accident, as after burns, drops of
moisture may be seen gathering on the denuded surface and may result in
considerable loss if the denuded surface is large.

The skin is a protective covering. We are constantly surrounded with
bacteria, dirt, etc., and the skin prevents their absorption.

It contains glands which secrete a fluid fat. This keeps the skin
soft and flexible, preventing it from becoming too dry. The skin also
prevents the underlying tissues from injury through abrasions or
contact with foreign substances, as in various industries.

It also contains sweat glands, which throw off body waste in the form
of salts and moisture in the perspiration; this helps to regulate the
body heat and to aid in keeping the skin soft.

The kidneys and the skin are interdependent; if the kidneys are
inactive the skin must throw off a larger quantity of waste and if
the skin is inactive, or if for any reason its pores are closed, the
kidneys become more active.

The skin also throws off carbon dioxid and, to a slight extent, it
absorbs oxygen.

Besides digesting and absorbing food, the _intestines_ eliminate waste.

In their work of elimination, they pass off all undigested matter. They
also carry off bile pigment, bile salts, mucus, other decomposition
products—also a little unabsorbed fat.

Coarse articles of food containing fibers which do not digest, such
as the bran of grains and the coarser fibers of fruits and vegetables
(much of their substances are not food in the strictest sense), are
valuable, as they increase the peristaltic movements of the intestines
and assist in carrying the waste excretions along their course.

The intestines also carry off the organic refuse which is produced by
the chemical action of oxygen. This refuse consists of carbon dioxid
and the nitrogenous waste.

Combustion, or burning of fuel in any form (oxidation to release latent
heat and energy), always leaves a residue, and it is the work of the
intestines to eliminate much of this refuse. When coal is burned, gas,
smoke, ashes, and cinders constitute the waste; if these were not
allowed to escape or were not removed from a stove the fire would soon
go out—the smoke and gas would smother it and the accumulation of ashes
would prevent the circulation of oxygen.

This is true in the body—the carbon dioxid not being allowed to pass
off would soon put out the fires of life; it would poison the body
and inhibit the action of the nerves. If the waste is not thrown from
the system we notice it in a feeling of lassitude, both mental and
physical. If the nitrogenous waste (like ashes and cinders) is not
eliminated, one will die in convulsions in a few days.

The absolute necessity of a free elimination of waste will be readily
seen. If the engine is to do its work, the engineer sees that it is
kept perfectly clean—otherwise it becomes clogged, works inefficiently,
and soon wears out. The same is true in the body—clogging in any part
overworks and wears out other parts dependent on the work of the
defective one.

Constipation, or a failure of the intestines to eliminate the waste
is a grave menace to the system. The poisonous gases accumulating are
absorbed by the system.

The _blood_ carries the digested food and the oxygen to the various
tissues and organs, which select from among the nutrients offered to
them the ones suited to their growth and repair.

It is the universal medium of exchange.

It carries carbon dioxid to the lungs and the wastes of the tissues to
the other eliminative organs.

It carries impure material to the purifying organs, and pure material
away from them.

When it is lacking in quality or quantity the body suffers and if the
lack continues the body dies.

Every organ contributes its share to the work of the blood and every
organ takes from the blood some of its elements. If the blood pressure
is too low, stagnation may occur. If it is too high an abnormal
condition of the system results.

In fact, on the condition of the blood depends the effective working of
the entire organism.

Constant effort then should be intelligently exerted to eat the proper
foods, to exercise judiciously, to think healthful thoughts, to secure
thorough elimination of waste in order that the whole body shall be fit
for the work which its owner desires it to do.


_SUMMARY_

The processes which the food undergoes in digestion—conversion into
condition to be absorbed by the body; in absorption through the walls
of the intestines and stomach, and the metabolic processes which it
undergoes in being converted into heat and energy and again broken down
and eliminated as waste, are, in brief, as follows:

_The Saliva_ begins the digestion of starches and sugars in the mouth,
and continues this digestion for a time in the stomach.

_The Stomach_, when in normal condition, digests the proteins. If any
proteins fail of digestion in the stomach the process is completed in
the intestines. It has little absorptive power.

_The Small Intestine_ digests and absorbs the fats and continues the
digestion of starches, sugars, fats, and proteins, when this digestion
is not completed in the stomach.

The large part of the food is absorbed through the small intestine,
though a small part is absorbed through the walls of the stomach and
through the large intestine.

Fats are almost entirely absorbed in the small intestine. They are
absorbed through the lacteals and are carried into the blood-stream.

The intestines, aside from their work of digestion and absorption,
excrete bile pigment, bile salts, mucus, and other decomposition
products, also such food materials as are not digested.

_The Liver._ The proteins, the starches (converted into maltose),
and sugars pass into the liver. The sugar (including the sugar in
vegetables, milk, fruits and that used for sweetening as well as the
carbohydrates which have been changed into maltose) is converted into
glycogen in the liver, stored for a time, and again broken down into a
condition in which it may be absorbed into the blood.

The proteins pass through the liver but are not acted on by this organ
until they again return to the liver through the blood stream, after
they have been partly oxidized in the tissues. The liver further
oxidizes them, putting them into condition to be excreted by the
kidneys and intestines.

The liver also breaks up the worn-out red corpuscles putting them into
condition to be eliminated in the bile.

It oxidizes and renders harmless poisonous substances absorbed in the
food, such as fermented food products and alcohol.

The _Muscles_ oxidize the fats and sugars liberating the latent heat
and energy. They partly oxidize proteins which are further broken up in
the liver.

The _Nerves_ oxidize food materials stored in the nerve cells,
providing nervous energy.

The _Lungs_ absorb oxygen and throw off carbon dioxid, watery vapor,
and some organic substances.

The _Kidneys_ and the _Skin_ excrete water, carbon dioxid, and
nitrogenous waste.

The _Blood_ carries the vital elements derived from the food to all the
organs and tissues, keeping them alive and actively functioning. It
also carries waste products to the skin, lungs, kidneys, and intestines
for elimination.


_FACTORS INFLUENCING DIGESTION_

As before stated, it is not the food eaten, but that which the body
digests and assimilates, or appropriates to its needs, which counts.
Many factors influence such nourishment. The principal aids are a
forceful circulation, the plentiful breathing of oxygen, and free
elimination.

       *       *       *       *       *

[Sidenote: The Appetite]

If one has no appetite, we have been told in the past to abstain from
food until the system calls for it, or to eat but a very little of the
lightest food at regular meal times. This is right, but it deals with
the effect and not the cause of the lack of appetite.

The chances are that this lack is due to retained waste. Whenever there
is too much waste in the system, the chances are that the digestive
organs will not call for more food, and when the appetite is lacking
the effort should be made to see that the system is thoroughly clean.
Every muscle and tissue must be relieved of the excess of waste. The
correction of the lack of appetite, then, is not only abstinence
from food, but brisk exercise, plenty of fresh air in the lungs,
free drinking of water, and the elimination of the waste through the
intestines, skin, lungs, and kidneys.

One should not be led into forming the habit of irregular eating,
however. The stomach forms habits and the supply of food must be
regular, just as the nursing child must be fed regularly, or digestive
disturbance is sure to result.

Care should be taken not to eat between meals nor to eat candy or
indigestible foods.

The lack of appetite may be due to mental preoccupation which does
not let the brain relax long enough for the physical needs to assert
themselves. One should relax the brain in pleasant thought during the
meal.

But the chief thing to bear in mind is to create the demand for food by
relieving the system of its waste, by calling for more supply to the
muscles through exercise, and by giving the system plenty of oxygen
through deep breathing.

The appetite is partly under control of the will and may be trained. It
is more or less capricious and may be satisfied with little, or it may
demand large amounts of food. Grief or worry will destroy it, as will
foul air, and overfatigue.

A voracious appetite may be due to an irritation of the nerves of the
stomach or to a disturbance of digestion of one kind or another. This
is shown by the fact that sometimes those with abnormal appetites are
thin and undernourished because of non-digestion of the food. If the
food is eaten slowly and well chewed, the desire for too great an
amount will be lessened. The food will also be better digested.

The chalk-eating, clay-eating, salt-eating habits are well known. The
desire is largely mental and may be treated by substituting healthful
thoughts for morbid longings, and changing the monotonous or restricted
diet for one more liberal.

If the appetite is lacking because of physical exhaustion, it is unwise
to eat, because the digestive organs are tired, and to load a tired
stomach with food, still further weakens it and results in indigestion.
The better plan is to drink two glasses of cold water and lie down for
an hour.

Lack of appetite and the taste for highly seasoned food may come from
a monotonous diet or one that does not contain sufficient coarse food
or sufficient water to stimulate peristalsis; the result is stagnation
and constipation, with the disorders that follow in its train. The
monotonous diet, from its effect on the mind, results in lack of desire
for food. Both the condition and the appetite are often stimulated and
changed by a greater variety in the kinds of food.

Care should be taken not to form the habit of using stimulants too
freely, particularly with children.

Condiments and stimulants, used to make the food “appetizing,” unduly
stimulate the nerves, and pervert the natural taste, and foods
containing their natural amount of spices or extractives no longer
tempt one. Those whose nerves are highly keyed, form the habit of
seasoning the food too highly. This undue stimulation calls for more
food at the time of eating than a normal appetite would demand. The
taste being cultivated for the stimulant, the habit of eating too much
food is formed.

A wise provision of Nature makes the system, in a normal condition,
its own regulator, protesting against food when it has not assimilated
or eliminated that consumed. One should learn to obey such protests
and cut down the quantity when Nature calls “enough,” and exercise to
eliminate waste, thus creating a better assimilation. Nature does not
call for more food until she has eliminated the excess of waste.

There are exceptions, however. Some phases of indigestion cause a
gnawing sensation in the stomach which is often mistaken for a desire
for food. This is not a normal appetite. Water will usually relieve it.

Often loss of appetite is the result of a clogging of the intestines
or liver, or is due to an excess of bile, which, not having been
properly discharged into the intestines, has entered the blood stream
or regurgitated into the stomach. A torpid liver often expresses itself
in a dull mental force, the toxins deadening the nerve cells.

The lack of desire for exercise of those living in warm climates
results in a sluggish activity of the system. As a result it demands
less food, and habits of excessive seasoning to stimulate the appetite
have been formed.

The desire for excessive stimulants, such as salt, may be a cultivated
taste and the habit should be corrected.

There is a difference between the cultivated and the normal appetite.
A child rarely shows a desire for stimulants such as tea or coffee,
excessive salt, pepper, pickles, catsups, etc., unless unwisely
encouraged by an adult, who does it, _not because it is food for the
child, but because the individual himself has cultivated a taste for
it_.

It is as easy to form healthful tastes and habits of eating as
unhealthful ones, and care should especially be exercised over the
formation of healthful habits in the growing child.

One should not allow himself to become “finicky” or no food will give
him its best service.

Time, energy, muscular activity, nerve force, and money are spent in
combining, seasoning, and cooking foods in such a manner as often to
render them difficult of digestion.

Let me repeat for emphasis—_when the appetite wanes, deep breathing of
fresh air to supply an abundance of oxygen to oxidize the waste, thus
putting it in condition to be expelled from the system, brisk exercise
to accelerate the circulation, that the blood may carry the oxygen
freely and that the tissues may liberate the carbon dioxid and other
waste, and a copious drinking of water, are the best tonics for loss of
appetite or for a lack of vitality_.

       *       *       *       *       *

[Sidenote: Season and Climate]

The food required by the body varies according to the season of
the year and the temperature. Thus, during cold weather, the body
craves hot foods and drinks, and the heavier foods which furnish more
heat-producing elements. In summer, the lighter foods, fruits, and
the proteins supplied in green vegetables instead of in meats, are
relished, and cold foods and drinks are desired as aids in equalizing
the heat of the body. The total amount of food taken in summer may
be lessened because so much food is not required to maintain the body
heat and energy. The lessened amount puts less strain on the digestive
system.

Owing to the increased perspiration, the desire for water is greater
in summer, while in winter or in cool weather, from the opposite
condition, the quantity of water taken is usually insufficient.

In travel, when one shifts with more or less rapidity from one
temperature to another, the diet should not be altered too greatly or
too suddenly; the system must be allowed time to accommodate itself to
the change.

The occupation must be taken into consideration. Great muscular
activity requires a more liberal diet than a sedentary habit, no matter
what the climate may be.

Certain tribes that inhabit the tropics subsist almost entirely on
meat, while many of the inhabitants of Russia and Norway live on
breadstuffs almost to the exclusion of meat.

       *       *       *       *       *

[Sidenote: Age]

It is quite obvious that the food should vary according to the body
needs. The needs of the adult, the child, and the infant vary. The baby
may not take the food which is required by the child from the age of
three to ten, and the aged, not exercising vigorously, does not need
the hearty food of the growing child or the active adult. The need for
food depends, however, on activity more than on years.

It is more difficult to make those in middle and old age, who are
not active, realize that the body no longer needs so much food, due
to the fact that it is not so actively building tissue, and that an
oversupply causes a serious tax on the digestive system. It brings in
its train ills which might easily be avoided by simpler habits and a
little study of the actual needs of the body.

More food than the activity of the system demands, taken in later or
middle life, causes most of the diseases which afflict this period.
Obesity, arteriosclerosis, liver disease, gastro-intestinal diseases,
biliousness, kidney diseases, gout, and allied conditions, can all be
traced to an overtaxed digestive system, with faulty elimination and
weakened organs. These show the rebellion of Nature at being compelled
to work overtime.

While these diseases are most frequent after forty, the condition of
the system which designates age is not always measured by years.

In the ordinary individual who has allowed himself to sit and become
lazy in his habit of life, certain changes in the system occur and the
body needs less food than is required in more active life. There are
not such heavy calls on reserves for repair, either of nerve force or
of material.

Unless active exercises and interests have been kept up, the muscular
system begins to deteriorate, the heart action is slower, and there is
a lessening of nerve tone. Relaxation of the digestive and intestinal
organs occurs, peristalsis is less vigorous, and the glands become
less active, owing to the lessened call for energy. From this cause,
unless the amount of food is reduced in proportion to the body needs,
constipation and other digestive derangements may result.

If one stops physical and mental activity at any age, the vital forces
recede, muscles and vital organs become weak and inactive, and the
waste of the system is not fully eliminated. Such a man at thirty or
forty is physically and mentally older than the man who is in active
business or is taking daily vigorous exercise, at seventy or eighty.
The latter may follow the same diet which he followed at fifty, while
the former should follow the diet of the old man who has stopped active
work.

Young men who through excessive drafts on their vitality have exhausted
their forces often act and look twice their years. For these the diet
should be simple, easily digested, and nutritious, and often reduced in
quantity.

Formerly it was thought that at fifty years of age a man or a woman
was on the down-hill slope; they were considered “aged.” Owing to the
discoveries of scientific tests of the condition of arteries and vital
organs, it is now known that years do not play so large a part in the
matter of age.

A man or a woman at fifty, who is in vigorous mental and physical
health, is in the prime of life, while many from twenty-five to thirty,
who have dissipated their vital forces, may be said to have entered the
age of decrepitude. The saying, “Man is as old as his arteries,” should
be expanded to “Man is as old as his tissues.”

People have thought too long that age is a matter of years. They
need to be aroused to recognize the fact that the condition of age
is a matter of health of body and mind; that the spirit, which sees
to it that the body which it inhabits is kept vigorous and strong by
healthful and happy thoughts and an active interest in the world’s
affairs, is “young,” no matter what the years number. Optimism and
cheer keep one young; pessimism and habits of mental depression age
one.

One of the encouraging signs of the times is that more and more
people are learning to know that their activities need not be given
up because they have reached a certain age. If the children which
formerly needed care, have grown and gone to homes of their own, the
activities of the mother and father are freed to find vent in other
directions. If children no longer need immediate care, the parents
have time to make better conditions for the children of others less
fortunate. They should interest themselves in public questions that
affect these children and their own, indirectly if not directly. New
life and strength have been found by many by changing their activities
and keeping the thoughts young and the interest vivid. The body will
respond marvelously to the mandates of the inner self.

       *       *       *       *       *

[Sidenote: Habit and Regularity of Eating]

There is no doubt that the _habit_ of eating governs one’s convictions
of what the system requires. One is inclined to think that a desire
for a food is a requirement of Nature; yet it may simply be the
continuation of a habit due to indigestion.

Chronic abnormal functioning of the organs, such as is seen in
indigestion, constipation, sluggish liver, etc., are physical habits.

If a mother feeds her babe every three hours the child will usually
wake and call for food about this period. If she has formed the habit
of nursing the child every two hours, it will call for food in about
two hours, even though all symptoms indicate that the child is overfed.

It is important that both child and adult establish regular and
hygienic habits because the digestive juices secrete themselves at the
regular periods established. _A right habit is as easily formed, and as
difficult to change, as a wrong one._

If one forms the habit of eating a certain amount of food, the stomach
calls for about the same amount, and when one first begins to change
the quantity it protests, whether the change be to eat more or less.

Few people form the habit of drinking sufficient water, particularly if
they have been taught that water at meals is injurious. In this busy
life, few remember to stop work and drink water between meals, and if
not consumed at the meal time the system suffers. Many people look
“dried up.”

The habit of drinking two glasses of water on first arising, and six or
eight more during the day is an important one.

There is no doubt that a large number of people constantly overload the
digestive organs. This, as well as the bolting of food, insufficiently
masticated, cannot be too strongly denounced. _All food should be
chewed to a pulp before being swallowed._

       *       *       *       *       *

[Sidenote: Frequency of Meals]

To avoid overeating, many theorists are advocating two meals a day.

When two meals a day are eaten, the first meal should be at nine or
ten o’clock in the morning and the second meal at five or six o’clock
in the afternoon; whereas, for the average person who eats two meals
a day, this custom means that he goes without food until the midday
meal and then eats two meals within six hours, with nothing more for
eighteen hours.

The argument in favor of two meals a day has been that the digestive
system is inactive during sleep, and, therefore, it is not ready for
a meal on arising. Pawlow’s experiments, however, show that digestion
continues during sleep, though less actively; and it must be borne
in mind that the average evening meal is eaten about six o’clock and
that there are about four waking hours between this meal and the sleep
period; also, that the average individual is awake and moderately
active an hour before the morning meal. This gives five waking hours
between the evening and the morning meal. About the same time, five
hours, elapses between the morning and the midday meal, and between
the midday and the evening meal, so that three meals a day divide the
digestion periods about evenly. If the amount of food supplied by two
meals seems to be sufficient for the needs of the individual, and it is
not practical to eat at the hours stated, then omit the midday meal.

In the strain of business life, returning at once to work, after the
eating of a heavy meal in the middle of the day, calls all of the
surplus blood to the brain; this, in many cases, results disastrously.
For this reason, the taking of the heavy meal at night, when the system
may relax and time be given to proper digestion, has come to be an
institution of city life.

More frequent meals, served in lighter quantity with greater
regularity, so that the system is not overloaded at any one meal, is
rational for delicate or undernourished nerves and tissues.

The reason invalids or those whose digestive organs are delicate should
have the heaviest meal at midday, is because the vigor of the system is
greater at this time than later in the day; the increased temperature
in fever in the late afternoon retards assimilation. Those whose
digestive organs are delicate should not be confined to three meals a
day if less food taken oftener is better borne and assimilated, but the
meals should be at regular times.

       *       *       *       *       *

[Sidenote: Effect of Exercise and Breathing on Digestion]

Food is stored in the muscles for immediate use when needed. If all of
the food supplied to the muscles is not used for their daily needs, an
excess accumulates unless the muscles are exercised sufficiently to
use up the supply. A constant accumulation results in obesity. This
condition, by overlaying the organs with fat, compresses them and
hampers their activity. If the accumulation continues it ultimately
causes a degeneration of the tissues. Apoplexy occurs in those carrying
an excess of fat due to a weakening of the walls of the arteries of the
brain.

The blood, owing to variations in the external temperature, has
a tendency to retreat from the skin through contraction of the
capillaries and to engorge the internal organs. Exercise brings the
blood to the skin and muscles, causing the waste, broken down by the
chemical activity going on every instant of life, to be picked up by
the blood and carried to the eliminating organs. Therefore, since
the blood is needed in the digestive organs during digestion, active
exercise should not be taken immediately after meals.

Exercise taken in the proper amount and at proper times uses up the
excess of material, benefits digestion, aids the work of the liver
and intestines, keeps the circulation active, the waste eliminated,
and results in a feeling of vigor and fitness for one’s work whether
physical or mental.

Exercise should be counted as a necessary part of one’s daily
activities—as necessary as eating one’s meals. If faithfully done the
habit will be formed and the system will soon call for exercise as it
does for food.

The young child’s blood circulates freely, his breathing is
unrestricted, the waste of the system is fully burned up, potential
energy is released, and the result is, he must be active. The effort of
the teacher, or of those having the care of children should be, not to
restrain the child but rather to direct his activity in advantageous
and effective use of his energy.

A little child is an object lesson in alternating exercise, sleep, and
food. Almost every waking moment a child is squirming, twisting, and
turning, using every muscle of his little body, particularly every
vital organ. No excess of waste accumulates in his tissues. The adult
does not, as a rule, twist or turn or freely stretch the muscles of the
vital organs. The child and the animal stretch and yawn to start the
circulation whenever they awaken from sleep. This is instinct—Nature’s
law. Man jumps out of bed and begins dressing with mind bent on the
business of the day.

The necessity of oxygen is evident. The body will subsist about
forty days on the food stored within it without resupply, but it can
endure only a few seconds without oxygen, because heat, occasioned by
the chemical action of oxygen, is necessary to keep up the physical
activity termed “life.” Carbon dioxid (carbonic acid gas) accumulates
and poisons the system.

_The necessity of habits of full, correct breathing cannot be too fully
emphasized._

The quantity of oxygen daily consumed should equal the sum of all other
food elements.[8]

Oxygen is necessary in the combustion of fats, starches, and sugars, as
it is necessary in the combustion of carbon in wood or coal, and, as
explained on pages 123 and 124, oxygen is necessary to keep the body
warm.

Deep breathing aids digestion and assimilation, not only because of the
regular exercise given to the pancreas, the spleen, the stomach, and
the liver by the correct movement of the diaphragm, but also because of
the latent heat which the oxygen liberates within the digestive organs
and out among the tissues.

While the chemical action of food creates activity within, this
activity is materially aided by exercise. Exercise and oxygen are also
necessary for chemical action in tearing down waste and in putting raw
material into condition to be appropriated to the body needs.

_Two glasses of water in the morning and fifteen minutes of brisk
exercise in well-selected movements, to start a forceful circulation
and to surge the water through the digestive organs, are a daily
necessity if one is to keep clean and strong within._

Exercises should be interspersed with deep breathing of _pure_ air.

In breathing guard against drawing up the chest; make the muscular
effort, while practicing full breathing, to expand the entire rib cage,
back, front, and side.

_It is as important to cleanse the body within as without. It is the
method employed by all men and women who would retain strong vital
forces to a ripe old age. They fully enjoy the mere_ LIVING.

       *       *       *       *       *

[Sidenote: Ventilation]

It is of the utmost importance that one not only forms the habit of
correct, full breathing, but also sees to it that the air in the home,
or in the place of business, is pure. A window opened at the top and
bottom is essential in any place of business—or at least a draft
through the room.

There should be plenty of _circulating_ air in the sleeping room. Many
restless nights are due to stagnant air.

Teachers find that when they keep their schoolrooms well ventilated
the children are less restless, their minds are more alert, they more
quickly comprehend what is said to them, and that both they and the
children are much less fatigued at the end of the day.

Proper ventilation, and proper exercise have so definite a bearing
on the condition of the body which we term “tired” that this subject
properly follows.

       *       *       *       *       *

[Sidenote: Fatigue, Disturbed Balance]

Since the condition of the body in fatigue so materially affects
the digestion, absorption, and assimilation of food, as well as the
elimination of waste, it is not amiss to discuss it here.

The habit of eating when overfatigued is almost sure to result in
indigestion. Muscular or mental activity has called the blood away from
the digestive organs and enough time has not elapsed to restore the
equilibrium. The digestive organs are not in condition to take care of
the food promptly and fermentation begins.

A few minutes of active exercise and deep breathing for the brain
worker, or a half-hour of rest after muscular activity, will equalize
the circulation and restore the blood to the stomach and intestines.

People fail to remember that the amount of blood in the body is a fixed
quantity, and if an excess of it is called to one portion, the supply
is lessened to other portions.

The regular work of the body in keeping up the heart action and the
circulation requires a certain amount of energy produced by a certain
amount of oxidized foodstuffs. The system in normal condition,
with normal breathing, readily furnishes this energy. If more than
the normal amount is used in increased work, greater combustion is
necessary. The extra amount of waste which has been liberated by this
extra work must also be carried away. If combustion does not take
place, the extra energy is not supplied, and that required for the
constant bodily needs is called on.

If the waste is not removed from the system and the energy not
resupplied to the parts doing the extra work, the muscles, nerves, and
tissues are then in the state termed “tired.” They remain so until the
circulation has carried the waste to the eliminating organs and has
brought more foodstuffs to the tissues, thus restoring more energy than
is needed for the work constantly going on in the body.

It must be remembered that for combustion oxygen is required and if
undue energy is necessary deep breathing is imperative.

_The relief, then, from the state of the body we call fatigue is
in equalizing the circulation through exercise or rest, according
to the occupation, and supplying oxygen through full breathing._
This more forceful circulation calls the blood from the unduly
distended capillaries, removes the waste, and brings a new supply of
energy-building foodstuffs.

In mental work, the nerves and the brain call for the surplus energy,
while in muscular work the tissues require it, hence undue work, either
mental or physical, expresses itself in bodily fatigue, until the
demand in all parts of the body is equalized.

When equilibrium is restored, the body is “rested.”

The relief from fatigue due to mental activity is in exercise and deep
breathing.

Carbon dioxid dulls the nerves of sensation and the brain action and
may produce more or less stupor. It may be because the circulation in
some part of the body is sluggish (most often the portal circulation
through the liver), so that sufficient oxygen is not carried to that
part.

Relief from this “inertness” is experienced most quickly by exercise to
quicken the circulation and supply the oxygen. Exercise in one’s room
by the open window, or at least with the air in the room pure, is often
preferable to outdoor exercise, because the body can be nude, or so
loosely clothed that the oxygen may not only enter the lungs but also
circulate about the skin.

Fifteen minutes of brisk exercise in one’s room is better than a
five-mile walk, because if the exercises are intelligently selected,
every organ and tissue is used, while walking exercises only about
one-fourth of the muscles.

After sleeping in a room in which the air is impure, one arises
fatigued, because the supply of oxygen is insufficient to liberate the
energy required for circulation and catabolism.

_Harmony_, either mental or physical, _is rest_.

With a little more intelligence in keeping up the supply of oxygen, in
establishing correct breathing habits, and in understanding the law of
distribution of circulation, which means the harmony of forces, this
tired world could not only draw a deep, restful breath, but would be
invigorated to enjoy life to the full.

       *       *       *       *       *

[Sidenote: Sleep]

During sleep all the processes of the body are retarded.

Blood flow and breathing become slower and the digestive processes
slacken. For this reason, if one goes to bed immediately after eating
a heavy meal, digestion is retarded. This may react on the nerves,
producing fitful or unrestful sleep. Fever or nightmare may result. The
annoying, sleepy feeling which often comes on after a meal indicates
a lack of balance in the system—usually that more food has been eaten
than the body requires. Lessening the amount of food and increasing
the exercise and the oxygen, and cleansing the intestinal tract will
prevent it.

On the other hand, if the alimentary tract is entirely empty, sleep
may not come because there is too much blood in the brain. A glass of
hot milk or cocoa, or a couple of crackers, will call the blood to the
stomach and will often aid sleep.

After eating a heavy meal, from three to three and a half hours should
elapse before retiring for sleep.

       *       *       *       *       *

[Sidenote: Influence of the Mind]

The state of mind has much to do with regulating the digestive system.
Cheerful thoughts keep the nerves of the entire organism in a normal
state, while disagreeable thoughts cause a tense, unnatural condition.

The nerves of the digestive organs are affected by the tenseness of
the mind, just as are the nerves to any other part of the body. As an
illustration, if one continuously thinks ugly, disagreeable thoughts,
these thoughts affect the chemical activities of digestion and
assimilation, resulting in an excess of acid in the blood, and actual
illness results. Digestion and assimilation being impaired, the tissues
become weakened, they lose their resistance, and, as a result, the
organs may prolapse. We then have what is called a “vicious circle”—the
mind affects the body unpleasantly and the body the mind.

We are learning to consider many factors in looking for the causes of
disease, particularly those due to general weakness, or a disturbed
mental state. Even the temper shown in a crying babe may affect its
digestion by disturbing the normal chemical activity.

Among the blood and digestive disturbances which may result from
anxiety, worry, fear, or disagreeable thoughts, are anemia,
neurasthenia, indigestion, constipation, prolapsed viscera, and, in
fact, all diseases which result from faulty nutrition and resultant
weakened tissues.

Disagreeable thoughts affect the appetite, in fact they sometimes cause
it to be entirely lost.

All so-called “new thought,” “ologies,” or “isms,” conducive to the
formation of the habit of looking on the bright side of life, or of
looking for good and joy in life, of kindness, love, and helpfulness,
favorably affect the digestion and consequently the health. The
practice is Christian _Sense_.

The nerves control the peristaltic movements of the stomach and the
action of the absorptive cells, as well as the cells which secrete the
digestive juices. Thus it is that a food which one likes is not only
more palatable, but it will also digest more readily, the digestive
juices flowing more freely because of the mental stimulus.

It is well, therefore, to begin the meal with something especially
appetizing, that the flow of the digestive juices may be incited. For
this reason, if one cares for fruit, it is an excellent custom to begin
the meal with fruit, or with a well-made soup, containing protein
extractives, which will stimulate the flow of digestive juices.

The habit of finishing a meal with some tasty dessert is based on the
scientific principle that its palatability will cause the gastric
juices to flow more freely after the meal, thus aiding in its digestion.

Dainty service in a sick-room, because of the psychic effect of a meal
daintily served, is of utmost importance. Because of the effect on the
mind, the sight of a meal served on soiled linen will almost stop the
flow of gastric juice and will destroy the desire for food, while a
meal well served on dainty linen, with garnishings and tasteful table
decorations, incites the flow of gastric juices.

The careful wife and mother, who notes any failure of appetite in
members of her family, should attend carefully to the garnishing of
her dishes and to serving them in a neat, attractive manner; also to
changing her table decorations, so far as may be consistent that the
eye as well as the sense of smell and taste may be pleased and the
effect of the mind on digestion be exerted.

It is strange, but it is true, that a fresh flower, or a new table
decoration, may so pleasantly affect one afflicted with nervous
indigestion that the meal more readily digests, while an untidy table,
or a lot of food served untidily will retard digestion.

The custom, among hearty eaters, of serving a plate too plentifully,
destroys the appetite of one whose digestion is not so active. Our
grandmother’s overloaded table, with sufficient food of various kinds
to serve many times the number of participants, might stimulate the
appetite of hearty, strong men, but the very sight of so much might
turn the appetite of one more delicate.

The mind must be relaxed and directed to pleasant themes during a meal
or the condition of the nerves of the digestive organs will not permit
a free secretion of digestive juices. Chronic indigestion is sure to
result from this practice. Dinner, or the hearty meal at night, rather
than at noon, is preferable for the business or professional man or
woman, because the cares of the day are over and the brain force
relaxes. The vital forces are not detracted from the work of digestion.

Foods which are forced down, with a mind arrayed against them, do not
digest so readily, because the dislike hinders the flow of the gastric
juices. Any food fails of prompt digestion when the nerves controlling
the stomach are acting feebly; however, while they digest more slowly
during mental protest, they _do_ nourish the system.

Likes and dislikes are largely mental. Certain foods continuously
disagree and they should be avoided; but many abstain from wholesome
food because it has disagreed a _few_ times. It may be that it was not
the particular food but the weakness of the stomach at the time.

Many foods disagree at certain times because of the particular
conditions regulating the secretion of digestive juices. When this
condition has continued for some time it becomes chronic and a special
diet is required, together with special exercises, to bring a better
blood supply to stomach and intestines and to regulate the nerves
controlling them, in order to correct the abnormality.

One may so form the habit of criticism or of being disgruntled or
thinking he cannot eat this food and that, that his entire system
suffers. Much indigestion is more mental than physical.

       *       *       *       *       *

[Sidenote: Effect of the Circulation]

It can be readily seen that any tissue, playing so important a part in
digestion as the blood, needs to be kept in as nearly perfect condition
as possible. A vigorous circulation stimulates digestion; a poor
circulation retards it.

If the blood is poor in quality the digestive organs are not nourished
and the digestive secretions are lessened in quantity and quality.

If the blood is imperfectly aërated it carries an insufficient supply
of oxygen, combustion is lessened, and the waste, not being in a
condition to be removed, remains in the tissues, stagnation results,
and a slow poisoning process goes on which gradually causes the system
to fail to meet the demands made on it.

The blood tissue can only be kept in condition by an adequate but not
excessive amount of good food taken at the proper time, and such active
exercise as will thoroughly aërate the blood by bringing the air to the
smallest air cells in the lungs.

If one would fight to prevent the money used in daily exchange from
being debased, he ought to be much more ready to use every means in
his power to prevent a deterioration of the blood, that medium of
exchange in his body on which such vital issues depend.

       *       *       *       *       *

[Sidenote: Tobacco and Alcohol]

Tobacco and alcohol are two substances which, in excess, materially
retard digestion.

The effect tobacco on the stomach is shown by its action on the small
boy with his first cigar. Habituated to its use, the nerves become
blunted and the nicotin narcotizes them. The use of tobacco renders
the sense of taste less delicate, due to the action of the nicotin on
the nerves of the taste buds. Men who use tobacco in excess miss the
pleasures of taste; all food tastes much alike to them.

Tobacco, due to its action on the vagus nerve, many times causes
disorders both of circulation and digestion. The starches are usually
not well digested by those who are habitual users of tobacco.

Smoking before meals or when the stomach is empty often occasions
nausea.

Because of its narcotic action it often exerts a soothing influence
particularly in men of highly nervous temperament who are unwilling to
take the necessary exercise to equalize nerve activity.

It was formerly held by physiologists that alcohol was a food, because
its oxidation liberates heat, and it was assumed that this liberation
of heat was the same as that freed by the combustion of fats, starches,
and sugars uniting with oxygen. More recent knowledge, however, has
unquestionably determined that the body decomposes alcohol into carbon
dioxid and water, thus liberating heat, yet the reaction produces cold
and the body requires more heat to warm it.

The blood-vessels of the skin dilate from overstimulation, and heat is
radiated faster than it is generated, so that the temperature of the
body is really lowered though alcohol gives a sensation of heat. The
body, therefore, loses the power to resist cold.

It was formerly used by physicians for its supposed stimulant action,
but it has been determined that the apparent stimulant effect is due to
irritation of the nerves, particularly of the nerves of the stomach;
the temporary spur to activity is followed, however, by depression of
the body forces.

The habitual use of alcohol, from overstimulation of the nervous
system, affects this system, deranging it permanently, gradually
lowering both mental and physical ability, and causing a catarrhal
condition of the stomach and intestines.

_Alcohol, therefore, even in small quantities, is a poison, and not a
food._

In certain conditions it may be used in emergency to spur a flagging or
failing organism to action, but owing to the facility with which the
alcohol habit is acquired its use should not be continued beyond the
period when its immediate action is deemed necessary.

Because tobacco and alcohol are both poisons, the healthy organism
has no need of them. The diseased or deranged organism can often find
greater benefit from natural remedies than from the artificial stimuli
of these substances.

It is a known fact that far more men than women suffer from dyspepsia.
One reason for this may be found in the prevalent habit of spitting.
Smokers, in whom the irritation of the nicotin causes an excess of
saliva, often suffer from gastric troubles, because they expectorate,
thus wasting this valuable digestive juice.

Aside from the filthiness of the habit, which has caused laws to be
enacted against it, one would think that a little reflection would
cause those addicted to it to consider what it means to their health.
Overstimulation means weakened salivary glands, impaired secretion,
and consequent lessened digestive power. For the sake of their own
health if not from motives of decency, men should abandon the habit of
expectorating.


FOOTNOTES:

[8] EDITOR’S NOTE:—Measurements of seventy thousand women show that
sixty-two per cent. of women use only about one-half of their lung
capacity and less than nine per cent. use their full capacity.




CHAPTER VII

COOKING


The question of the proper selection and cooking of food is so vital to
the health and resultant happiness of every family, and to the strength
and well being of a nation, that every one to whom cooking is entrusted
should have special preparation for the work. Every girl should be
given practical and thorough training in dietetics in our public
schools. The study is as dignified as the study of music and art.
Indeed it can be made an art in the highest conception of the term.
Surely the education of every girl in the vocation in which she sooner
or later may engage, either actively or by directing others, means more
than education in music and drawing.

We must all eat two and three times every day; there are few things
which we do so regularly and which are so vital; yet in the past we
have given this subject less study than any common branch in our
schools. When the dignity of the profession of dietetics is realized,
the servant problem will be largely solved.

The wholesome cooking of food is as important as its selection, because
the manner of cooking makes it easier or more difficult of digestion.

The necessity of a thorough education in this regard is recognized by
men who follow cooking as a profession, and a regular apprenticeship
must be served before a cook is recognized as proficient. He can then
command good wages.

In cooking any food, heat and moisture are necessary, the time needed
varying from thirty minutes to several hours. Baked beans, and meats
containing much connective tissue, as boiling and roasting cuts,
require the longest time.

The purposes in the cooking of foods are:

 To develop the flavor which makes the food appetizing, thus
 encouraging the flow of gastric juice;

 To sterilize, thereby killing all parasites and microörganisms, such
 as the tapeworm in beef, pork, and mutton, and the trichinæ in pork;

 To convert the nutrients into a more digestible form, by partially or
 wholly converting the connective tissue into gelatin.

According to the variety and kind, food may be roasted, broiled,
boiled, stewed, baked, steamed, or fried.

       *       *       *       *       *

[Sidenote: Cooking of Meats]

The fundamental principle to be observed in the cooking of meat
concerns the retention of the juices, since these contain a large
part of the nutriment. The heat develops the flavor, and the moisture
together with the heat dissolves the connective tissue and makes it
tender.

A choice piece of meat may be toughened and made difficult of
digestion, or a tough piece may be made tender and easy to digest, by
the manner of cooking.

_Soups._ To make meat soups, the connective tissue, bone and muscle
should be put into cold water, brought _slowly_ to the boiling point,
and allowed to simmer for several hours.

It must be remembered that the gelatin from this connective tissue does
not contain the tissue-building elements of the albuminoids. These are
retained in the meat and about the bones of the boiling piece.

The albumin of meat is largely in the blood and it is the coagulated
blood which forms the scum on soup. Soup should cook slowly, or much of
the nutrition is lost in the coagulated blood, or scum.

If a soup containing nutrition is desired, it must be made from boiling
meat, connective tissue, and bone with marrow.

While bouillons and prepared cubes contain very little nutriment they
contain the extractives, and the flavors increase the flow of digestive
juices and stimulate the appetite. It is for this reason that soups are
served before a meal; when they are relished, they aid a copious flow
of gastric juice and saliva.

Many mistake the extractives and flavor for nourishment, thinking that
soups are an easy method of taking food, but the best part of the
nutriment remains in the meat or vegetables from which the soup is
made, and unless one desires merely the stimulating effect, bread or
crackers should supply the nourishment.

If soup meat is used in hashes the lost nutritive material in the form
of gelatinoids and extractives may be restored by adding to it a cup of
rich soup stock.

In preparing _Beef Tea_, the meat should be finely minced, placed in a
mason jar, and a very little cold water added. It should stand an hour
or two to aid in the extraction of the albumin. The jar should be then
placed in a kettle of water which should be kept at the boiling point
for two hours. In this way none of the nutriment is lost. Beef tea, if
properly prepared and only the juice is used, is expensive, but when
concentrated nourishment is necessary, cost should not figure.

The beef teas made from cubes contain the extractives and are
appetizers, but they contain very little if any nutrition.

_Roasting._ Roasting and broiling of meats are the most universally
used methods. The savage as well as civilized man prepares his meat by
direct application of heat without water.

In roasting or broiling the meat is subjected suddenly to a high
temperature which coagulates the albumin of the outer layers and
prevents the escape of the juices. For this reason the oven should
be thoroughly hot before the roast is put in. Unless the heat is
sufficient to sear the surface, the moisture, or juice, will escape and
the connective tissue will be toughened.

The roast should be turned as soon as one side is seared and just
enough water added to prevent it from burning.

It is important to remember that the smaller the cut to be roasted,
the hotter should be the fire. An intensely hot fire coagulates the
exterior and prevents the drying up of the meat juice. After the
surface is coagulated and seared, to prevent the evaporation of its
juices, the roast should be covered so as to cook more slowly to
prevent too great hardening of the surface.

Frequent basting of a roast with the fat, juice, and water in the
roasting pan, still further sears the surface so that the juices
do not seep through, and keeps the air in the pan moist; the heated
moisture materially assists in gelatinizing the connective tissue.
Roasting pans are now made which are self-basting.

Raising the temperature of the juices subjects the inner portions of
the meat to moist heat and it is thus stewed in its own juices. The
retention of these juices and of the extractives adds to the flavor and
the palatability.

Roasted or broiled meats, if properly cooked, are more readily digested
and they are usually most relished because their flavor is better
retained.

_Pot Roasts._ For a pot roast, the meat should be well seared in fat,
then a small amount of water added, and the meat cooked _slowly_ at
about 180 F., until done. A fireless cooker is excellent for this as
for any other food needing to be slowly cooked. The juices seep out in
the water and form a rich gravy which should be served with the meat.

_Broiling._ The same principle of quickly searing the surface applies
to broiling. In broiling, however, the heat is applied direct, because
the process is quicker. The meat is placed over a very hot flame or hot
coals and both sides quickly seared to prevent the juice from escaping.

The object of the direct application of the heat is to enable it to
quickly penetrate to the center of the chop or steak so as to coagulate
the albumin and prevent the escape of the water. Meat intended for
broiling should be cut at least an inch thick, as otherwise it becomes
too hard and dry in the process of broiling.

Meat containing much connective tissue, such as the neck, chuck, and
rump, is not adapted to broiling, because it takes too long for this
tissue to become gelatinized. It may be pan broiled, a little water
added, and cooked slowly until done. Prepared in this way it is cheap,
nourishing, and palatable.

Steak broiled in a skillet, especially round steak which has been
pounded to assist in breaking the connective tissue, is often first
dipped in seasoned flour, which is well worked into it. The flour
absorbs the meat juices so that none of them are lost.

When broiling meats in a skillet the skillet must be very hot before
the meat is placed on it, and as soon as one surface of the meat is
seared, it should be turned to sear the other side. The skillet should
be kept covered so as to retain the moisture.

_Boiling._ One important fact, too frequently overlooked, or, perhaps,
not known by many cooks, is that when water has reached the boiling
point its temperature cannot be further raised by increasing the heat
applied. The addition of heat only increases the production of steam
and causes the water to “boil away.” Therefore as soon as the water has
begun to boil the gas may be turned down or the fire kept at just the
level necessary to maintain the boiling. The food cooks just as soon
and the fuel bills are lowered. Hard boiling has no greater effect on
any food than moderate boiling.

When boiled meat is intended to be eaten—not merely boiled for soup—the
water should be boiling when the meat is placed in it in order that the
albumin on the surface may be immediately coagulated and prevent the
escape of the nutrients into the water. It is impossible to make a rich
broth and to have a juicy, highly flavored piece of boiled meat at the
same time.

Meats used for boiling contain more connective tissue, therefore they
require much longer cooking in order to gelatinize this tissue. They
are not as rich in protein as are steaks.

Meat “shrinks” in boiling because of the escape of the water in the
tissues into the water in which it is boiled. Meat may thus lose
one-fourth to one-third of its weight and bulk.

_Stewing._ This differs from boiling in that the temperature is lower
and the meat or vegetables are cut in pieces so that the water may come
in contact with more of the surface thus aiding in the extraction of
the juices.

The scum, which appears on the surface of a stew, is usually skimmed
off and, as in the case of soups, much nutrition is lost. It should
be retained, as it will disappear when the stew is thickened. It is
usually removed from beef tea in order that it may not offend the eye
or the capricious appetite of an invalid.

Stews should be covered and should not be cooked in too much water, as
the juices are weakened and too great an amount of flour is necessary
to thicken them, thus rendering them less digestible. They are cooked
slowly at low temperature (130 to 160 F.) and so do not need much water.

If properly made, stews are both economical and nutritious, as no
nutrition is lost in evaporation and all material save bone or gristle
is utilized.

_Baking._ Meats, when baked, are covered with a crust, either of batter
or pastry. This prevents the escape of the volatile matters, and meats
thus cooked are richer, especially if they contain much fat. For this
reason they are seldom suitable for invalids, or for those who have any
form of stomach trouble.

_Steaming._ This method of cooking is applied mainly to vegetables,
puddings, etc. Steamed puddings and dumplings are softer than when
baked. The cover must not be removed during the time of steaming, or
they may become soggy, hence less digestible.

_Frying._ This is the least desirable method of cooking. If a lighted
match is placed near the smoke of superheated fat the fat will catch
fire, showing that it is volatilizing, or being reduced to a vapor.

The extreme heat liberates fatty acids which soak into the food and
render it difficult of digestion. It is wise not to employ this method
of cooking unless the food is completely immersed in the hot fat by
means of a wire basket. This facilitates its removal with greater
ease. The surface albumin is coagulated more quickly when the food is
submerged, thus preventing it from soaking up too great an amount of
fat.

Deep-fat cooking requires close watching and for this reason most cooks
use a skillet. Unless the skillet is very hot and the meat is turned
frequently, the meat juices are lost both by evaporation and by the
meat adhering to the pan.

In cooking in deep fat, if not left too long and if the fat is at the
right heat, the meat fibers do not soak up the fat, because the water
in the tissues is so rapidly turned to steam that the fat cannot enter;
the interior thus cooks in its own juices as in roasting or broiling.
Fish or chops fried in deep fat are palatable and of high flavor.
Boiled fish, however, if the water is well salted to prevent too great
softening, is better for invalids, as it is more easily digested.

Fish fried whole in deep fat may have the skin removed after frying.
The fish fibers are thus not brought into contact with the fat.
Special utensils for frying fish in this way may now be obtained.

Fats are readily absorbed in their natural condition, but, if changed
by extreme heat, they are irritants.

_For digestibility, therefore, boiled, broiled, and roasted foods are
preferable to foods cooked in fats._

Such food as fried potatoes, mush, eggs, French toast, and griddle
cakes, cooked by putting a little grease into a frying pan, are
more difficult of digestion than foods cooked by any other means,
particularly when the fat is heated so that it smokes.

       *       *       *       *       *

[Sidenote: Cooking of Cereals]

One safe rule is to cook most foods too much rather than too little;
overcooking is uncommon and harmless, while _undercooked_ foods are
common and difficult of digestion.

All partially cooked cereal foods should be cooked at least as long as
specified in the directions.

One reason why breakfast foods, such as rolled oats, are partially
cooked by the manufacturer, is because they keep longer.

As has been stated, the nutrients of the grain are found inside the
starch-bearing and other cells, and the walls of these cells are made
of crude fiber, on which the digestive juices have little effect.
Unless the cell walls are broken down, the nutrients can not come under
the influence of the digestive juices until the digestive organs have
expended material and energy in getting at them. Crushing the grain in
mills and making it still finer by thorough mastication breaks many
of the cell walls, and the action of the saliva and other digestive
juices also disintegrates them more or less, but the heat of cooking
accomplishes the object much more thoroughly.

The invisible moisture in the cells expands under the action of heat,
and the cell walls burst. The water added in cooking also plays an
important part in softening and rupturing them. The cellulose or cell
wall is also changed by heat to a more soluble form. Heat makes the
starch in the cells at least partially soluble, especially when water
is present.

The solubility of the protein is probably, as a rule, somewhat lessened
by cooking, especially at higher temperatures. Long, slow cooking is
therefore better, as it breaks down the crude fiber and changes the
starch to a soluble form without materially decreasing the solubility
of the protein.

The fireless cooker is particularly desirable in the cooking of cereals.

 In experiments made with rolled oats at the Minnesota Experiment
 Station, it appeared that cooking (four hours) did not make the starch
 much more soluble. However, it so changed the physical structure of
 the grains that a given amount of digestive ferment could render much
 more of it soluble in a given time than when it was cooked for only
 half an hour.

 On the basis of the results obtained, the difficulty commonly
 experienced in digesting imperfectly cooked oatmeal was attributed to
 the large amounts of glutinous material which surrounds the starch
 grains and prevent their disintegration. When thoroughly cooked the
 protecting action of the mucilaginous protein is overcome, and the
 compound starch granules are sufficiently disintegrated to allow the
 digestive juices to act. In other words the increased digestibility
 of the thoroughly cooked cereal is supposed to be largely due to
 a physical change in the carbohydrates, which renders them more
 susceptible to the action of digestive juices.

_Pastry._ Pastry is usually difficult of digestion because the fat
it contains interferes with the proper solution of the starch. The
objectionable features apply to such pastry as is made by rubbing fat
into flour, as in pie crust, crust for meat pies, apple dumplings, etc.
It does not apply to most puddings. Butter or fat is used in cakes,
cookies, etc., but it is not rubbed into the flour; it is mixed with
sugar and eggs which hold it in suspension until the flour is acted on
by the liquids.

The coating of the starch granules with fat prevents them from coming
in contact with liquids. The fat does not furnish sufficient water to
enable the cells to swell and dissolve the cell wall and so coats the
starch granules as to prevent them from absorbing water in mixing, or
saliva in mastication. This coating of fat is not removed until late in
the process of digestion, or until the food reaches the intestines.

The same objection applies to rich gravies, unless the flour is
dissolved in water and heated before being mixed with the fats.

Pastry and biscuits require a somewhat hotter temperature than bread,
because the process of cooking consumes less time.

       *       *       *       *       *

[Sidenote: Cooking of Vegetables]

Since the root vegetables contain a large proportion of carbohydrates,
they should be well cooked, in order that the crude fiber may be broken
and the cells fully dissolved. Most vegetables are unpalatable and
indigestible unless, by the cooking process, the starch granules are
broken.

Vegetables are best cooked in soft water as lime or magnesia, the
chemical ingredients which make water “hard,” make the vegetables less
soluble.

Vegetables and fruits become contaminated with the eggs of numerous
parasites from the fertilizers used; hence they should be thoroughly
washed.

The objections to frying are as strong in regard to vegetables as to
meats. The coating of fat retards digestion, as shown on page 195.

The objection to frying does not hold so strongly in the case of
vegetables, such as potatoes, if fried _slowly_ in fat that is not
overheated, or to griddle cakes cooked slowly without smoke. It does
apply, however, if the fat is sufficiently heated to smoke.

The coating of vegetables and cereals with fat prevents the necessary
action of saliva on the starch globules. As previously stated, starch
digestion is begun in the mouth and continued for a short time in
the stomach, while the fats are not emulsified until they reach the
intestine.

The starch granules in cereals and vegetables are in cells, the
covering of which is composed largely of nitrogenous matter. The
protein is not acted on by the saliva, and the nitrogenous matter
is largely digested in the stomach. It is more easily dissolved if
it is broken or softened by cooking, so that the carbohydrates can
come in contact with the saliva, but if encased in fat, the gastric
juices cannot digest the protein covering and the saliva cannot reach
the starch until the fat is emulsified in the intestines. This means
that whenever starch globules are surrounded with fat, the digestive
ferments reach these globules with difficulty and foods improperly
fried must be digested mostly in the intestines. For this reason, eggs,
poached or boiled, are more easily digested than when fried.

Vegetables and fruits of most sorts may be baked and are usually
rendered more digestible by the process.

Tubers of all sorts, if to be cooked by boiling, should be put on the
fire in cold water. The gradual heating of the water allows the tuber
to become warmed through before boiling begins and the interior and
exterior thus are completely cooked about the same time. If placed
in boiling water, the exterior, being cooked before the interior,
particularly when vegetables are peeled before cooking, either
separates, as in potatoes, making them “mushy,” or the vegetables are
served with the interior not thoroughly cooked.

Vegetables will cook as quickly and more evenly in water kept just at
the boiling point as in water that is boiling hard.

All pods, seeds, or leaves, as in green vegetables, should be put in
boiling water that none of the nutritive material may be lost and that
the cooking action may be quickly begun.

       *       *       *       *       *

[Sidenote: Cooking of Fruit]

Opinions differ markedly regarding the relative wholesomeness of
raw and cooked fruit. Europeans use comparatively little raw fruit,
it being considered less wholesome than cooked fruit. In the United
States, raw fruit is considered extremely wholesome, and is used in
very large quantities; it is relished quite as much as cooked fruit, if
indeed it is not preferred to it.

It has been suggested that the European prejudice against raw fruit
may be an unconscious protest against unsanitary methods of marketing
or handling and the recognition of cooking as a practical method of
preventing the spread of disease by fruit soiled with fertilizers or
with street dust. If the cooking is thorough, it insures sterilization.

As with all vegetable foods, the heat of cooking dissolves the fiber
in the cell walls. The moisture causes the cell contents to expand and
rupture the walls. The change in texture occasioned by cooking renders
it softer, more palatable, and more readily acted on by the digestive
juices. This is obviously of more importance with the fruits like the
quince, which is so hard that it is unpalatable raw, than it is with
soft fruits like strawberries.

Cooking in water extracts so little of the nutritive material present
in fruit that such removal of nutrition is of no practical importance
unless the amount of water used is excessive. Because they contain much
water fruits should be cooked in as little water as may be necessary to
prevent them from burning.

 The idea is quite generally held that cooking fruit changes its acid
 content, acid being sometimes increased and sometimes decreased by the
 cooking process. Kelhofer showed that when gooseberries were cooked
 with sugar, the acid content was not materially changed, these results
 being in accord with his conclusions reached in earlier studies with
 other fruits. The sweeter taste of the cooked product he believed to
 be simply due to the fact that sugar masks the flavor of the acid.

 It is often noted that cooked fruits, such as plums, seem much sourer
 than the raw fruit, and it has been suggested that either the acid
 was increased or the sugar was decreased by the cooking process. This
 problem was studied by Sutherst, and, in his opinion, the increased
 acid flavor is due to the fact that cooked fruit (gooseberries,
 currants, plums, etc.) usually contains the skin, which is commonly
 rejected if the fruit is eaten raw. The skin is more acid than the
 simpler carbohydrates united to form a complex carbohydrate.

 In some fruits, like the apple, where the jelly-yielding material must
 be extracted with hot water, the pectin is apparently united with
 cellulose as a part of the solid pulp. As shown by the investigations
 of Bigelow and Gore at the Bureau of Chemistry, forty per cent. of the
 solid material of apple pulp may be thus extracted with hot water, and
 consists of two carbohydrates, one of which is closely related to gum
 arabic. That such carbohydrates as these should yield a jelly is not
 surprising when we remember that they are similar to starch in their
 chemical nature, and, as everyone knows, starch, though insoluble in
 cold water, yields when cooked with hot water a large proportion of
 paste, which jellies on cooling.

 When fruits are used for making pies, puddings, etc., the nutritive
 value of the dish is, of course, increased by the addition of flour,
 sugar, etc., and the dish as a whole may constitute a better balanced
 food than the fruit alone.[9]


FOOTNOTES:

[9] C. F. Langworthy, Ph.D.—In charge of Nutritive Investigations of
the United States Experiment Station.




CHAPTER VIII

FOOD REQUIREMENTS OF THE SYSTEM


As previously stated, the object of foods is:

 To supply the needs of the body in building new tissue as in the
 growing child.

 To repair tissue which the catabolic activity of the body is
 constantly tearing down and eliminating; and

 To supply heat and energy.

The heat and energy are not alone for muscular activity in exercise
or movement. It must be kept in mind also that the body is a busy
workshop, or chemical laboratory, and heat and energy are needed in the
constant metabolism of tearing down and rebuilding tissue and in the
work of digestion and elimination.

In this chapter, a few points given in the preceding pages are repeated
for emphasis.

The proteins represented in purest form in lean meat build tissue, and
the carbonaceous foods, starches, sugars, and fats, supply the heat and
energy.

An excess of proteins, that is, more than is needed for building and
repair, is also used for heat and energy.

The waste products of the nitrogenous foods are broken down into carbon
dioxid, sulphates, phosphates, and other nitrogenous compounds, and
excreted through the kidneys, skin, and the bile, while the waste
product of carbonaceous foods is largely carbon dioxid and is excreted
mostly through the lungs.

Since the foods richest in protein are the most expensive, those who
wish to keep down the cost of living, should provide, at most, no more
protein than the system requires. Expensive meats may be eliminated and
proteins be supplied by eggs, milk, legumes, and nuts.

The fundamental thing is to decide on the amount of protein—two to four
ounces, nearly a quarter of a pound a day—and then select a dietary
which shall provide this and also supply heat and energy sufficient for
the day.

If the diet is to include meat, a goodly proportion of protein will be
furnished in the lean meat. This will vary greatly with the different
cuts of meat, as shown in Table IV, page 54. If, as often happens, one
does not care for fats, then the starches and sugars must provide the
heat. If much sugar is eaten less starches and fats are needed.

The normally healthy individual is more liable to take too much protein
than too little, even though he abstain from meat.

If the diet is to include meat, it will be of less bulk, because the
protein is more condensed; for the same reason, if it includes animal
products of eggs and milk and a fair proportion of legumes, it will be
less bulky than a vegetable diet. Yet unless vegetables, fruits, and
plenty of water are consumed one must guard against constipation. This
point is important for busy people who eat their meals in a hurry and
proceed at once to active mental work.

Those who engage in physical labor are much more likely to take
a complete rest for a half-hour, or an hour, after eating. The
_thinkers_ seldom rest, at least after a midday meal, and those who
worry seldom relax the mental force during any waking hour; their
brains are as active as those of mental workers.

Every housewife, to intelligently select the daily menus for her
family, needs a thorough knowledge of dietetics. She must understand
the chemistry of food that she may know food values.

The difficulty which confronts the housewife is to provide a meal
suited to the needs, tastes, or idiosyncrasies of the various members
of her household. Peculiarities of taste, unless these peculiarities
have been intelligently acquired, may result in digestive disturbances.
As an illustration: one may cultivate a dislike for meat, milk, or
eggs, as is often the case, and if the proteins for the family is
largely supplied by these, the individual who omits them from the meal,
eats too large a proportion of starches and sugars, and not sufficient
protein—legumes, nuts, etc. If this is long continued the blood becomes
impoverished and anemia is produced.

The relief lies in _cultivating a taste for all foods_.

In active work, more heat is liberated, thus more fat, starches, and
sugar are required for the resupply. As previously stated, if an excess
of starch (glycogen) is stored in the liver, or an excess of fat in the
tissues, this excess is called on to supply the heat and energy when
the fats and carbohydrates daily consumed are not sufficient for the
day’s demands. This is the principle in reduction of flesh.

It is interesting to note that habits of combining foods are, perhaps
unconsciously, based on dietetic principles.

Meats, rich in protein, are served with potatoes or with rice, both of
which are rich in starch.

Bread, containing little fat, is served with butter.

Beans, containing little fat, are cooked with pork.

Starchy foods of all kinds are served with butter or cream.

Macaroni, which is rich in starch, makes a well-balanced food when
served with cheese.

Pork and beans, bread and butter, bread and milk, chicken and rice,
macaroni and cheese, poached eggs on toast, and custards, form balanced
foods.

A knowledge of such combinations is important when one must eat a hasty
luncheon and wishes to supply the demands of the body in the least
time, giving the least thought to the selection; but hasty luncheons,
with the mind concentrated on other things, are to be strongly
condemned.

It has been estimated that the average daily need of the adult is
forty-five ounces of solid food, one-fourth animal and three-fourths
vegetable. Twice as much water as solids should be taken.

The laborer, engaged in heavy muscular activity, needs and can
assimilate more than the sedentary office worker. Those who work but a
few hours a day require less food, as a rule, than those who work long
hours.

Cold weather demands more heat-producing foods; a hot climate, inducing
inactivity of body, diminishes the need for food.

The invalid needs less food than the healthy.

The inhabitant of the frigid zone needs much fat; he who lives in the
tropics but little fat.

The old need less food than the growing youth or the hearty adult.

The poor must often take what he can get while the rich eat to satiety.
Yet all these food needs vary with the individual and with the sex and
activity.

It has been computed that the system needs daily three hundred grains
of nitrogen and four thousand eight hundred grains of carbon. To obtain
this amount of nitrogen if bread alone were eaten it would require
four pounds of bread from the whole wheat. The carbon in this amount
of bread largely exceeds that required. If eaten alone, six pounds of
beef would be necessary to supply the proper amount of carbon, and
twenty-three pounds of eggs. The nitrogen in this amount would far
exceed the requirement.

One pint of milk, 2-1/2 ounces of bread, and six ounces of beef are
about equal in nutritive value.

One can see, therefore, why a diet composed of too great a quantity
of one substance gives an overbalance of one and an underbalance of
another.

Therefore, it is more economical to use some fat and sugar in the diet
and less meat. More vegetables, perhaps, and more fluid should be taken
by many.

Authorities vary in their estimates of the amount of food required by
the individual. It varies with the activity, the season, the age, the
sex, and it varies in the same individual on different days.

Billings estimates that the daily diet of a healthy, hard-working man
should contain: 20 ounces (1-1/4 pounds) of lean meat; 22 ounces, about
1-1/3 pounds or 1-1/3 loaves of baker’s bread; 10 ounces or about 4
medium sized potatoes; and several glasses of fluid. Since the fluid
should be twice the amount of solids, this would mean about 12 glasses.

Others compute that the amount of food weighed dry, needed by the
average person of sedentary habits, is as follows: For breakfast, 8
ounces; for luncheon, 6 ounces; for dinner, 9 ounces, with 48 ounces or
3 glasses of water. These two give extremes.

In active persons from 3 to 3-1/2 ounces (about one-fourth of a pound)
of nitrogenous food will replace the nitrogen lost from the body.
One ounce (1-1/16 of the ordinary brick) of butter a day supplies
the necessary fat, and about 15 to 20 ounces (1 to 1-1/4 pounds) of
carbohydrate are required.

According to Thompson, from two to three pints of urine are excreted
each day; ten ounces of water are lost by the lungs, and eighteen
ounces are evaporated from the skin. This amount, about eighty ounces
or ten glasses, must be replaced daily to maintain the body in its
equilibrium of supply and demand. A part of this is supplied in the
food.

These figures may be altered somewhat according to the individual or
the climate as previously mentioned, but they constitute a fair average.

Dr. W. S. Hall estimates that the average man at light work requires,

  each day 106.8 grams of protein[10]
            57.97 grams of fat
           398.84 grams of carbohydrates

These elements, in proper proportions, may be gained through many food
combinations. He gives the following as an example:

  Bread            1  lb.
  Lean Meat       1/2  ”
  Oysters         1/2  ”
  Cocoa            1  oz.
  Milk             4  ozs.
  Sugar            1  oz.
  Butter          1/2  ”

A medium-sized man at out-of-door work, fully oxidizes all waste of the
system and he requires a higher protein diet—125 grams. In such event
he does not require so much starch and sugar. If, on the other hand,
he were to take but 106.8 grams of protein, as above, he would require
more carbohydrates. One working or exercising in the fresh air breathes
more deeply and oxidizes and eliminates more waste, hence he has a
better appetite, which is simply the call of nature for replacing the
waste.

Experiments in the quantity of food actually required for body needs,
made by Prof. R. H. Chittenden, of the Sheffield Scientific School,
Yale University, have established, beyond doubt, the fact that the
average individual consumes very much more food than the system
requires. In fact, most tables of food requirements, in books on
dietetics, are heavy, yet the amount of food required as a result of
Professor Chittenden’s experiments would seem to be too light for a
continuous diet.

Professor Chittenden especially established the fact that the
average person consumes more protein than is necessary to maintain
a nitrogenous balance. It was formerly held that the average daily
metabolism and excretion of nitrogen through the kidneys was sixteen
grams, or proportionate to about one hundred grams of protein or
albuminoid food.

Professor Chittenden’s tests, covering a period of six months, shows
an average daily excretion of 5.86 grams of nitrogen, or a little less
than one-third of that formerly accepted as necessary; 5.86 grams of
nitrogen corresponds to 36.62 grams of protein or albuminoid food.

Professor Chittenden’s experiments concerning the amount of foodstuffs
actually required by three groups of men, one group of United States
soldiers, a group from the Yale College athletic team, and a group of
college professors, all showed that the men retained full strength,
with a higher degree of physical and mental efficiency, when the body
was not supplied with more protein than was liberated by metabolic
activity, and when the quantity of carbonaceous food was regulated to
the actual requirements for body heat and energy.

It may be well to call attention here to the fact that most of the food
elements, called on for work, are not derived from those foods just
consumed or digested, but from those eaten a day or two previous, which
have been assimilated in the muscular tissues.

Dr. W. S. Hall gives the rations for different conditions, as shown in
the following tables:


TABLE XI

RATIONS IN DIFFERENT CONDITIONS

  ———————————————————————————+—————————+——————+—————————+——————————
                             | Proteins|      | Carbo   | Energy
                             |         | Fats |hydrates |  in
      CONDITIONS             +————+————+      +————+————+ Calories
                             |Low |High|      |Low |High|
  ———————————————————————————+————+————+——————+————+————+——————————
  Man at light indoor work   | 60 |100 |  60  |390 |450 | 2764
  Man at light outdoor work  | 60 |100 | 100  |400 |460 | 2940
  Man at moderate outdoor    |    |    |      |    |    |
    work                     | 75 |125 | 125  |450 |500 | 3475
  Man at hard outdoor work   |100 |150 | 150  |500 |550 | 4000
  Man at very hard outdoor   |    |    |      |    |
    winter work              |125 |180 | 200  |600 |650 | 4592
  U. S. Army rations         | 64 |106 | 280  |460 |540 | 4896-5032
  U. S. Navy rations         |... |143 | 292  |557 |... | 5545
  Football team (old régime) |... |181 | 292  |557 |... | 5697
  College football team (new)|125 |125 | 125  |500 |... | 3675
  ———————————————————————————+————+————+——————+————+————+——————————

TABLE XII

RATIONS VARIED FOR SEX AND AGE

  ———————————————————————————+—————————+——————+—————————+——————————
                             | Proteins|      | Carbo-  | Energy
     VARIATIONS OF           |         | Fats |hydrates |  in
      SEX AND AGE            +————+————+      +————+————+ Calories
                             |Low |High|      |Low |High|
  ———————————————————————————+————+————+——————+————+————+——————————
  Children, two to six       | 36 | 70 |  40  |250 |325 | 1520-1956
  Children, six to fifteen   | 50 | 75 |  45  |325 |350 | 1923-2123
  Women with light exercise  | 50 | 80 |  80  |300 |330 | 2272
  Women at moderate work     | 60 | 92 |  80  |400 |432 | 2720
  Aged women                 | 50 | 80 |  50  |270 |300 | 1870
  Aged men                   | 50 |100 | 400  |300 |350 | 2258
  ———————————————————————————+————+————+——————+————+————+——————————

The unit of measurement for the calories of energy is the amount of
heat required to raise the temperature of one kilogram of water from
zero to 1° centigrade or 4° Fahrenheit.

In estimating the number of calories of energy given off by the
different foods, Dr. Hall represents

  1 gram of carbohydrates as 4.0 calories
  1  ”   ”  fats          ”  9.4    ”
  1  ”   ”  proteins      ”  4.0    ”

To determine the relative energy which a food represents, it is only
necessary to multiply the number of grams of protein in that food by 4,
the fat by 9.4, and the carbohydrates by 4, and add the results.

Thus according to the food required for the average man at light work
given on page 225:

  106.8 grams of proteins      ×  4  = 427.20 calories of energy
   57.97  ”   ”  fat           × 9.4 = 544.94    ”     ”    ”
  398.84  ”   ”  carbohydrates ×  4  = 1595.36   ”     ”    ”
                                       ———————
                                       2567.51 = the calories of
  energy required for the average man at light work.


TABLE XIII

The following gives a balanced supply for a day according to the
preceding tabulation:

     _Amount of Food_             _Calories_

  2 tablespoonfuls fruit with sugar           55
  2 eggs                                     140
  1/2 pound lean meat (protein)              243
  1 pound bread                             1206
  1/2 pint soup                              307
  1 tablespoonful cocoa                      135
  2 potatoes (average size)                  100
  1/2 pint of milk                           150
  2 pats butter (1 cubic inch)               119
  2 tablespoonfuls sugar                     112
                                            ————
                                            2567

Dr. Chittenden’s experiments would indicate that a man leading a very
active life, and above the average in body weight, can maintain his
body in equilibrium indefinitely with a daily intake of thirty-six to
forty grams of protein, or albuminoid food, with a total fuel value of
1600 calories.

In order to bring oneself to as limited a diet as Professor
Chittenden’s men followed, however, it would be necessary to have all
food weighed so as to be sure of the correct proportions; otherwise the
actual needs would not be supplied and the body would suffer.

It is a question whether the men with whom he experimented could have
followed so limited a diet for an indefinite period.

As stated, however, authorities differ on the amount of food required.

  Dr. Hall suggests                   106 grams of protein
  Ranke suggests                      100 grams of protein
  Hultgren and Landergren suggest     134 grams of protein
  Schmidt suggests                    105 grams of protein
  Forster and Moleschott suggest      130 grams of protein
  Atwater suggests                    125 grams of protein

A wise provision of Nature enables the body to throw off an excess
of food above its needs without injury, within limitations; but, as
stated, there is no doubt that the average person exceeds these limits,
exhausting the digestive organs and loading the system with more than
it can eliminate; the capacity for mental work becomes restricted, and
the whole system suffers.

       *       *       *       *       *

[Sidenote: Mixed Diet versus a Vegetarian Diet]

From the fact that only from two to four ounces of nitrogenous food
are required to rebuild daily tissue waste, it is apparent that this
amount can readily be supplied from the vegetable kingdom, since
nuts, legumes, and cereals are rich in proteins; yet there is a
question whether a purely vegetable diet is productive of the highest
physical and mental development. Natives of tropical climates live
on vegetables, fruits, and nuts, and it may be purely accidental, or
be due to climatic or other conditions, that these nations have not
made the greatest progress. Neither have the Eskimos, who live almost
entirely on meat, attained the highest development.

The greatest progress and development, both as nations and as
individuals, have been made by inhabitants of temperate climates, who
have lived on a mixed diet of meat, eggs, milk, grains, vegetables,
fruits, and nuts. They have shown more creative force, which means
reserve strength.

The Eskimo has demonstrated, however, that a diet of meat alone
supplies all physical needs; the meat tissue providing growth and
repair and the fat supplying all of the carbonaceous elements. The
fat, as previously stated, yields more heat than starches and sugars,
and Nature provides this heat for climates in which most warmth is
required. This may be the reason why natives of warm climates have
formed the habit of using vegetables and grains for their heat and
energy rather than meat. It is also the natural reason why man in
temperate climates eats more meat in winter than in summer.

An unperverted, natural instinct will always be found to have a sound
physiological basis. For example, if, by reason of some digestive
disturbance, one has become emaciated, all of the fat having been
consumed, and the cause of the disturbance is removed by an operation
or otherwise, one is seized with an almost insatiable desire for fat,
often eating large chunks of the fat of meat or large quantities of
butter or cream at a meal. When obstructions are removed, Nature makes
immediate effort to readjust her forces.

Those who object to eating meat should study carefully to learn if the
proper proportion of protein is supplied with each day’s rations. The
legumes—peas, beans, nuts, and grains—must be supplied. While the wheat
kernel contains twelve per cent. of protein, the white flour does not
contain as large a percentage and it will be noted by reference to
Tables II and III, that the majority of fruits and vegetables contain
little nitrogenous substance.

Unless the whole of the grain and the legumes form a goodly proportion
of the diet the danger is in consuming too large a bulk of waste and
too much starch in a purely vegetable diet.

In a vegetarian diet, one is liable to eat too freely of cereals; as
a result, the liver becomes clogged and torpid and the stomach and
intestines are deranged and rendered incapable of full digestion and
absorption. The clogged system refuses to assimilate more food.

_It follows, therefore, that, unless one is a thorough student of
dietetics, the mixed diet is by far the safest to follow._

One can better run short of starch or fat in one day’s rations than
to be short of protein, because if the two or four ounces daily
requirement is not provided the tissues are consumed and the blood is
impoverished. It is a rare condition in which a reserve of glycogen
and fat is not stored in the system. On the other hand, an excess of
nitrogenous foods calls for a very active circulation and plenty of
oxygen in the system.

It has been held that the vegetarian has a clearer brain, and, if this
be true, it may be due to the fact that he is not eating too much and
thus his system is not overloaded.

Experience, however, does not prove that he has greater mental,
physical, and moral power and efficiency.

In fasting, likewise, the mental power is at first clear and forceful,
but the reason becomes unbalanced if the fast be too prolonged.

_A complete diet may be selected without animal flesh, but including
animal products of eggs, milk, cream, and butter, together with
vegetables, fruits, cereals, and nuts, yet, if the vegetable diet be
selected, the legumes, the whole of the grains, and nuts, must be
given their share in each day’s rations._

       *       *       *       *       *

[Sidenote: Diet when Traveling]

Each year sees an increase in the number of travelers. The question of
diet many times is of great importance. For those of abundant means the
question is simplified, oftentimes, by the railway dining-car service,
but for those who from economic reasons must patronize the wayside
railway restaurants or other eating places, the diet question is not so
easily solved.

A carefully planned lunch-box is often an aid to the preservation of
regular habits and a preventative of digestive disturbances, due to a
sudden and radical change of diet.

The inactivity and sedentary habit enforced by a long journey, in which
there is small chance for exercise, generally causes constipation. The
shaking of the boat or train also aids this, as it interrupts normal
peristalsis. The motion of the boat or train often produces nausea and
vomiting and thus deranges the digestive organs.

Greasy or illy prepared food hastily eaten at a lunch counter provokes
various gastric and intestinal ills.

The danger of infected or polluted water complicates the problem,
especially when the sick or infants are involved. Many an attack of
typhoid fever has been traced to the drinking water used during a
vacation trip.

The invention of the vacuum bottle has solved one need of the traveler.
The invention of the electric heater has solved another.

Sterilized and cooled milk may be carried by means of the vacuum
bottle for use with children or the sick, and the portable stove will
enable the boiling and sterilizing of water, when a larger supply is
needed than can be carried in a vacuum bottle. By its means, also,
a hot drink can be prepared for the aged, the invalid, or other
individual, when necessary, as in an emergency.

All fried and greasy food and unripe fruits should be avoided.

One had better lessen the amount of food than suffer the gastric
difficulties occasioned by too much fatty food.

Hard whole wheat crackers with fruit and milk can be had at almost any
eating house. These give a well-balanced meal and are often preferable
to prepared dishes. Fresh fruit, especially the acid fruits, should
form a large part of the diet.

The traveler, on extended journeys, should always provide some of the
easily carried condensed foods, so that if the food obtained by the
way is unpalatable or illy prepared, or in case food is unobtainable,
the needs of the system may be met. Beef meal, whole wheat or oatmeal
crackers, malted milk, chocolate, meat extracts, etc., occupy little
space and may often prove invaluable.

Tablets of soda and also of lime are easily carried and may be used
when soda water or lime water is needed as in nausea or indigestion.

If it is possible, the water drunk while traveling should be boiled.

The bowels must be kept active and fresh fruits and water are the best
aids in accomplishing this.

The remedies recommended for car sickness or seasickness are legion;
what is an aid in one case is almost or quite without avail in
another. Lemon juice or a slice of lemon in the mouth is generally of
most avail, though lime water in some cases has proven of service.
Attacks can often be mitigated or avoided by not starting on a journey
when overtired, by light eating for several days previous to beginning
a journey, with care in securing good elimination and plenty of fresh
air.

If traveling by boat a reclining chair on deck is far preferable to
lying in a berth in a stuffy stateroom.

Nausea can often be prevented or remedied by deep breathing or by the
sipping of hot water with a little soda.


FOOTNOTES:

[10] For table of weights see pages 357-359.




CHAPTER IX

DIETS


_Before giving any diets, let me first of all impress the importance of
eating slowly, of good cheer, of light conversation during a meal, and
of thoroughly masticating the food. Remember it is the food assimilated
which nourishes._

The following diets allow sufficient food for average conditions, when
the vital organs are normal.

Fruit, as previously stated, contains a very small quantity of
nutrition. It is more valuable for its diuretic effect, and to
stimulate the appetite; for this reason it may well be eaten before a
meal.

The citrus fruits tend to neutralize too high acidity of the blood,
increasing its alkalinity. For this reason, also, they are best before
a meal, particularly before breakfast; they have a more laxative and
cleansing effect if eaten before the other food. The custom has been,
however, to eat fruits after dinner for dessert and they are so given
in the following menus.

Table XI (page 207) gives the total amount of protein, carbohydrate,
and fat needed daily for the work of the body. The method of
determining the number of calories produced by each variety of food is
also given on page 208.

By a little study of the food one ordinarily eats in connection with
this tabulation and the tables given on pages 233 to 241, it can be
determined whether the food taken each day is well or illy balanced and
whether one is eating too much or not enough.

Table XIII (page 209) gives the balanced supply for a day of the most
commonly used foods and may be consulted as a basis from which to work
in constructing balanced meals.

Because of the wide variation in methods of preparing food in the home,
an exact and absolute standard cannot be fixed.

All foods contain combinations of mineral salts, particularly calcium
(lime), sodium, magnesium, and potassium. In each food, however, some
mineral predominates. For instance, potatoes contain both calcium
and potassium but the potassium content is larger than the calcium.
For this reason when potassium salts are needed in a diet, potatoes
and other potassium-containing foods make a valuable contribution.
When potassium needs to be limited these foods should be omitted
from the diet. When calcium is needed, as in growing children,
calcium-containing foods should be made a large part of the diet.

In conditions of health the construction of a balanced diet is a
comparatively simple matter. In conditions of disease, however, the
question of diet is often one that can only be solved by a skilled
dietitian, after a chemical analysis. Unfortunately, the number of
these in the United States is not large and their services are not
available in many cases in which they are needed.

A diet in which the acid-forming elements are in excess will ultimately
result in a lessening of the alkalinity of the blood. The blood
then, to maintain its balance, withdraws alkaline substances from the
tissues. A balance must, therefore, be maintained between the acid and
alkaline foods. This has a bearing on scurvy and also in gout.

Foods which are called acid, that is, they tend to lessen the normal
alkalinity of the blood, are, oats, barley, beef, wheat, eggs, rice,
and maize. When the proportion of acid in the blood is too great the
supply of these foods should be lessened.

Alkaline foods, or those which leave no acid residue, are carrots,
turnips, potatoes, onions, milk, blood, peas, lemon and orange juice,
and beans. These may be used when there is too much acid in the system.

Neutral foods are sugar, the vegetable oils, and animal fats.

All the content of the foods must be taken into consideration in
building a diet, the carbohydrate, fat, and protein being considered as
well as the mineral. A consideration of the mineral content, however,
should not be neglected. One-eighth grain of iron is taken daily in
the ordinary mixed diet. The fact that in one quart of milk, according
to Hutchinson, there are 1/2 grains of calcium shows how valuable this
food is to the growing child for bone and tissue building. It must also
be considered when constipation results from a milk diet. Milk and its
derivatives are poor in iron, while meat, fish, potatoes, fruits, and
bread are poor in calcium. Animal foods are rich in sodium; vegetables
and fruits in potassium.

The following shows the foods which contain mineral salts, in larger
proportions.

  Calcium         Milk contains 1-1/2 grams of lime (calcium) in
  (lime)          every quart; next in lime content come eggs,
                  then cereals, especially rice, radishes, asparagus,
                  spinach, veal, olives (16%), apples
                  and strawberries. Tea, coffee, rhubarb, and
                  cabbage cause deposits of the oxalate of
                  calcium.

  Potassium       Egg yolk, potatoes, apples, lemons, limes,
  Sodium          oranges, olives (60%) and strawberries.
  Magnesium

  Sulphur         Cabbage, asparagus, fibrin of meat, eggs,
                  casein of milk, corn, turnips, cauliflower, and
                  asparagus.

  Iron            Yolk of egg, beef, spinach, dandelions, apples,
                  lettuce, lentils, strawberries, navy beans,
                  peas, potatoes, wheat, and oatmeal.

  Phosphorus      Meat and most vegetables.

A knowledge of the carbohydrate content of foods is useful also in
making up a diet, especially in diabetes. Friedenwald and Ruhrah give
the following in their order:

  Less than 5%    String beans, asparagus, spinach, pickles,
                  lettuce, cucumbers, greens, celery, Brussels
                  sprouts, rhubarb, sauerkraut, tomatoes, ripe
                  olives, cauliflower.

  From 5 to 10%   Leeks, eggplant, pumpkin, kohlrabi, cabbage,
                  radishes, collards, watermelon, mushrooms,
                  beets, okra, strawberries, turnips,
                  lemons, rutabagas, squash, musk melons,
                  peaches, onions, cranberries.

  From 10 to 15%  Blackberries, green onions, oranges, green
                  olives, tomato catsup, currants, raspberries,
                  apricots, parsnips, pears, apples, lima beans.

  From 15 to 20%  Nectarines, huckleberries, cherries, green peas,
                  almonds, potatoes, succotash, fresh figs,
                  prunes, grapes, baked beans, green corn.

  Over 20%        Plums, boiled potatoes, bananas, sweet potatoes.

In the following menus the effort has been to give a correct balance
of the various food elements with the approximate calories furnished
by each meal. They are suggestive only and may be varied according
to the season of the year, the habits of work, or the tastes of the
individual, care being taken to preserve the relative proportions.

For instance, if much starch or fat is taken at a meal and little
protein, the balance should swing in the other direction for another
meal, the amount of protein being increased and that of carbohydrate
decreased.

Common sense must rule in the matter, as one individual would be
illy fed on a diet which would be entirely adequate for another of
more sedentary habit and weaker digestion. All the habits of life
such as exercise, breathing, and mental activity must be taken into
consideration.

As previously remarked, there must be a variety in the diet which will
stimulate the appetite, and, unless the tastes of the various members
of a family are capricious, they may be gratified.

If potatoes are not relished rice may be substituted.

Plain bread may be varied by rolls or biscuits.

Well-masticated nuts may supply the protein usually served in meat and
are often a welcome change.

The protein balance is important as this substance is the basis for
growth and repair of the tissues of the body.

When the protein balance of the family meal is provided by meat, if for
any reason one member of the family does not care for meat, the protein
may be supplied by eggs, or by the legumes as shown on pages 232-234.

_Let me repeat that everyone should watch his likes and dislikes in the
matter of food and guard against allowing himself to become finicky; he
should not cultivate a dislike for a food which may disagree with him
at a certain time or the taste of which he does not like, if that food
is wholesome._

Remember that the likes and dislikes for food are largely matters of
cultivation and one misses much enjoyment and much of health which
comes from a well-nourished body by habitually sitting down to a table
in a pessimistic frame of mind because the food served does not suit
the fancy.

It is very difficult for a mother to provide a meal which suits each
member of her family and consideration for her as well as for self
should teach one to guard against a critical attitude.

The following is an example of a badly balanced menu. It was given
a family, including a child, by a mother who “had no time to study
foods. She gave her folks what was the easiest to get and filled them
up the quickest.” This mother may have wasted hours in gossip with the
neighbors, or on “fancy work.”

  _Breakfast_

  Rolls with butter
  2 cups coffee

  _Luncheon_

  Fried sweet potato
  Bread and butter
  Prunes
  Tea

  _Dinner_

  Macaroni with cheese
  Bread and butter
  Boiled potato
  Boiled rice with milk
  Tea with milk and sugar

The cardinal sin of such a diet is in the lack of protein, the great
predominance of starch, and the inadequate supply of fat. An excessive
amount of sugar, however, was taken in the tea. This was taken to
satisfy the taste, not realizing that the system demanded it for energy.

The child was given one egg and one slice of bread for breakfast. Being
a light eater it asked for no more, but her mother wondered why the
child was so pale and suffered from constipation.

No water was given with any meal.

_There are thousands of such illy nourished children in our schools,
lacking in brain power and readily subject to infection, because of
badly combined or poorly prepared food._

The number of calories in such a diet may suffice to sustain life, but
the balance is insufficient, the amount inadequate, the tissues are not
repaired, the secretions lack some of their necessary ingredients or
are scanty, and the functions of the body are not well performed.

       *       *       *       *       *

[Sidenote: Sedentary Occupation]

The following diet is for one who has attained full growth and who
exercises no more than to walk a few blocks a day. The diet may seem
light, but when one is sitting indoor most of the time, and has little
outdoor exercise, less waste protein is oxidized and less starch, fat,
and sugar are required for heat and energy. If too much carbonaceous
food is consumed, one will store up too much and become too large. If
more protein is consumed than is oxidized and eliminated one is liable
to various derangements of the system.

Every person at sedentary employment should exercise each day without
fail, being particular to bring a thorough circulation to the vital
organs. He should fully inflate his lungs many times a day and see to
it that the air in the room is pure.

In nearly all of the following menus coffee and tea have been omitted
because, as before stated, they are not foods but _stimulants_, and
the caffein and thein may overstimulate the nerves and the heart. They
sometimes retard digestion. Some other warm drink should be substituted
when there is digestive disturbance, or when the digestion is weak.
They should never at any time be used strong. They are used simply for
their pleasing flavor, or for warmth.

The following diet is suggested for one of sedentary habit who is not
exercising and does not use up much mental or physical energy.


DIET I

_Breakfast_

  Fruit
  Cereal coffee or toast coffee
  Dry toast (one slice), or one muffin, or one gem
  1 slice of crisp bacon
  1 egg

If one has taken brisk exercise, or is to take a brisk walk of two or
three miles, a dish of oatmeal or some other cereal, with cream and
sugar, may be added.

_Luncheon_

  Fruit
  Creamed soup or purée
  Meat, cheese or peanut butter sandwich, or two thin slices of
    bread and butter
  Cup of custard, or one piece of cake, or two cookies

If purée of peas or beans is used the sandwich may be omitted and one
slice of bread is sufficient. If the soup contains much cream or is
made of corn or potato, the cake or cookies may be omitted.

_Dinner_

  Meat, gravy, potatoes or rice
  One vegetable (green peas, green beans, cauliflower, greens,
    corn. Do not use dried baked beans or dried peas with
    lean meat)
  Salad or fruit
  Ice cream or pudding, such as bread, rice, tapioca, cornstarch,
    or chocolate, or an easily digested dessert.

Diet II gives the calories of energy required by a business man or
brain worker who uses much mental force.


DIET II

_Breakfast_

  1 orange without sugar                            100
  1 shredded wheat biscuit with sugar and cream     175
  2 slices bacon                                     75
  2 tablespoonfuls creamed potato                   160
  1 egg                                              70
  2 slices toast with butter                        250
  1 baked apple                                      85
  2 cups cocoa                                       80
                                                   ————
                                                    995

_Luncheon_

  1 bowl oyster stew                                    250
  6 crackers                                            120
                                                        ———
                                                        370

_Dinner_

  1/2 pint clear soup with croutons                      75
  1 portion beefsteak                                   433
  2 tablespoonfuls green beans                           70
  2 baked potatoes (medium size)                         90
  2 slices bread                                        175
  1 pat butter                                           33
  2 tablespoonfuls rice pudding with raisins and cream  450
                                                       ————
                                                       1326
                                                        995
                                                        370
                                                       ————
                                                       2691

Diet III gives approximately the calories required for one taking
moderate exercise.


DIET III

_Breakfast_

  Fruit with sugar                                     100
  2 tablespoonfuls oatmeal with cream and sugar        170
  1 piece broiled fish four inches square              205
  2 slices buttered toast                              250
  1 cup coffee with cream and sugar                    125
                                                      ————
                                                       850

_Luncheon_

  2 tablespoonfuls beans baked with bacon              150
  1 baked apple with cream                             200
  1 cup cocoa                                           68
  2 slices bread (thin) with butter                    200
                                                      ————
                                                       618

  _Dinner_

  1/2 pint purée (vegetable)                           150
  1 portion boiled mutton                              300
  2 potatoes (medium size)                              90
  2 slices bread and butter                            250
  2 tablespoonfuls scalloped tomato                    150
  2 tablespoonfuls brown betty or peach tapioca
      with light cream                                 300
  1 cup coffee with cream and sugar                    125
                                                      ————
                                                      1365
                                                       850
                                                       618
                                                      ————
                                                      2833

       *       *       *       *       *

[Sidenote: For the Girl or Boy from 13 to 21]

There is no time in life when one needs to be so watchful of the diet
as during these years. Growth is very rapid and much protein is needed
to build tissue, particularly to build the red blood corpuscles. Anemia
may be produced by a faulty diet or by one which lacks eggs, meat,
fresh vegetables or fruit, particularly in developing girls.

The red meats, the yolk of eggs, spinach and all kinds of greens are
important articles of diet at this time, because of the iron which they
contain. They should be supplied freely. Butter and milk are valuable
and _regular exercises with deep breathing are imperative_.

If the appetite wanes, be sure that the girl or boy is getting
sufficient brisk exercise in the fresh air.


DIET IV

_Breakfast_

  Fruit
  Oatmeal, shredded wheat biscuit or triscuit, or some other well
    cooked cereal with cream and sugar
  One egg, boiled or poached (cooked soft), or chipped beef in
    cream gravy
  Cereal coffee, toast coffee, or hot water with cream and sugar
  Buttered toast, gems, or muffins

_Luncheon_

  Cream soup, bean soup, or purée with crackers or dry toast
  Bread and butter
  Fruit and cake, or rice pudding, or bread, tapioca, cocoanut, or
    cereal pudding of any kind, or a cup of custard, or a dish
    of ice cream

_Dinner_

  Meat (preferably red meat)
  Potatoes
  Vegetables, preferably spinach, or greens of some kind, or beets
    boiled with the tops
  Graham bread
  Fruit, graham bread toasted or graham wafers. Cake of some
    simple variety.
  Candy (small quantity)

A growing child is usually hungry when it returns from school, and
it is well to give a little easily digested food regularly at this
time, but not sufficient to destroy the appetite for the evening meal.
Irregular eating between meals, however, should be discouraged. An egg
lemonade is easily digested and satisfying. If active and exercising
freely, craving for sweets should be gratified to a limited extent.

The growing boy or girl takes from six to eight glasses of water a day.

Overeating, however, should be guarded against for many of the dietary
habits of adult life are formed in this period, and the foundation of
many dietetic difficulties and disturbances of the system are laid.

If one is not hungry at meal time, the chances are that he is not
exercising sufficiently in the fresh air.

_Thorough mastication should be insisted on._

One should encourage the habit of eating hard crusts or hard crackers
to exercise the teeth and to insure the swallowing of sufficient saliva.

The schoolboy or schoolgirl, anxious to be out at play, is especially
liable to bolt the food or to eat an insufficient amount. This should
be especially guarded against and parents should insist on the proper
time being spent at meals.

The dislike for meat or for certain vegetables or articles of food,
which develops in this period, should be guarded against. All wholesome
food should be made a part of the diet and the child should not
be indulged in its likes or dislikes, but should be instructed in
overcoming these.

Very few foods disagree at all times with a normal child and if they
do the cause usually lies in a disordered digestion which needs to be
restored by more careful attention to exercise, deep breathing, and to
elimination of the waste of the system.

       *       *       *       *       *

[Sidenote: The Athlete]

The young man active in athletics needs practically the same food as
given in Diet IV, yet more in quantity. He needs to drink water before
his training and at rest periods during the game.

If he is too fat, he should train off the superfluous amount by
exercise and by judiciously abstaining from much sugars, starches, and
fats.

Diets for reduction, however, must be governed by the condition of the
kidneys and the digestive organs.

Deep breathing habits are imperative though he must be careful not
to overtax lungs or heart by hard continuous straining, either at
breathing or at exercise.

       *       *       *       *       *

[Sidenote: The Laboring Man]

The man engaged in muscular work requires plenty of food; he can digest
foods which the professional or business man, or the man of sedentary
habits, cannot. He will probably be able to drink coffee and tea
without any disturbance to nerves or to digestion. In his muscular work
he liberates the waste freely and needs fats, starches, and sugars to
supply the heat and energy. This is especially true of men who work in
the fresh air; the muscular action liberates waste and heat and the
full breathing freely oxidizes the waste, putting it in condition to be
excreted through lungs, skin, kidneys, and intestines.

He should have more meat, eggs, and nitrogenous foods, and he also
needs more carbonaceous foods to supply heat and energy, as given in
Diet V. Three hearty meals a day are necessary.

His muscular movements keep the circulation forceful and the vital
organs strong so that his diet may be almost as heavy as that of the
football player. Meat or eggs, twice a day, with tea or coffee, and
even _pie_ may be eaten with impunity. He needs a good nourishing
breakfast of bacon and eggs or meat, also potatoes, or a liberal
allowance of bread and butter, corn bread, muffins, etc.


DIET V

_Breakfast_

                                                      _Calories_

  4 tablespoonfuls fresh or stewed fruit with sugar          100
  3 tablespoonfuls oatmeal with milk and sugar               200
  1 portion ham four inches square with fat                  200
  2 eggs                                                     140
  2 cups coffee with cream and sugar                         250
  2 slices bread and butter                                  250
                                                            ————
                                                            1140

_Luncheon_

  2 sandwiches (cheese)                                      300
  1 sandwich (marmalade)                                     125
  1 pint of milk                                             200
  1 slice cake or pie                                        100
                                                            ————
                                                             725

_Dinner_

  1/2 pint oyster stew or vegetable purée                    100
  2 baked potatoes                                           100
  4 tablespoonfuls macaroni with tomatoes and butter sauce   200
  4 slices thick bread and butter                            500
  2 portions roast beef (fat)                                400
  2 cups coffee                                              250
  1 slice pie                                                100
                                                            ————
                                                            1650
                                                            1140
                                                             725
                                                            ————
                                                            3515

       *       *       *       *       *

[Sidenote: Condition of Age]

The following constitutes an average which will supply the daily
requirement for the aged, or for one at any age whose organs are not
functioning strongly.


DIET VI

_Breakfast_

  Cereal, well cooked, with cream or sugar. Oatmeal is preferable
    because it is laxative
  One egg, boiled, poached, or baked (soft)
  One slice of toast
  Cereal coffee

_Dinner_

  Bouillon or soup
  Meat—small portion
  Potato (preferably baked)
  One vegetable
  Cup custard, or bread, rice, or other light pudding with lemon
    cream sauce

_Supper_

  Soup
  Bread and butter
  Stewed fruit
  Tea

These individuals need little meat. Tea, if used, should not be strong
and, for reasons given on page 104, should never be allowed to steep.

If the habit of life is active, if one exercises regularly, and if the
constitution is vigorous and the body not too encumbered with fat, a
greater variety and amount of food may be allowed, but great regularity
should be observed concerning the diet and the hours for meals.
Thorough mastication is more than ever a necessity.

If inclined to constipation, or if the kidneys are inactive, grapes or
an apple, or some fruit, well chewed, may be eaten just before retiring.

Careful attention must be given to securing thorough removal of waste
by attention to the eliminative organs, not overloading them.


_TABLES OF USE IN MAKING UP BALANCED DIETS_

The following table from Dudley Roberts is of material help in making
up combinations of foodstuffs for balanced diets:

  ——————————————————————+——————————————————————+—————————+—————————
    FOOD STUFF          |       Quantity       |Calories |Grams  of
                        |                      |of Energy| Protein
  ——————————————————————+——————————————————————+—————————+—————————
  Milk                  |   8 oz.  1 glass     |     160 |     8.4
  Skim milk             |   8 oz.  1 glass     |      80 |     8.0
  Cream                 |   8 gm.  1 tsp.      |      20 |     0.2
  Condensed milk        |                      |         |
    (sweetened)         |  20 gm.  hp. tsp.    |      50 |     1.8
  Condensed milk        |                      |         |
    (unsweetened)       |  20  ”    ”   ”      |      40 |     2.0
  Chocolate powd.       |  10  ”    ”   ”      |      90 |     1.2
  Beef juice, beef tea, |                      |         |
    bouillon, clear soup|    5 oz.  teacup     |    5-30 |     1.3
  Cream soup            |    8  ”  soup plate  | 100-250 |
  Sugar                 |   10 gm.  hp. tsp.   |      40 |
  Egg (whole)           |   50  ”     1        |      70 |
  Egg (yolk)            |   ——        1        |      55 |     2.4
  Butter                |   10 gm.  1 in. cube |      65 |     0.6
  Cheese                |    ”  ”     ”    ”   |      45 |     3.0
  Meat and fish (lean)  |   50  ”   hp. tbsp.  |      60 |    12.0
  Meat (medium fat)     |    ”  ”    ”    ”    |     100 |     7.0
    ”  (very fat)       |    ”  ”    ”    ”    |     150 |     4.0
  Oysters (small)       |    8  ”     1        |       3 |     0.5
  Oysters (large)       |   25  ”     1        |      10 |     1.5
  Crackers              | 3-10  ”     1        |   12-30 |     3-6
  Cereals (cooked)      |30-40  ”    teacup    | 110-150 |     3-5
  Cereals (prepared)    |  5-7  ”   hp. tsp.   |  18-25  | 0.5-0.7
  Shredded wheat        |   30  ”     1        |    100  |     3.0
  Triscuit              |   15  ”     1        |     50  |     1.5
  Peas (fresh or canned)|   35  ”   hp. tbsp.  |     25  |     2.0
  Peas (dried)          |   25  ”    ”    ”    |    100  |     6.0
  Bean (dried)          |   25  ”    ”    ”    |     90  |     5.0
  Bean                  |                      |         |
    (fresh or canned)   |   30  ”    ”    ”    |     30  |     1.0
  Potatoes              |                      |         |
    (medium size)       |   90  ” 1, 3 in. long|      80 |     1.0
  Jelly (sweet)         |   ——         teacup  |  50-100 |     —
  Apples                |  100  ”      1       |      40 |     0.2
  Oranges               |  125  ”  1 med. size |      60 |     0.5
  Bananas               |   50  ”  1 med. size |      45 |     0.7
  Dried fruit           |                      |         |
    (prunes, etc.)      |  100  ”  1 saucer    |         |
                        |              medium  | 100-200 |     1-3
  ——————————————————————+——————————————————————+—————————+—————————

The following tables[11] are exceptionally valuable in compiling
diets in various combinations. One can readily determine the number
of grams in various servings of different foods. For example: a small
serving of beef (round), containing some fat, weighs 36 grams; 40 per
cent., 14.4 grams, is protein, and 60 per cent., 21.6 grams, is fat
(no carbohydrates). One ordinary thick slice of white, home-made bread
weighs 38 grams; 13 per cent., 4.94 grams, is protein; 6 per cent.,
2.28 grams, is fat, and 81 per cent., 30.78 grams, is carbohydrate.

The proportion of proteins, carbohydrates, and fats required by the
average individual as suggested on page 208 can be readily made up from
various combinations of foods. Each individual may ascertain whether he
is taking too much food, or too large a proportion of proteins or of
carbohydrates or fats.

TABLE OF 100 FOOD UNITS

 ———————————————————————————+——————————————————+———————————+—————————————
                            |                  | Wt. of 100| Per cent. of
                            |   “Portion”      |  Calories |
                            |   Containing     +—————+—————+————+———+————
                            |   100 Food       |     |     |    |   |Car-
                            | Units (approx.)  |Grams| Oz. |Pro-|Fat|boh-
     NAME OF FOOD           |                  |     |     |teid|   |ydr-
                            |                  |     |     |    |   |ate
 ———————————————————————————+——————————————————+—————+—————+————+———+————

 COOKED MEATS

 [13]Beef, r’nd, boiled (fat) Small serving    | 36  | 1.3 | 40 | 60|  00
 [13]Beef, r’d, boiled (lean) Large serving    | 62  | 2.2 | 90 | 10|  00
 [13]Beef, r’d, boiled (med.) Small serving    | 44  | 1.6 | 60 | 40|  00
 [13]Beef, 5th rib, roasted   Half serving     | 18.5| 0.65| 12 | 88|  00
 [13]Beef, 5th rib, roasted   Very small s’v’g.| 25  | 0.88| 18 | 82|  00
 [14]Beef, ribs boiled        Small serving    | 30  | 1.1 | 27 | 73|  00
 [12]Calves foot jelly                         |112  | 4.  | 19 | 00|  81
 [12]Chicken, canned          One thin slice   | 27  | 0.96| 23 | 77|  00
 [12]Lamb chops, broiled, av. One small chop   | 27  | 0.96| 24 | 76|  00
 [12]Lamb leg, roasted        Ord. serving     | 50  | 1.8 | 40 | 60|  00
 [13]Mutton, leg, boiled      Large serving    | 34  | 1.2 | 35 | 65|  00
 [13]Pork, ham, boiled (fat)  Small serving    | 20.5| 0.73| 14 | 86|  00
 [13]Pork, ham, boiled        Ord. serving     | 32.5| 1.1 | 28 | 72|  00
 [13]Pork, ham, r’st’d (fat)  Small Serving    | 27  | 0.96| 19 | 81|  00
 [13]Pork, ham, r’st’d (lean) Small serving    | 34  | 1.2 | 33 | 67|  00
 [13]Veal, leg, boiled        Large serving    | 67.5| 2.4 | 73 | 27|  00

 VEGETABLES

 [12]Artichokes, av. canned                    |430  | 15. | 14 |  0|  86
 [12]Asparagus, av. canned                     |540  | 19. | 33 |  5|  62
 [12]Asparagus, av. cooked                     |206  | 7.19| 18 | 63|  19
 [12]Beans, baked, canned     Small side dish  | 75  | 2.66| 21 | 18|  61
 [12]Beans, Lima, canned      Large side dish  |126  | 4.44| 21 |  4|  75
 [12]Beans, string, cooked    Five servings    |480  |16.66| 15 | 48|  37
 [12]Beets, edible portion,                    |     |     |    |   |
     cooked                  Three servings    |245  | 8.7 |  2 | 23|  75
 [12]Cabbage, edible portion                   |310  |11   | 20 | 8 |  72
 Carrots, cooked             Two servings      |164  | 5.81| 10 | 34|  56
 [12]Cauliflower, as purchased                 |312  |11.  | 23 | 15|  62
 [12]Celery, edible portion                    |540  |19.  | 24 |  5|  71
 Corn, sweet, cooked         One side dish     | 99  | 3.5 | 13 | 10|  77
 [12]Cucumbers, edible pt.                     |565  |20.  | 18 | 10|  72
 [12]Eggplant, edible pt.                      |350  |12.  | 17 | 10|  73
 Lentils, cooked                               | 89  | 3.15| 27 |  1|  72
 [12]Lettuce, edible pt.                       |505  |18.  | 25 | 14|  61
 [12]Mushrooms, as purchased                   |215  | 7.6 | 31 |  8|  61
 Onions, fresh, edible pt.                     |200  | 7.1 | 13 |  5|  82
 [12]Onions, cooked           2 large s’v’gs   |240  | 8.4 | 12 | 40|  48
 Parsnips, cooked                              |163  | 5.84| 10 | 34|  56
 [12]Peas, green, canned      Two servings     |178  | 6.3 | 25 |  3|  72
 [12]Peas, green, cooked      One serving      | 85  | 3.  | 23 | 27|  50
 Potatoes, baked             One good sized    | 86  | 3.05| 11 |  1|  88
 [12]Potatoes, boiled         One large sized  |102  | 3.62| 11 |  1|  88
 [12]Potatoes mashed(creamed) One serving      | 89  | 3.14| 10 | 25|  65
 [12]Potatoes, chips          One-half s’v’g   | 17  | 0.6 |  4 | 63|  33
 [12]Potatoes, sweet, cooked  Half av. potato. | 49  | 1.7 |  6 |  9|  85
 [12]Pumpkins, edible pt.                      |380  |13.  | 15 |  4|  81
 Radishes, as purchased                        |480  |17.  | 18 |  3|  79
 Rhubarb, edible pt.                           |430  |15.  | 10 | 27|  63
 [12]Spinach, cooked          Two ord. s’v’gs  |174  | 6.1 | 15 | 66|  19
 Squash, edible pt.                            |210  | 7.4 | 12 | 10|  78
 [12]Succotash, canned        Ord. serving     |100  | 3.5 | 15 |  9|  67
 [12]Tomatoes, fresh as                        |     |     |    |   |
     purchased               Four av.          |430  |15.  | 15 | 16|  69
 Tomatoes, canned                              |431  |15.2 | 21 |  7|  72
 [12]Turnips, edible pt.      2 large s’v’gs   |246  | 8.7 | 13 |  4|  83
 Vegetable oysters                             |273  | 9.62| 10 | 51|  39

 FRUITS (DRIED)

 [12]Apples, as purchased                      | 34  | 1.2 | 3  |  7|  90
 Apricots, as purchased                        | 35  | 1.24| 7  |  3|  90
 [12]Dates, edible portion    Three large      | 28  | 0.99| 2  |  7|  91
 [12]Dates, as purchased                       | 31  | 1.1 | 2  |  7|  91
 [12]Figs, edible portion     One large        | 31  | 1.1 | 5  |  0|  95
 [12]Prunes, edible portion   Three large      | 32  | 1.14| 3  |  0|  97
 [12]Prunes, as purchased                      | 38  | 1.35| 3  |  0|  97
 [12]Raisins, edible portion                   | 28  | 1.  | 3  |  9|  88
 [12]Raisins, as purchased                     | 31  | 1.1 | 3  |  9|  88

 FRUITS (FRESH OR COOKED)

 [12]Apples, as purchased     Two apples       |206  | 7.3 | 3  |  7|  90
 Apples, baked                                 | 94  | 3.3 | 2  |  5|  93
 Apples, sauce               Ord. serving      |111  | 3.9 | 2  |  5|  93
 Apricots, cooked            Large serving     |131  | 4.61| 6  |  0|  94
 [12]Bananas, edible pt.      One large        |100  | 3.5 | 5  |  5|  90
 [12]Blackberries                              |170  | 5.9 | 9  | 16|  75
 Blueberries                                   |128  | 4.6 | 3  |  8|  89
 [12]Blueberries, canned                       |165  | 5.8 | 4  |  9|  87
 Cantaloupe                  Half ord. serv’g  |243  | 8.6 | 6  |  0|  94
 [12]Cherries, edible portion                  |124  | 4.4 | 5  | 10|  85
 [12]Cranberries, as purchased                 |210  | 7.5 | 3  | 12|  85
 [12]Grapes, as purchased, av.                 |136  | 4.8 | 5  | 15|  80
 Grape fruit                                   |215  | 7.57| 7  |  4|  89
 Grape juice                 Small glass       |120  | 4.2 | 0  |  0| 100
 Gooseberries                                  |261  | 9.2 | 5  |  0|  95
 Lemons                                        |215  | 7.57| 9  | 14|  77
 [12]Lemon juice                               |246  | 8.77| 0  |  0| 100
 Nectarines                                    |147  | 5.18| 4  |  0|  96
 Olives, ripe                About seven       | 37  | 1.31| 2  | 91|   7
 Oranges, as purchased, av.  One very large    |270  | 9.4 | 6  |  3|  91
 [12]Oranges, juice           Large glass      |188  | 6.62| 0  |  0| 100
 Peaches, as purchased, av.  Three ordinary    |290  |10.  | 7  |  2|  91
 [12]Peaches, sauce           Ord. serving     |136  | 4.78| 4  |  2|  94
 Peaches, juice              Ordinary glass    |136  | 4.80| 0  |  0| 100
 Pears                       One large pear    |173  | 5.40| 4  |  7|  89
 [12]Pears, sauce                              |113  | 3.98| 3  |  4|  93
 Pineapples, edible p’t’n, av.                 |226  | 8.  | 4  |  6|  90
 [12]Raspberries, black                        |146  | 5.18|10  | 14|  76
 Raspberries, red                              |178  | 6.29| 8  |  0|  92
 Strawberries, av.           Two servings      |260  | 9.1 |10  | 15|  75
 [12]Watermelon, av.                           |760  |27.  | 6  |  6|  88

 DAIRY PRODUCTS

 [12]Butter                   Ordinary pat.    | 12.5| 0.44| 0.5|99.5| 00
 [12]Buttermilk               1-1/2 glass      |275  | 9.7 |34  | 12|  54
 [12]Cheese, Am., pale        1-1/2 cubic in.  | 22  | 0.77|25  | 73|   2
 [12]Cheese, cottage          4 cubic in.      | 89  | 3.12|76  |  8|  16
 [12]Cheese, full cream       1-1/2 cubic in.  | 23  | 0.82|25  | 73|   2
 [12]Cheese, Neufchatel       1-1/2 cubic in.  | 29.5| 1.05|22  | 76|   2
 [12]Cheese, Swiss            1-1/2 cubic in.  | 23  | 0.8 |25  | 74|   1
 [12]Cheese, pineapple        1-1/2 cubic in.  | 20  | 0.72|25  | 73|   2
 [12]Cream                    1/4 ord. glass   | 49  | 1.7 | 5  | 86|   9
 Kumyss                                        |188  | 6.7 |21  | 37|  42
 [12]Milk, condensed, sweet’nd                 | 30  | 1.06|10  | 23|  67
 [12]Milk, condensed, unsw’t’nd                | 59  | 2.05|24  | 50|  26
 [12]Milk, skimmed            1-1/2 glass      |255  | 9.4 |37  |  7|  56
 [12]Milk, whole              Small glass      |140  | 4.9 |19  | 52|  29
 Milk, human, 2d week                          |162  | 5.7 |11  | 47|  42
 Milk, human, 3d month                         |171  | 6   | 7  | 46|  47
 [12]Whey                     Two glasses      |360  |13   |15  | 10|  75

 CAKES, PASTRY, PUDDINGS, AND DESSERTS

 [12]Cake, chocolate layer   Half ord. sq. pc. | 28  | 0.98| 7  | 22|  71
 [12]Cake, gingerbread       Half ord. sq. pc. | 27  | 0.96| 6  | 23|  71
 Cake, sponge               Small piece        | 25  | 0.89| 7  | 25|  68
 Custard, caramel                              | 71  | 2.51|19  | 10|  71
 Custard, milk              Ordinary cup       |122  | 4.29|26  | 56|  18
 Custard, tapioca           Two-thirds ord.    | 69.5| 2.45| 9  | 12|  79
 [12]Doughnuts               Half a doughnut   | 23  | 0.8 | 6  | 45|  49
 [12]Lady fingers            Two               | 27  | 0.95|10  | 12|  78
 [12]Macaroons               Four              | 23  | 0.82| 6  | 33|  61
 [12]Pie, apple              One-third piece   | 38  | 1.3 | 5  | 32|  63
 [12]Pie, cream              One-fourth pc.    | 30  | 1.1 | 5  | 32|  63
 [12]Pie, custard            One-third piece   | 55  | 1.9 | 9  | 32|  59
 [12]Pie, lemon              One-third piece   | 38  | 1.35| 6  | 36|  58
 [12]Pie, mince              One-fourth piece  | 35  | 1.2 | 8  | 38|  54
 [12]Pie, squash             One-third piece   | 55  | 1.9 |10  | 42|  48
 Pudding, apple sago                           | 81  | 3.02| 6  |  3|  91
 Pudding, brown betty       Half ord. s’v’g    | 56.6| 2.  | 7  | 12|  81
 Pudding, cream rice        Very small s’v’g   | 75  | 2.65| 8  | 13|  79
 Pudding, Indian meal       Half ord. s’v’g    | 56.6| 2.  |12  | 25|  63
 Pudding, apple tapioca     Small serving      | 79  | 2.8 | 1  |  1|  98
 Tapioca, cooked            Ord. serving       |108  | 3.85| 1  |  1|  98

 SWEETS AND PICKLES

 [12]Catsup, tomato, av.                       |170  | 6.  |10  |  3|  87
 Candy, plain                                  | 26  | 0.9 | 0  |  0| 100
 Candy, chocolate                              | 30  | 1.1 | 1  |  4|  95
 [12]Honey                   Four teasp’ns     | 30  | 1.05| 1  |  0|  99
 [12]Marmalade (orange)                        | 28.3| 1   | 0.5|2.5|  97
 Molasses, cane                                | 35  | 1.2 | 0.5|  0|99.5
 [12]Olives, green, edible portion Five to     |     |     |    |   |
   seven                                       | 32  | 1.1 | 1  | 84|  15
 [12]Olives, ripe, edible portion Five to      |     |     |    |   |
   seven                                       | 38  | 1.3 | 2  | 91|   7
 [12]Pickles, mixed                            |415  |14.6 |18  | 15|  67
 [12]Sugar, granulated       Three heap’g tsp. |     |     |    |   |
                             or 1-1/2 lumps    | 24  | 0.86| 0  |  0| 100
 [12]Sugar, maple            Four teaspoons    | 29  | 1.03| 0  |  0| 100
 [12]Syrup, maple            Four teaspoons    | 35  | 1.2 | 0  |  0| 100

 NUTS, EDIBLE PORTION

 [12]Almonds, av.            Eight to 15       | 15  | 0.53|13  |77 |  10
 [12]Beechnuts                                 | 14.8| 0.52|13  |79 |   8
 [12]Brazil nuts             Three ord. size   | 14  | 0.49|10  |86 |   4
 [12]Butternuts                                | 14  | 0.50|16  |82 |   2
 [12]Cocoanuts                                 | 16  | 0.57| 4  |77 |  19
 [12]Chestnuts, fresh, av.                     | 40  | 1.4 |10  |20 |  70
 [12]Filberts, av.           Ten nuts          | 14  | 0.48| 9  |84 |   7
 [12]Hickory nuts                              | 13  | 0.47| 9  |85 |   6
 [12]Peanuts, av.            Thirteen double   | 18  | 0.62|20  |63 |  17
 [12]Pecans, polished        About eight       | 13  | 0.46| 6  |87 |   7
 [12]Pine nuts (pignolias)   About eighty      | 16  | 0.56|22  |74 |   4
 [12]Walnuts, California     About six         | 14  | 0.48|10  |83 |   7

 CEREALS

 [12]Bread, brown, average   Ord. thick slice  | 43  | 1.5 | 9  | 7 |  84
 [12]Bread, corn (johnny                       |     |     |    |   |
     cake) av.              Small square       | 38  | 1.3 |12  |16 |  72
 [12]Bread, white, home made Ord. thick slice  | 38  | 1.3 |13  | 6 |  81
 [12]Cookies, sugar          Two               | 24  | 0.83| 7  |22 |  71
 Corn flakes, toasted       Ord. serving       | 27  | 0.97|11  | 1 |  88
 [12]Corn meal, granular,                      |     |     |    |   |
     av.                    2-1/2 level tbsp.  | 27  | 0.96|10  | 5 |  85
 Corn meal, unbolted, av.   Three tbsp.        | 26  | 0.92| 9  |11 |  80
 [12]Crackers, graham        Two crackers      | 23  | 0.82| 9.5|20.5| 70
 [12]Crackers, oatmeal       Two crackers      | 23  | 0.81|11  |24 |  65
 [12]Crackers, soda          3-1/2 “Uneedas”   | 24  | 0.83| 9.4|20 |70.6
 [12]Hominy, cooked          Large serving     |120  | 4.2 |11  | 2 |  87
 [12]Macaroni, av.                             | 27  | 0.96|15  | 2 |  83
 Macaroni, cooked           Ord. serving       |110  | 3.85|14  |15 |  71
 [12]Oatmeal, boiled         1-1/2 serving     |159  | 5.6 |18  | 7 |  75
 [12]Popcorn                                   | 24  | 0.86|11  |11 |  78
 [12]Rice, uncooked                            | 28  | 0.98| 9  | 1 |  90
 [12]Rice, boiled            Ord. cereal dish  | 87  | 3.1 |10  | 1 |  89
 [12]Rice, flakes            Ord. cereal dish  | 27  | 0.94| 8  | 1 |  91
 [12]Rolls, Vienna, av.      One large roll    | 35  | 1.2 |12  | 7 |  81
 [12]Shredded wheat          One biscuit       | 27  | 0.94|13  |4.5|82.5
 [12]Spaghetti, average                        | 28  | 0.97|12  | 1 |  87
 [12]Wafers, vanilla         Four              | 24  | 0.84| 8  |13 |  71
 Wheat, flour, e’t’e w’h’t,                    |     |     |    |   |
     av.                    Four tbsp.         | 27  | 0.96|15  | 5 |  80
 [12]Wheat, flour, graham,                     |     |     |    |   |
     av.                    4-1/2 tbsp.        | 27  | 0.96|15  | 5 |  80
 [12]Wheat, flour, patent,                     |     |     |    |   |
     family and straight                       |     |     |    |   |
     grade spring wheat,                       |     |     |    |   |
     av.                    Four tbsp.         | 27  | 0.97|12  | 3 |  85
 [12]Zwieback                Size of thick     |     |     |    |   |
                             slice of bread    | 23  | 0.81| 9  |21 |  70

 MISCELLANEOUS

 [12]Eggs, hen’s, boiled     One large egg     | 59  | 2.1 |32  |68 |  00
 [12]Eggs, hen’s, whites     Of six eggs       |181  | 6.4 |100 | 0 |  00
 [12]Eggs, hen’s, yolks      Two yolks         | 27  | 0.94|17  |83 |  00
 [12]Omelet                                    | 94  | 3.3 |34  |60 |   6
 [12]Soup, beef, av.                           |380  |13.  |69  |14 |  17
 [12]Soup, bean, av.          Very large plate |150  | 5.4 |20  |20 |  60
 [12]Soup, cream of celery    Two plates       |180  | 6.3 |16  |47 |  37
 [12]Consommé                                  |830  |29.  |85  |00 |  15
 [12]Clam chowder             Two plates       |230  | 8.25|17  |18 |  65
 [12]Chocolate, bitter        Half-a-square    | 16  | 0.56| 8  |72 |  20
 [12]Cocoa                                     | 20  | 0.69|17  |53 |  30
 Ice cream (Phila.)          Half serving      | 45  | 1.6 | 5  |57 |  38
 Ice cream (New York)        Half serving      | 48  | 1.7 | 7  |47 |  46
 ———————————————————————————+——————————————————+—————+—————+————+———+————


TABLES SHOWING AVERAGE HEIGHT, WEIGHT, SKIN SURFACE, AND FOOD UNITS
REQUIRED DAILY WITH VERY LIGHT EXERCISE

BOYS

  ————+———————————+———————————+—————————————+————————————
      | Height in | Weight in | Surface in  | Calories or
  Age |  Inches   |  Pounds   | Square Feet | Food Units
  ————+———————————+———————————+—————————————+————————————
    5 |   41.57   |   41.09   |      7.9    |    816.2
    6 |   43.75   |   45.17   |      8.3    |    855.9
    7 |   45.74   |   49.07   |      8.8    |    912.4
    8 |   47.76   |   53.92   |      9.4    |    981.1
    9 |   49.69   |   59.23   |      9.9    |   1043.7
   10 |   51.58   |   65.30   |     10.5    |   1117.5
   11 |   53.33   |   70.18   |     11.0    |   1178.2
   12 |   55.11   |   76.92   |     11.6    |   1254.8
   13 |   57.21   |   84.85   |     12.4    |   1352.6
   14 |   59.88   |   94.91   |     13.4    |   1471.3
  ————+———————————+———————————+—————————————+————————————

GIRLS

  ————+———————————+———————————+—————————————+————————————
      | Height in | Weight in | Surface in  | Calories or
  Age |  Inches   |  Pounds   | Square Feet | Food Units
  ————+———————————+———————————+—————————————+————————————
    5 |   41.29   |   39.66   |      7.7    |    784.5
    6 |   43.35   |   43.28   |      8.1    |    831.9
    7 |   45.52   |   47.46   |      8.5    |    881.7
    8 |   47.58   |   52.04   |      9.2    |    957.1
    9 |   49.37   |   57.07   |      9.7    |   1018.5
   10 |   51.34   |   62.35   |     10.2    |   1081.0
   11 |   53.42   |   68.84   |     10.7    |   1148.5
   12 |   55.88   |   78.31   |     11.8    |   1276.8
  ————+———————————+———————————+—————————————+————————————

MEN

  ——————————+————————+———————————+————————+—————————+——————————+—————
  Height in | Weight |  Surface  |        | Calories|Food Units|
   Inches   |   in   | in Square |Proteids| or Fats | Carbo-   |Total
            | Pounds |   Feet    |        |         |hydrates  |
  ——————————+————————+———————————+————————+—————————+——————————+—————
      61    |  131   |   15.92   |   197  |   591   |    1182  | 1970
      62    |  133   |   16.06   |   200  |   600   |    1200  | 2000
      63    |  136   |   16.27   |   204  |   612   |    1224  | 2040
      64    |  140   |   16.55   |   210  |   630   |    1260  | 2100
      65    |  143   |   16.76   |   215  |   645   |    1290  | 2150
      66    |  147   |   17.06   |   221  |   663   |    1326  | 2210
      67    |  152   |   17.40   |   228  |   684   |    1368  | 2280
      68    |  157   |   17.76   |   236  |   708   |    1416  | 2360
      69    |  162   |   18.12   |   243  |   729   |    1458  | 2430
      70    |  167   |   18.48   |   251  |   753   |    1506  | 2510
      71    |  173   |   18.91   |   260  |   780   |    1560  | 2600
      72    |  179   |   19.34   |   269  |   807   |    1614  | 2690
      73    |  185   |   19.89   |   278  |   834   |    1668  | 2780
      74    |  192   |   20.33   |   288  |   864   |    1728  | 2880
      75    |  200   |   20.88   |   300  |   900   |    1800  | 3000
  ——————————+————————+———————————+————————+—————————+——————————+—————

WOMEN

  ——————————+————————+———————————+————————+—————————+——————————+—————
  Height in | Weight |  Surface  |        | Calories|Food Units|
   Inches   |   in   | in Square |Proteids| or Fats | Carbo-   |Total
            | Pounds |   Feet    |        |         |hydrates  |
  ——————————+————————+———————————+————————+—————————+——————————+—————
      59    |  119   |   14.82   |   179  |   537   |    1074  | 1790
      60    |  122   |   15.03   |   183  |   549   |    1098  | 1830
      61    |  124   |   15.29   |   186  |   558   |    1116  | 1860
      62    |  127   |   15.50   |   191  |   573   |    1146  | 1910
      63    |  131   |   15.92   |   197  |   591   |    1182  | 1970
      64    |  134   |   16.13   |   201  |   603   |    1206  | 2010
      65    |  139   |   16.48   |   209  |   627   |    1254  | 2090
      66    |  143   |   16.76   |   215  |   645   |    1290  | 2150
      67    |  147   |   17.06   |   221  |   663   |    1326  | 2210
      68    |  151   |   17.34   |   227  |   681   |    1362  | 2270
      69    |  155   |   17.64   |   232  |   696   |    1392  | 2320
      70    |  159   |   17.92   |   239  |   717   |    1434  | 2390
  ——————————+————————+———————————+————————+—————————+——————————+—————

 NOTE.—With active exercise an increase of about 20 per cent. total
 food units may be needed.


DIETARY CALCULATION WITH FOOD VALUES IN CALORIES PER OUNCE

  ————————————————————————+——————————+———————+———————————————+——————
                          | Proteids |  Fats | Carbohydrates | Total
      _Breakfast_         +——————————+———————+———————————————+——————
                          |          |       |               |
  Gluten gruel, 5 oz.     |   23.5   |   1.0 |     30.0      |
  Soft-boiled egg         |   26.3   |  41.9 |               |
  Malt honey, 1 oz.       |          |       |     86.2      |
  Creamed potatoes, 5 oz. |   15.0   |  40.0 |    104.0      |
  Zwieback, 2 oz.         |   22.8   |  52.8 |    171.6      |
  Pecans, 3/4 oz.         |    8.4   | 141.0 |     13.4      |
  Apple, 5 oz.            |    2.5   |   6.5 |     83.0      |
                          |   ————   | ————— |    —————      | —————
                          |   98.5   | 283.2 |    488.2      | 869.9
  ————————————————————————+——————————+———————+———————————————+——————


DIETARY CALCULATION WITH FOOD SERVED IN 100 CALORIES PORTIONS

  ——————————————+——————————+——————————+——————+———————————————+——————
                | Portions |          |      |               |
                |   in     | Proteids | Fats | Carbohydrates | Total
                | serving  |          |      |               |
    _Dinner_    +——————————+——————————+——————+———————————————+——————
                |          |          |      |               |
  French soup   |     1/2  |     10   |   20 |       20      |
  Nut sauce     |   1      |     29   |   55 |       16      |
  Macaroni, egg |   1      |     15   |   59 |       26      |
  Baked potato  |   2      |     22   |    2 |      176      |
  Cream gravy   |     1/2  |      5   |   33 |       12      |
  Biscuit       |   1-1/2  |     20   |    2 |      128      |
  Butter        |   1      |      1   |   99 |               |
  Honey         |   2      |          |      |      200      |
  Celery        |     1/4  |      4   |      |       21      |
  Apple juice   |     1/2  |          |      |       50      |
                |  ——————  |    ———   |  ——— |      ———      | ————
                |  10-1/4  |    106   |  270 |      649      | 1025
  ——————————————+——————————+——————————+——————+———————————————+——————


HOURLY OUTGO IN HEAT AND ENERGY FROM THE HUMAN BODY AS DETERMINED IN
THE RESPIRATION CALORIMETER BY THE U. S. DEPT. OF AGRICULTURE

        _Average_ (154 lbs.)                 _Calories_

  Man at rest (asleep)                           65
  Sitting up (awake)                            100
  Light exercise                                170
  Moderate exercise                             190
  Severe exercise                               450
  Very severe exercise                          600


FOOTNOTES:

[11] These are from _Food and Dietetics_ (Norton), published by
the American School of Home Economics, Chicago. They are used in a
number of schools of Domestic Science and in the Dietetic kitchens in
hospitals.

[12] _Chemical Composition of American Food Materials_, Atwater and
Bryant, U. S. Department of Agriculture, Bull. 28.

[13] _Experiments on Losses in Cooking Meats_ (1900-03), Grindley, U.
S. Department of Agriculture, Bull. 141.

[14] Laboratory number of specimen, as per _Experiments on Losses in
Cooking Meats_.




CHAPTER X

DIET IN ABNORMAL CONDITIONS


In the dietetic treatment of any disordered organ, the object must be
to give that organ as much rest from its regular work as is consistent
with keeping up the general nutrition of the system. The stomach and
intestines and liver are so closely allied that, when one is affected,
the others are liable to affection also, and the dietetic treatment is
regulated accordingly.

In abnormal conditions it is necessary to say that the food must be
regulated according to the case. Yet, broadly speaking, a diet largely
of protein, which is digested in the stomach, rests the intestines and
stimulates the liver, and a diet largely of carbohydrates rests the
stomach, because the gastric juice is not active in starch digestion.

When the body is not in normal condition, because certain elements
are lacking in the blood, these elements must be supplied in larger
proportions in the food, and the case is one for a food chemist, or for
one who has made food conditions a study.

The better medical colleges, recognizing the importance of proper food
in health and disease, have in the last few years broadened their
curriculum to include the subject of dietetics. Educated physical
culturists and food specialists, for the correction of deranged
conditions of the system, due to poor circulation and abnormal nerve
and blood conditions, are doing much of the corrective work, due to the
fact that instruction has not been given in the medical colleges.

Diets for the reduction of an abnormal amount of fat must also be
governed according to the individual condition.

In the early stages of various diseases, when toxins are being
produced, as a rule the system is not properly eliminating the waste,
and it is often advisable to abstain from food for from one to three
days, according to conditions. Brisk exercise, deep breathing, and a
free use of water are desirable. A laxative is often recommended.

The diets given here for abnormal conditions are to enable those in
charge of an invalid to gain an intelligent understanding of the needs
of the system and to supply those needs through the proper foods. In
serious cases, however, special diets will be ordered by the medical
attendant to suit the needs of the individual.

A chemical analysis of the blood and the excretions is often the only
method of determining just the diet in the individual case.

Government chemical laboratories in charge of efficient chemists should
be so located as to be accessible to every physician.

The system readily excretes an excess of vegetable products, and, as a
rule, no acute difficulties result from such an excess. Such chronic
difficulties as constipation, torpid liver, and indigestion, however,
frequently result when an excess of starch is taken above that consumed
in energy.

On account of the readiness with which putrefaction occurs in protein
products, care should be taken not to consume these in too great
proportion.

A study of the physical ailments of thousands of women has shown, by
the constituents in the blood and the condition of the different organs
of the digestive system, the habitual taste for foods. One can usually
determine which food the individual has formed a habit of eating,
because the system will show a lack of the elements which that patient
has denied herself on account of her likes and dislikes.

It is necessary to change the mental attitude toward certain foods
before the system will readily assimilate them; thus, as stated, _a
taste for foods which the body requires should be cultivated_.

Every mother, with growing children, should be a thorough student
of the chemistry of food. If the child’s bones do not increase
sufficiently in size and strength after the second year, care in the
selection of foods rich in protein and phosphates of lime and magnesium
may correct it. Such a child should have scraped meat and whole wheat
bread with milk and eggs.

If the child stores up too much fat, increase the amount of exercise
and of oxygen consumed, and either cut down the proportion of sweets
and starches or decrease the quantity of food and require more thorough
mastication.

If one is thin and undernourished, chemical analysis of the contents of
the stomach, intestines, and urine is sometimes desirable. The nerves
should be relaxed, and proper food, exercise, and breathing should
accompany medical treatment, if medicine is needed. Often an entire
change in thought and diet are helpful.

Sometimes a torpid condition of the liver and sluggish activity of the
intestines are indicated. Special exercises to stimulate this activity
and to encourage correct poise and deep breathing are most essential.
The mind must often be stimulated and an interest be awakened,
directing the thoughts in new channels.

Worry and tensity of thought are among the chief causes in the majority
of cases of lack of flesh and of a very large number of blood and
digestive disorders.

       *       *       *       *       *

[Sidenote: Anemia]

In anemia there is either a decrease in the number of red blood
corpuscles or an insufficient amount of blood. When there are too few
red blood corpuscles, “oxygen carriers,” the necessary quantity of
oxygen is not furnished the tissues and the system becomes clogged
with waste. The patient easily tires and is disinclined to exercise,
thus the decreased number of red corpuscles are not kept in forceful
circulation and the carbon dioxid is not freely thrown off by the
lungs; this further aggravates the condition.

Since the blood is made from the foods assimilated, the point is to
supply food which builds blood tissue. Exercise and deep breathing will
encourage the elimination of waste and promote a forceful circulation
which insures nourishment to the tissues. As stated, it is the food
assimilated, not always the amount eaten, that counts.

In this condition it is of vital importance that one keep up a good
circulation; the stomach, intestines, liver, and spleen must be
strengthened through exercise and deep breathing of pure air, for the
red blood corpuscles are oxygen carriers, and the insufficient supply
must do double duty or the waste of the system will not be oxidized
and eliminated, and the blood-forming organs will further fail in their
task.

Exercise must be graded to the case, being gentle at first so as
not to overtire the easily fatigued muscular system. It should
be intelligently directed to the joints and to the vital organs,
particularly to the liver and intestines, that they may be kept in
normal activity. The exercises must be followed with plenty of rest,
and accompanied by deep breathing. The habit of full breathing is one
of the most effective agencies in correction of anemia, because the red
blood corpuscles must carry their full quota of oxygen or the system is
clogged with waste. Oxygen also rejuvenates these corpuscles.

Unless the blood furnished to the tissues is of good quality and
contains sufficient oxygen, the nutrition of the body suffers, the
activity of the various organs is hindered, and the health becomes
impaired. Functional derangements, particularly in the digestive
tract follow, and faulty digestion and difficult absorption further
impoverish the blood.

The work, therefore, in the correction of anemia, lies in foods which
build blood and in daily exercise and deep breathing of fresh air,
accompanied by rest.

The windows at night should admit a good circulation of air through the
sleeping room, and as much time as possible should be spent in the open
air.

Anemia occurs many times in growing girls, due to an improperly
balanced diet, caused by a capricious appetite and by the habit of
satisfying this appetite with sweets, pickles, etc.

The body, during growth, needs increased nutritive material, not only
to replace the waste, but also to meet the demands for new building
material for the various organs, particularly the brain and the
nervous system. Overwork either in school or in industrial occupations,
the hasty eating of meals, or insufficient amounts of food, also aid in
reducing both the quantity and quality of the blood.

Worry is one chief cause of anemia.

Insufficient sleep, due to late hours, further increases the tension of
the nerves and lowers the vitality, causing depression which interferes
with digestion.

When the red blood corpuscles are decreased the oxidation of the fats
is interfered with, because oxygen is necessary to burn the fat. The
non-use of the fatty material causes it to be stored in the tissues
so that the body often appears well nourished and plump. The muscles,
however, are flabby and weak and usually the pallor of the skin shows
the lack of coloring matter in the blood.

The digestive organs are often weak. They must not be overloaded or the
very object of the extra feeding will be defeated. In such cases the
food must be taken in less quantity and more frequently. Also a diet
rich in albumin and iron must be supplied.

It will often be found that one whose blood is lacking in hemoglobin
and in the proper proportion of red blood corpuscles has had a dislike
for the foods rich in iron, or perhaps through poverty, or some other
cause, has not been able to get the right kind of food.

The yolks of eggs, the red meats (such as steak, mutton, or the breast
of wild game) and the deeply colored greens (such as spinach, chard,
dandelions, etc.) contain a goodly proportion of iron. The dark leaves
of lettuce, celery, and cabbage contain iron; these vegetables are apt
to be bleached before being marketed.

It is better, in anemia, to take the yolks of two eggs than one whole
egg, as the iron is in the yolk. A good way to take the yolks of eggs
is in egg lemonade or in eggnog, with a little flavoring.

Anemia sufferers have usually formed the habit of eating starches
and sweets. It will usually be found that they have no desire for
vegetables containing iron, or for meats rich in albuminoids, and this
habit is shown in the blood composition. They often eat the white of
the egg and discard the yolk, rich in iron. Tact and persuasion will
often be necessary to induce them to take the proper foods.

If constipation is present, whole wheat bread, oatmeal, stewed prunes,
grapes, stewed or baked apples, and oranges, should be taken freely.

When the anemic individual is thin, he should take as much fat food as
the system will assimilate. Bacon is well digested and palatable. Fat
may be taken in milk, cream, and butter.

The food must be made attractive to tempt the appetite, which is
usually poor, and within reason one should be allowed any wholesome
food which he desires. Condiments often stimulate the stomach and
intestines to better action.

Vinegars, because of their action on the blood, should not be allowed
nor rich pastries and sauces.

Beef may be scraped and made into sandwiches or used in purées and meat
broth, which may also have a beaten egg in it.

The following is a suggestive diet in anemic conditions:


DIET VII

One pint of milk, to be sipped slowly before arising.

_Breakfast_

 Fruit

 Broiled steak or two eggs, soft-boiled, poached, or baked, with bacon

 Cereal coffee, chocolate, or cocoa

 Toast, or graham, or whole wheat bread, or graham or corn muffins;
 butter

_Middle of the Forenoon_

 Lemonade with a tablespoonful of beef juice (not beef extract) or with
 a beaten egg, or a

 Glass of egg malted milk, or an

 Eggnog

_Lunch_

 Split pea or bean soup with toast and butter, or scraped beef sandwich
 with lettuce

 Fruit or vegetable and nut salad (no vinegar)

 Fruit, fresh or stewed

 Bread with plenty of butter

 Cake

 A glass of milk, cocoa, or chocolate—preferably milk

_Middle of Afternoon_

 Egg lemonade or eggnog of two eggs beaten in boiling milk with sugar
 and spices

_Dinner_

 Bouillon

 Tenderloin steak, roast beef, or lamb chops

 Baked potato

 Spinach, beet, or dandelion greens

 Custard, fruit gelatin, or cornstarch pudding, or rice with lemon
 cream or butter sauce

 Bread and plenty of butter

 Glass of milk or weak tea

When appetite is persistently absent, attention should be paid to the
eliminative organs in order to remove all clogging of the system by
retained waste.

If the stomach and intestines are prolapsed as a result of improper
nourishment and resultant weak tissues, rest in bed, with special
exercises which will replace the organs and strengthen the supporting
tissues, is required.


_STOMACH DISORDERS_

Most chronic cases are due to worry; to improper hygiene, such as
irregular meals; fat and greasy foods; hasty eating; too much sweets;
insufficient mastication, with resulting lack of saliva; wrong choice
of foods; too frequent eating, giving the stomach no rest; too large
an amount of food; too highly spiced foods; coffee or tea; a general
run-down condition, with a weakness of muscles of the stomach, due to
insufficient blood supply; to a weakened or over-strained condition of
nerves controlling the stomach; and usually to insufficient exercise
and fresh air.

       *       *       *       *       *

[Sidenote: Indigestion or Dyspepsia]

Indigestion or dyspepsia is the broad term commonly applied to most
chronic stomach and intestinal difficulties, due, not alone to
structural disease or to displacements, but also to their inability to
perform their normal functions. The term includes troubles arising from
so many different causes that in each case the cause must be determined
and remedied before definite results can be attained through diet.

The most usual is that the gastric glands are pouring out an
insufficient amount of secretion; almost always there is a deficiency
of hydrochloric acid. In some cases in which the food has irritated and
inflamed the stomach there may be a sufficient secretion of this acid,
but an inflamed stomach throws off more mucus and the extra quantity of
mucus neutralizes the hydrochloric acid.

When the acid is deficient or absent, the proteins are not well
digested and the food may ferment; bacteria may produce putrefactive
changes and the formation of gas. The gas interferes with the movement
of the diaphragm, pressing it against the heart, causing pain and even
palpitation.

Indigestion is usually accompanied by constipation, or by irregular
action of the intestines.

Plenty of fresh air, and exercise, directed definitely to muscles and
nerves of the stomach, that it may be strengthened by a better blood
supply, as well as exercises and deep breathing to build up the general
health, should be systematically followed.

Easily digested food, well masticated, and regular meals served
daintily, will gradually regulate digestion.

Food should not be of too great a variety at one meal. It must be
simple and well prepared; when nerves and muscles are weak it should be
served less in quantity but more frequently. Sometimes light food every
hour or every two hours is best.

Cheerful constructive thoughts are the very best of medicine for
digestive derangements.

A glass of cold water from one-half to an hour before the meal will
cleanse the stomach by washing out the mucus and will promote the
secretion of saliva and the gastric juices.

The intelligent medical treatment of stomach difficulties is aided
by a chemical analysis of the stomach contents. If the stomach is
not secreting normal proportions of pepsin or hydrochloric acid, the
deficiency of either can be determined. Such chemical analysis will
alone determine what elements are lacking.

Permanent relief must lie in gaining a good circulation of blood
through the entire body and through the stomach, that it may be
strengthened and thus enabled to secrete these elements in proper
proportions.

[Sidenote: Nervous Indigestion]

This is due to the general depleted condition of the nerves. In such
cases the entire nervous system should be regulated through exercise,
breathing, rest, and a change of thought. Physicians usually recommend
change of scene to cause a change of thought.

The diet should be light and laxative, and low in protein. Cream soup,
bread and milk, malted milk, buttermilk, cream, fruits, crackers and
milk, custards, egg lemonade, and gruels, furnish easily digested food.

Tea, coffee, much meat, fried food, highly spiced food, pastry,
candies, pickles, alcohol, and tobacco should be avoided.

When the walls of the stomach are weak and distended or prolapsed,
light food served in small quantities at regular but more frequent
periods is preferable to a hearty meal, which further distends the
stomach walls. The stomach does not secrete sufficient gastric juices
to digest a meal large enough to supply the needs of the system, if
food is taken only three times a day.

When a loss of weight occurs, it usually indicates a failure to
_assimilate_ rather than the failure to eat a sufficient amount of
food. A good circulation, particularly through the vital organs, must
be established; deep full breathing of fresh air, and regular and
complete rest periods, should be observed.

Usually, in chronic cases, a dietitian, or a physician, is not called
until the condition has prevailed for so long that other complications
have set in and the patient has lost much flesh. It takes months to
pull the system down and it takes months of following of proper hygiene
to build it up.

[Sidenote: Gastritis or Catarrh of the Stomach]

This involves an inflammation of the mucous lining of the stomach and
is a most common phase of indigestion. In acute cases the physician is
called at once. He can then treat the case in its initial stage and
cause a much more rapid recovery.

_Acute Gastritis_ is accompanied by nausea and vomiting and the patient
should refrain from taking food for at least two days. To allay thirst
a tablespoonful of water may be held in the mouth for a few moments
without swallowing it. A slice of lemon may be sucked if water excites
vomiting, or cold carbonated or acidulated waters may be sipped, a
teaspoonful at a time, every ten or fifteen minutes. Rest of both body
and mind must be obtained.

After two days begin the nourishment with water and a small portion
of liquid food (not over two ounces) every two hours. Toast tea, made
by pouring hot water over toast, oatmeal, or barley gruel (thoroughly
strained so that no coarse matter may irritate the stomach), limewater
and milk, and egg lemonade are easily digested. Increase the quantity
on the fourth day and lengthen the time between feedings to three
hours. Gradually increase the diet, adding semiliquid food, noted on
pages 237-238, soft-boiled eggs, moistened toast, raw oysters, etc.,
slowly returning to the regular bill of fare.

Avoid any food difficult of digestion and any vegetable containing
coarse fiber. Care in the diet must be observed for several weeks or a
relapse may occur.

_Chronic Gastritis_ is accompanied by a thickening of the mucous lining
of the stomach. It is usually caused by prolonged use of irritating
foods and the regulation of the diet is of utmost importance. Alcohol
is a common cause. The difficulty begins gradually and the relief will
be gradual.

There is an excessive secretion of thick, tenacious mucus which
prevents the gastric juices from mixing with the food. The resulting
fermentation of food causes heartburn and produces much gas. Thirst may
be excessive.

The stomach needs washing. The washing may be accomplished by drinking
two glasses of hot water at least an hour before breakfast, followed by
stomach exercises, to cause a surging of the water through the stomach.
This may be followed by a glass of cold water.

This may be uncomfortable at first, causing a full feeling, and one may
begin by drinking one glass, followed by stomach exercises, gradually
taking another glass within a half-hour of the first. This, by means of
the exercises, will wash out the mucus.

A glass of cold water half an hour before each meal is recommended
here, as well as for relief of indigestion.

In many cases as much as a pint of slimy mucus collects in the stomach
during the night. When the stomach cleansing by means of water drinking
is impossible, the physician often uses a stomach tube.

Chronic gastritis, in any of its phases, is frequently accompanied by
constipation, which reacts on the stomach, and the diet should be as
laxative as possible, without irritating the lining of the stomach.

In case an acute attack occurs, which is likely in chronic cases, the
diet under “Acute Gastritis” should be followed.

Pancreatinized milk is an excellent food in both chronic and acute
cases especially when they are severe. This is prepared by putting
“pancreatin” a pancreatic ferment (trypsin) into fresh milk.
Preparations of “pancreatin” are sold in the drug stores. Pepsin may be
used in the same way for making peptonized milk.

The pancreatinized milk does not form hard curds and readily passes
through the stomach for digestion in the intestine. The taste is rather
bitter; it may be disguised by flavoring. This may be given for a few
days, followed by milk and limewater, barley and toast water, kumyss,
oatmeal gruel, meat juices, scraped meat (raw, boiled, or roasted),
broths thickened with thoroughly cooked cereals, ice cream, egg
lemonade, gelatins and whipped cream, custards and raw oysters.

Fruit in the morning and just before retiring aid the intestines. Two
prunes chopped up with one fig, or a bunch of grapes, or an apple, just
before retiring may be eaten to assist the action of the intestines and
the kidneys.

Almost all fruits contain acids which increase the peristalsis, and the
resultant flow of gastric juice. Cooked pears, stewed or baked apples,
prunes, and dates are mild fruits which may be used if they agree. The
juice of an orange on arising may be used if relished.

All cereals should be thoroughly cooked.

The white meat of chicken, well masticated, is readily digested.

After an acute attack, as the solid food is resumed, it should be given
regularly and in small amounts.

_Thorough mastication is important. The food should be chewed until it
is reduced to a pulp._

Fats and food cooked in fat must be avoided. Dried beef, lean boiled
ham, and salt fish agree better with some than fresh meats. All sweets
must be forbidden. Starchy foods are apt to produce “sour stomach.”

Avoid meat with tough fiber, too fat meat (pork), sausage, lobster,
salmon, chicken salads, mayonnaise, cucumbers, pickles, cabbage, tea,
coffee, alcohol, pastry, too much sweets, and cheese if it disagrees.

Five to six light meals a day are preferable to three heavy meals.

_The flow of gastric juices_ is constitutional, thus the regulation
of digestion depends on the general vitality as well as on foods.
The circulation must be forceful, the habit of deep breathing and of
regular periods of complete rest of body and mind must be established.

Since one with chronic gastritis is liable to have many idiosyncrasies,
he should not be urged to eat foods for which he has a dislike. The
easily digested foods should be prepared in various ways and served in
an appetizing, dainty manner.

There are four special phases of chronic gastritis: Mucous Gastritis,
Hyperchlorhydria, Hypochlorhydria, and Achlorhydria.

In _Mucous Gastritis_ there is a profuse secretion of mucus in the
stomach. In this case it is always well to wash out the stomach before
introducing food, as suggested above.

The same general diet suggested for acute gastritis should be followed.

[Sidenote: Hyperchlorhydria]

The condition known as hyperchlorhydria shows a liberal excess of
hydrochloric acid. The condition is common, and is brought on by worry,
nervous excitement, eating when overtired, irregularity of meals,
imperfect mastication, and excessive use of alcohol.

The diet should be a mixed one, in about normal proportions. If
anything, it should incline more to proteins than to starches.

The hydrochloric acid is necessary for the digestion of proteins and
some physicians give a diet consisting almost entirely of proteins such
as eggs, lean meat, etc., because hydrochloric acid reduces the protein
to acid albumin, which is less irritating to the stomach than the free
hydrochloric acid. However, the proteins are stimulating to the stomach
and the protein proportion should not be carried to excess.

The best method is to follow a diet in which the foods have practically
their normal balance—avoiding all irritating foods.

The juice of one-fourth of a lemon taken one-half hour before the meal
will decrease the secretion of hydrochloric acid.

Limewater and milk may be used exclusively for two days; alkaline,
effervescing mineral water may be used and then the diet should follow
the general diet in chronic gastritis.

_Hypochlorhydria_ is a diminution in the amount of hydrochloric acid.
Since this acid is essential in gastric digestion of proteins, a
decrease in its supply diminishes the power of the stomach to digest
meat, eggs, etc. Physicians often administer hydrochloric acid about
one hour after a meal. It should not immediately follow the meal
consisting of part solid food, because it retards salivary digestion.
Acid fruits, such as lemonade or egg lemonade, should be given half an
hour after the meal instead of at the beginning.

Many advocate a diet omitting protein, but since protein foods
stimulate the flow of gastric juices, they should _not_ be omitted, but
taken less freely. The meals should be at least six hours apart so as
to allow time for digestion and to give the stomach rest.

[Sidenote: Achlorhydria]

When there is an entire absence of hydrochloric acid, as in
_achlorhydria_, the stomach, of course, cannot digest proteins and
this digestion must be accomplished entirely by the trypsin of the
pancreatic juice. The presence of liquefied protein, as beef juice in
the stomach, however acts as a stimulus to the gastric juice and is an
agency in again starting its flow.

The foods should be liquid, so as to pass through the stomach without
irritating it. Clear milk must be excluded, because of the action of
the rennin in coagulating the casein. This would irritate the stomach.

Pancreatinized milk (see page 99) may be used as an article of diet,
also milk with limewater, junket, gelatin, cream, butter, bacon, olive
oil, gruels, and any foods which will pass through the stomach without
change and are digested by the pancreatic juice in the intestines.

Bran must be excluded from any cereals. Cereals or any carbohydrates
cooked or masticated to a liquid state will pass through the stomach
without difficulty and be digested and absorbed in the small intestine.

[Sidenote: Dilatation or Prolapsus of the Stomach]

Dilatation results from continued overeating (especially when the
nerves are weak), or eating when overtired. The muscular walls become
so weak that they fail to contract. Peristalsis is likewise weak, and
the food, failing to digest promptly, ferments and forms gas. A dilated
stomach is enlarged and its weight and weakness cause it to prolapse.

In the prolapsed condition the pyloric, or lower orifice of the
stomach, is often nearly closed, partly by reason of its position and
partly by the weakened folds of the stomach walls. Because of this
obstruction to the free emptying of the contents into the duodenum,
it is imperative that the food be of the simplest form, thoroughly
masticated, and perhaps predigested and concentrated so as to be in
as small an amount as possible. A chunk of food could not easily pass
through the pylorus.

All liquid or semiliquid food should be subject to the chewing
movements until it, also, is mixed with saliva. The stomach should not
be overloaded with either food or water and for this reason six or more
light meals a day, at regular intervals, is best.

A dilated stomach does not necessarily indicate that the digestive
juices are not secreted in normal proportions, and easily digested
proteins need not be avoided. It is desirable to furnish the proteins
in concentrated form, as in meats, so as to get the most nutrition with
the least bulk. They should be thoroughly masticated.

Milk may be used, with limewater, if sipped slowly and mixed with
saliva.

Sugar should be used very sparingly, because it ferments readily and
aggravates the distention. If it is evident that fermented products are
in the stomach, it should be washed out with a stomach pump.

A tumor near the pylorus, or constriction of the pyloric orifice by
prolapsus, will also cause dilatation of the stomach.

Beef juice, any of the better grades of meats, well masticated and
containing no gristle, limewater and milk, soft-cooked eggs, and
well-cooked cereals and vegetables should constitute the diet.

Avoid vegetables containing coarse fiber, fried foods, and freshly
baked bread.

Liquid with the meal should be avoided, on account of the tendency to
overload the stomach.

Cold water, taken a swallow at a time at intervals during the day, has
a tonic effect on the relaxed muscles. It also incites the flow of
gastric juice.

The best and quickest means of correcting a prolapsed and dilated
stomach is by rest in bed for several weeks, with special exercises
to raise the viscera and to strengthen all abdominal muscles, as well
as the muscular coat of the stomach itself. The food must be given in
small quantities every hour.

[Sidenote: Ulcer of the Stomach]

When this condition is severe, accompanied with severe pains and
vomiting of blood, the nourishment is given through the rectum for from
five to ten days. Then, for ten days, a milk diet with bouillon, barley
water, a beaten egg, and once a day, after the third day, strained
oatmeal gruel is taken.

Limewater is added to the milk to avoid the formation of large curds
and to neutralize the acids of the stomach. The patient is given half
a cup of milk every hour for three days, from 7 A.M. to 9 P.M. From
the third to the tenth day the quantity may be increased to one cupful,
then to a cup and a half, and the periods between feedings lengthened
to two hours. If the milk is thoroughly heated, but not boiled, before
the limewater is added, it digests more readily.

After ten days, for the succeeding ten days the nourishment should be
given every two hours and the diet varied by semiliquid foods, such
as gruels, toast water, soft-boiled egg (once a day), beef juice, two
softened crackers (once a day), gelatin, buttermilk, and strained
soups. (See page 313, Semisolid Foods.)

After twenty days the patient, if all is well, may very gradually
resume a normal diet, beginning with baked potatoes, softened toast,
lamb chops, a small piece of steak or white meat of chicken. It is
imperative that all food, liquid or solid, be thoroughly mixed with
saliva and that solids be chewed to a pulp.

Liquids must not be swallowed either hot or cold, but about body
temperature. Cold water may be taken into the mouth when more palatable
than warm and held there until about body temperature before it is
swallowed. All liquids should be sipped, not swallowed in gulps.

When the condition of ulcer has existed for some time complete rest in
bed for from six to ten weeks is advisable. Either the diet suggested
above or, if it is desired to gain in weight, a diet of milk, cream,
and eggs may be followed. All solid food should be avoided.


_INTESTINAL DISORDERS_

Most cases of intestinal difficulties may be traced to a clogged
condition, either due to a weakness of the nerves and of the
intestinal muscles, with resultant weak peristalsis, or to insufficient
lubrication.

If the waste is not promptly moved through the intestines, irritation
may result and the poisons from bacterial fermentation will be absorbed
by the system.

Deranged digestion in the stomach also interferes with digestion in the
intestines. Likewise delayed intestinal digestion affects digestion in
the stomach.

       *       *       *       *       *

[Sidenote: Constipation]

A large number of cases of constipation become chronic because of the
failure to respond to Nature’s call at a regular time each day. Many
others are due to weakness of the muscular walls of the intestines
or to the nerves controlling them. In this event the intestinal
peristalsis is weak.

Constipation may be mechanical, due to obstruction of the intestine in
some part of its course, _e. g._, prolapsus, tumor, or a kink in the
bowel itself.

Still another cause is a failure of the liver to discharge sufficient
bile into the intestines to lubricate the feces.

Many chronic cases are due to the pill and drug habit. When one
continues to take pills, the condition brings a result similar to
the feeding of “predigested” food—if the work is done for the organs
they become lazy and rely on artificial aid. _Every part of the body
requires activity for strength._

If the intestines are cramped by the clothing it may cause constipation
by restraining their normal exercise during movements of the body in
walking, etc. Exercises for the intestines should be taken morning and
night.

Constipation may exist even when there apparently is a daily movement
of the bowels. Material may accumulate in the large intestine because
only a part of the contents is discharged and may cause the unpleasant
symptoms which accompany constipation.

It may arise from irregularity in meals, or from overeating, thus
causing derangements of digestion from disturbance of the normal
process.

Insufficient food may cause it, because the mass is not large enough to
be acted on by the muscular movements of the intestines.

Too much strong tea, by its astringent action, lessens the secretions
of mucus and causes the mass to become too dry.

Too little water may be taken and the food not sufficiently moistened;
food may be concentrated and leave little residue.

Overeating, especially when the intestinal muscles are weak, furnishes
a greater bulk than the intestines have the power to propel, hence a
semi-paralysis and inactivity result.

Anxiety and grief or worry may inhibit the action of the nerves and
thus cause a stagnation of movement on the part of the bowels.

The _cause_ of the difficulty must be ascertained before relief can be
gained.

The most natural relief for constipation, therefore, comes through
exercise, particularly when directed to the muscles of the stomach and
of the intestines and to the nerve centers controlling them.

The free use of water and such foods as figs and raisins, prunes,
dates, grapes, apples, and rhubarb, which are laxative in effect, are
helpful. These have best effect when eaten just before retiring or when
the stomach is empty.

The use of vegetables which furnish a large bulk of fiber is often
beneficial. Cabbage, celery, lettuce, spinach, mustard greens, oyster
plant, and asparagus consist largely of residue. Onions are also
laxative, especially when boiled. Tomatoes possess a special laxative
effect for many individuals.

When derangements of digestion make raw fruits undesirable, they may
be cooked and thus used for their laxative effect. They are not so
laxative when cooked with much sugar, because much sugar may cause
fermentation and gas. A little bicarbonate of soda added to acid fruits
after cooking will correct the acidity and not so much sugar will be
needed.

Two or three glasses of water should be taken on rising and before
retiring. This cleanses the stomach as well as aids in relieving the
dryness of the bowel contents.

Oatmeal, or any cereal containing the bran, is laxative. Such are bran
or corn-meal bread, Boston brown bread made with molasses, and Graham
bread.

Children should be trained to attend to Nature’s call regularly _every_
day. The best time is shortly after breakfast.

[Sidenote: Enteritis]

_Inflammation or Catarrh of the Intestines_ is similar in its nature to
Gastritis or Catarrh of the Stomach.

_Acute Enteritis_, or cholera morbus, is usually caused by a strong
irritant—either by some food which disagrees, by unripe fruits, or by a
mass of undigested food.

A fast of two or three days is the usual initial dietetic treatment.

A free drinking of water not only soothes the irritated intestines, but
it cleanses the intestinal tract and assists in eliminating elements
of fermentation; if these are not eliminated, they will be absorbed
into the blood.

Absolute quiet in bed is necessary.

After the fast, a liquid and semiliquid diet is followed until
inflammation is relieved and diarrhea and vomiting have ceased. Milk,
strained gruels, broths, strained soups, buttermilk, eggs (soft cooked
or raw), beef juice, barley water, custards, junket gelatins, soft
puddings, etc., are most nourishing and cause little irritation. (See
page 313, Semisolid Foods.)

Milk should be mixed with limewater to prevent the formation of large
curds and should be sipped. Water should not be taken, as it tends to
increase the diarrhea. Ice may be held in the mouth to relieve thirst.

All irritating foods, such as coarse vegetables, pickles, acid fruits
and fruits with coarse seeds, candies, beer, wines, and salads must be
omitted.

_Chronic Enteritis_ has the same general cause as acute enteritis,
though its onset is slow and it takes a correspondingly longer time to
correct.

A milk diet for two or three weeks may be necessary to rest the bowels.

When food is taken, if undigested particles appear in the stool, it may
be necessary to use predigested foods for a while.

[Sidenote: Dysentery]

If acute, dysentery demands complete rest in bed. The diet, in both
acute and chronic cases, must be confined to easily digested foods such
as peptonized or pancreatinized milk (see pages 99 and 308), boiled
milk, meat juice, and the white of egg, beaten and served with milk.

Blackberry brandy and tea made from wild cherry bark tend to check the
inflammation.

During convalescence, care must be taken not to overfeed. Fruits
and vegetables should be avoided. Begin a more liberal diet with an
increased amount of beef juice, gradually adding tender beefsteak,
roast beef, fish, white meat of chicken, eggs, custards, jelly, dry
toast, blancmange, well-boiled rice, and other easily digested food.
The beef and egg are particularly valuable, because of the anemia
occasioned by the loss of blood.


_DERANGEMENTS OF THE LIVER_

The liver is not, in a strict sense, a digestive organ, but the
digested food must pass through it and undergo certain chemical changes.

For a fuller understanding of the reasons for the following suggestions
regarding diet in liver derangements, the chapter on the “Work of the
Liver,” pages 151-152 should be reread.

It will be recalled that the liver acts not only on the foods,
but it also stands on guard to neutralize poisonous ferments, due
to putrefactions absorbed from the intestines, and to render them
harmless. To a limited extent it also oxidizes alcohol.

After the gorging of a heavy meal, the overloaded blood and liver
express themselves in a sluggishness of the brain and one feels
mentally as well as physically inert.

Since both carbohydrates and protein undergo chemical changes in the
liver, it is evident that a diet consisting of an excess of either,
must overwork the liver, not only through the nutritive food elements
absorbed, but through the toxic substances which may be produced.

The regulation of diet, when the liver is in an abnormal condition,
must be more in the _quantity_ than in the _quality_ of food.

The condition of the liver depends also on the activity of the
intestines, since the poisonous products from imperfectly digested and
fermenting food, not being eliminated, will be absorbed and carried
to the liver. If the food remains in the intestines too long, it is
attacked by the bacteria always present there, fermentation results and
poisons are absorbed and carried to the liver, which usually can render
them harmless to the system. If for any reason the liver is diseased,
overloaded, or its action is sluggish, these toxins are absorbed in
larger quantities than the liver is able to handle, hence they reënter
the blood and poison the system.

The most important corrective agencies, when the liver is inactive, is
a fast for a day or two, a free drinking of water, deep breathing, and
exercise so directed as to bring a free supply of blood to this organ.

_It is apparent that the blood must carry its full quota of oxygen to
assist in eliminating both the nitrogenous waste and the poisons._ It
must also be remembered that the liver must oxidize the waste from its
own tissues, as well as from other parts of the system.

       *       *       *       *       *

[Sidenote: Biliousness]

This condition is due to the overproduction of bile which may be
absorbed into the blood to inactivity of the body and a resultant
sluggish circulation of blood; to overwork of the liver due to
overeating; and to insufficient breathing of pure air. It may also
result from constipation and the resultant absorption of toxic matter,
as previously described.

It may be occasioned also by obstruction of the opening of the bile
duct into the intestines from an excess of mucus in the duodenum. In
such cases exercises for the intestines are clearly indicated.

In the bending, twisting, and squirming movements which the infant in
the cradle makes, the liver is regularly squeezed and relaxed. The same
is true of the free movements of an active child at play. If during
adult life these same free movements of bending and twisting the trunk
were continued daily and correct habits of free breathing of pure air
were established, there would be little call for “liver tonics.”

The transformation of carbohydrates in the liver is an important part
of its work and in case of inactive liver the sugars and starches
should be limited in the diet. Protein stimulates the activity of the
liver, yet it is a mistake to allow a diet too rich in protein. The
best method is to cut down the quantity of food.

Two glasses of water an hour before breakfast, followed by brisk
exercise for the vital organs and deep breathing, are the best remedies.

The daily action of the bowels is imperative.

In extreme cases a fast of two or three days, with a copious use of
water, is recommended. Following this fast the diet should consist of
easily digested foods, eliminating those containing starch and sugar
in too great proportions, as bread, cereals, and potatoes. The amount
should be as limited as is consistent with the actual necessity for
rebuilding and for energy.

The taking of fats should be restricted in biliousness. The presence of
fat in the duodenum stimulates the flow of pancreatic juice, which in
turn stimulates the secretion of bile, thus overworking the liver.

Lemon stimulates the action of the gastric glands and thus tends to
increase the liver activity.

It has been thought that eggs and milk cause sluggish liver action.
There is no physiological reason for this if too much food is not
eaten. The fact is often lost sight of that milk is a food as well as a
beverage and that when milk constitutes an appreciable part of the diet
other foods should be limited accordingly.

 The DIET may be selected from the following:

 _Soups._—Light broths and vegetable soup with a little bread toasted
 in the oven.

 _Fish._—Raw oysters, fresh white fish.

 _Meats._—Mutton, lamb, chicken, or game.

 _Farinaceous._—Whole wheat or Graham bread and butter, toast buttered
 or dry, toasted crackers, cereals in small portions.

 _Vegetables._—Fresh vegetables, plain salads of watercress, lettuce,
 and celery, without oil or mayonnaise dressing. Lemon juice and salt
 may be used.

 _Desserts._—Gelatins, fruits, cornstarch, ice cream, junket, simple
 puddings,—all with _very little sugar_.

 _Liquids._—Hot water, lemonade, orangeade, toast water, buttermilk,
 loppered milk, and unfermented grape juice—not too sweet.

 AVOID.—All rich, highly seasoned foods, candies, cheese, pies, pastry,
 pancakes, or any fried foods, salmon, herring, mackerel, bluefish,
 eels, dried fruits, nuts, and liquors of all kinds.

       *       *       *       *       *

[Sidenote: Gallstones]

Gallstones occur most often in persons after middle life, especially in
those of sedentary habits.

A substance called cholesterin is normally present in solution in bile
and in the tissues. When, through inactivity of the liver, or when
because of sedentary habits the bile remains too long in the system,
the cholesterin is precipitated, and, mixed with mucus, it forms
gall-stones.

A diet composed mostly of starch and fat favors their formation.

All dietetic measures should be combined with exercise to promote the
flow of bile into the intestines.

Two glasses of hot water should be taken in the morning and before
retiring. Several glasses of cold water should be drunk through the day.

Sweets and starches should be largely eliminated from the diet; sweet
fruits and root vegetables must be avoided.

Fresh green vegetables and acid fruits may be taken. Potatoes contain
calcium, but because they contain much more potassium, which lessens
the liberation of calcium, they may also be used.

For foods rich in calcium which should be avoided see page 219.

Foods causing calcium oxalate deposits should be avoided as they may
cause the formation of gall-stones. For a list of these see p. 219.

Meat, if taken, must be lean and eaten only once a day. Beef and
chicken are the preferable meats. Fresh fish may be used.

Alcohol must not be taken and coffee and tea must be limited in
strength and quantity.

Active exercise must be practiced daily and full elimination secured
from the bowels.

The person afflicted with gall-stones must not sit too long or in a
cramped position.

The presence of fat in the duodenum increases the flow of pancreatic
juice which, in turn, stimulates the flow of bile, so olive oil is
often recommended in case of gall-stones. It is questionable whether it
is of benefit, because, as stated, much fat upsets the liver.

Watch the water supply. Hard water which contains lime should be boiled
to precipitate the calcium.


_DERANGEMENTS OF THE KIDNEYS_

The office of the kidneys is to eliminate from the system certain
nitrogenous elements in solution; the work of the kidneys, in most
conditions, is aided by copious drinking of water.

The influence exerted on the function of the excretory organs by the
components of the food has not been given the attention it merits.

If the fluids are not taken in sufficient amount and much animal food
is eaten, the urine becomes more concentrated and may irritate the
kidneys or the bladder and give rise to calculi (kidney stones) or to
the deposit of uric acid. Watery vegetables, juicy fruits, milk, water,
and most beverages, by increasing the output of urine, lessen its
acidity and density.

A diet limited to certain articles of food by the likes or dislikes of
the individual, as the starches and sugars, too large consumption of
acid fruits or too fatty foods may cause the appearance in the urine of
abnormal amounts of various substances, as sugar, phosphates, calcium
oxalate, or fatty acids.

Acid fruits in moderation aid digestion and favor suitable elimination,
but when eaten to excess, as lemons, taken two or three or more a day
by those striving to reduce flesh, the urine is increased in acidity,
and irritation of the bladder may ensue.

Too great an amount of food tends to overwork the kidneys as well
as the liver and various derangements result; these must be treated
dietetically as well as by medicine.

[Sidenote: Acute Nephritis]

In inflammation of the kidneys (nephritis), the secretion of urine is
lessened or may cease. The kidneys and digestive system must not be
overworked and all food must be eliminated save milk until the kidney
function is restored. It may be diluted with lime or Vichy, or skimmed
milk or buttermilk may be used.

Water flushes the kidneys and if the urine increases in amount when
water is given its use may be continued. When the amount of urine is
diminished or the kidneys are not functioning at all, water, or any
fluid or food that gives the kidneys work, must be given only on the
advice of a physician, as serious harm may be done unless the inflamed
kidneys are given as near perfect rest as possible. Sometimes even milk
must be reduced to one pint a day.

In the event that the kidneys do not excrete, the pores of the skin
must be kept freely open by sweat baths to assist in the elimination of
urea.

Dr. Hall recommends a milk and cream diet of from three to seven pints
a day, for a few days, according to the case—two parts of milk to one
of cream. If the urine is scanty, he reduces it to one and one-half
pints a day, taken in four or five installments. After the three to
seven days of milk diet he gradually introduces starches and fats into
the diet.

[Sidenote: Bright’s Disease]

This is an inflammatory condition of the kidneys in which albumin
appears in the urine. It results from irritation and may be acute or
chronic.

The appearance of albumin in the urine does not always indicate
disease. It may be temporary, merely indicating that the diet, for the
time being, is too heavy or contains an excess of protein, especially
meat. Several tests from one to two weeks apart are often necessary
to determine whether the condition is merely temporary or is due to
inefficient action of the kidneys.

When for any reason the kidneys have difficulty in eliminating the
nitrogenous waste of the system, the dietitian must eliminate protein
food as closely as may be consistent with the body necessities.
Besides restricting the amount of nitrogenous foods, the kidneys must
be assisted in eliminating the nitrogenous waste and the products of
inflammation by a copious drinking of water, unless the kidneys are so
inflamed that complete rest is indicated.

Hot water and hot drinks are best in the morning, such as toast
water, barley water, cream of tartar, lemon and acid drinks. Unless a
dropsical condition is present one may drink freely of cool water.

In acute cases the patient is put on a diet of from two to three pints
of milk a day, given one-half pint every three or four hours, diluted
with one-third as much hot water. Complete rest is imperative.

In chronic cases, exercise, judiciously directed to the extremities,
particularly to the legs and the back, will do more than anything
to aid the elimination of an excessive accumulation of fluid as in
dropsy. This condition is usually accompanied by constipation and poor
circulation, and exercises directed to the liver and bowels aid in
carrying off the excess of fluid by way of the intestines; this will
rest the kidneys. A cure requires patience and perseverance.

In chronic cases it is also well to follow a milk diet for a number of
weeks. The quantity of milk for an exclusive milk diet must depend on
the age and size of the patient as well as on his ability to exercise.
If he is confined to his room, from ten to sixteen glasses of milk a
day are sufficient. If he is taking a great deal of exercise, he may
take from eighteen to twenty glasses of milk a day. If he loses weight
on the milk diet, bread and rice may be added, or potato soup, cereals,
tapioca, and various gruels.

If the milk is not well borne, malted milk or predigested milk with
butter and cream may be substituted. If the casein in the milk is not
well digested, cheese must not be used. An egg once or twice a week and
fruit and fresh vegetables may be given, but meat should be omitted.

A. F. Pattee gives the following diet in Bright’s disease.


_DIET_

 _Soup._—Vegetable or fish soup, broths with rice or barley.

 _Fish._—Raw oysters or clams, fresh fish broiled or boiled.

 _Meats._—Eat sparingly, chicken, game, fat bacon, fat ham.

 _Farinaceous._—Stale bread, whole wheat bread, toast, milk toast,
 biscuits, macaroni, rice, cereals of all kinds.

 _Vegetables._—Onion, cauliflower, mashed potatoes, mushrooms, lettuce,
 watercress, spinach, celery, cabbage.

 _Desserts._—Ripe raw fruits, stewed fruits, rice, tapioca, bread and
 milk puddings, junkets, cocoa.

 _Liquids._—Toast water, weak tea, pure water, peptonized milk, malted
 milk, fresh buttermilk, milk and hot water in equal parts, whey,
 unfermented grape juice.

 AVOID.—Fried fish, corned beef, hashes, stews, pork, veal, heavy
 bread, batter cakes, lamb, mutton, beef, gravies, beans, peas, malt or
 spirituous liquors, tobacco, coffee, ice cream, cake, pastry.

This diet is tentative only and may be modified to suit the individual.
If improvement is manifest after a month or two of the restricted diet,
steak, roast beef, and eggs may be gradually added. If, when the urine
is examined, the use of meat causes a return of albumin, it must be
dropped.

In these cases, active outdoor exercise, full, deep breathing
systematically practiced at intervals, a calm quiet attitude of mind
and care not to overeat and to keep the bowels active will materially
aid recovery.

       *       *       *       *       *

[Sidenote: Uremia or Uremic Poisoning]

Interference with the action of the kidneys is apt to result in a
retention within the system of the elements which they, in normal
condition, eliminate from the system—such as urea, uric acid, urates,
sulphates, phosphates, etc. They are the result of the oxidation and
the breaking down of the proteins of the body. If the kidneys do not
eliminate these the result is a systemic poisoning, and the dietetic
treatment must be such as will aid them to act freely.

Fruits should be used freely. The citrus fruits (lemons, oranges,
limes, etc.) are the best; they neutralize acids and promote the
alkalinity of the blood.

When the system shows an excess of uric acid, the chances are that
the individual has not been living on a diet containing too large
a proportion of protein, but that he has been eating more than he
requires of all kinds of foodstuffs. His system thus becomes weakened
and he does not breathe deeply nor exercise sufficiently to oxidize and
throw off the waste.

Meats, eggs, and legumes should be eliminated from the diet. A free
drinking of water, milk with limewater, cereals, buttermilk, kumyss,
barley water, toast water, lemonade, orangeade, vegetables, and fruit
should form the diet.

Exercise and free breathing of fresh air are imperative. All food
should be thoroughly masticated.

[Sidenote: Excess of Uric Acid]

When this condition appears it is due to too great an amount of animal
or nitrogenous food. It causes dizziness, ringing in the ears, general
nervousness, and insomnia.

Uric acid does not render the urine acid but when the acidity of the
urine is increased, due to too much animal food, the tendency of the
uric acid to form a crystalline deposit is increased. This deposit, as
“gravel,” may occasion attacks of renal colic or become the basis, when
mixed with mucus, for kidney stones or stones in the bladder.

Headaches if due to uric acid will often cease when animal food is
lessened.

Too much candy or sweet foods, or too much fat, eaten in connection
with much protein, by deranging the liver function, change the
character of the urine and favor the production of uric acid, causing
such chronic ailments as bronchitis, asthma, severe nerve depression,
gout, and neuralgia.

The natural relief is obtained by control of the diet, supplying less
protein. One may either eliminate the proteins from the diet, or may
cut down the entire quantity of food. Free elimination through a
free action of the kidneys, the pores of the skin, and the lungs, is
necessary.

Systematic exercise, deep breathing, copious drinking of water, and
fresh air day and night, are the best aids. Exercise and deep breathing
promote a free elimination of waste through the pores of the skin, and
the free drinking of water creates a greater elimination through the
kidneys, thus throwing off the excess of acid.

The skins of fruits contain various acids which favor the alkalinity
of the blood. Therefore it is better, when there is an excess of uric
acid, to eat unpeeled fruits. Apples, eaten raw and unpeeled, because
of the acids, are of benefit. Citrus fruits, such as lemons, oranges,
and grapefruit, are advised. Pears, and other sweet or bland fruits,
because of the lack of acid, are less valuable.

Pea pods when young may be cooked with the peas. String beans, spinach,
celery, and asparagus are of value.

All rich sauces and gravies must be avoided.

[Sidenote: Gout]

Osler remarks that “gout is evidence of an overfed, overworked, and
consequently clogged machine.”

It is usually the result of high living. It most often attacks people
past middle age, who have indulged in large quantities of food,
especially the nitrogenous foods which are not thoroughly oxidized due
to sluggish circulation and shallow breathing. The process, imperfectly
carried on, allows the accumulation of the waste material which cannot
be excreted by the kidneys unless completely transformed by oxidation.
These insoluble materials are deposited in the joints, act as
irritants, and occasion the attacks of pain, swelling, and tenderness
which usually mark the acute condition.

It is most common in those who habitually overeat, take little
exercise, or who have frequently indulged in alcohol.

Sugar and fat in quantities are injurious as the oxidation of the
protein is not carried on as completely when these are in excess. In
fact, the entire system is more sluggish. Fat also interferes with
gastric digestion as it passes through the stomach unchanged, and if
the particles of food have a coat of the fat liquefied by the heat of
the stomach, it is difficult for the gastric juice to exert its power.

The use of meat and sugars tends to make the urine acid and the use of
vegetables favors its alkalinity, rendering it less acid. Therefore it
becomes necessary to eliminate meat from the diet, to cut down the fats
and carbohydrates, and to eat freely of fruits and vegetables.

Alcohol is absolutely prohibited.

In _acute cases_ a diet of bread and milk, or toast and milk, with
light vegetable broths, should be followed for from one to three days.

In _chronic cases_ the diet may consist of the following:

 _Soups._—Vegetable broths.

 _Fish._—Fresh fish, shell fish, raw oysters.

 _Meats._—It is better to omit all meats. If meat is eaten at all, it
 should be confined to game, chicken, and fat bacon.

 _Farinaceous._—Cereals, crackers, dry toast, milk toast, macaroni,
 graham or whole wheat bread, rye bread, oatmeal, and any of the
 breakfast foods.

 _Vegetables._—Celery, lettuce, watercress, all greens, without
 vinegar, string beans, green peas, potatoes, carrots, and beets.

 _Fruits._—All fruits, stewed or fresh. Unpeeled apples are especially
 recommended. (Greens, without vinegar and unpeeled apples, increase
 the action of the kidneys.)

 _Desserts._—Plain puddings, junket, rice, stewed or fresh fruits.

 _Liquids._—Pure water, toast water, barley water, buttermilk, malted
 milk, milk.

 Eat eggs sparingly, and in severe cases, not at all.

 AVOID.—Alcohol, coffee, tobacco, dried fruits, nuts, cheese, candies,
 pastries, pies, spices, rich puddings, fried foods, vinegar, pickles,
 lemons, rhubarb, mushrooms, asparagus, sweet potatoes, tomatoes,
 gravies, patties, rich soups, lobster, salmon, crabs, mackerel, eel,
 veal, pork, goose, duck, turkey, salted, dried, potted, or preserved
 fish or meat (except bacon).

It is not sufficient to eliminate the foods to be avoided. To reduce
the quantity of food is also necessary; yet this must be watched as the
diet should not be so rigid as to cause a lowering of vitality. Eating
between meals should not be allowed.

In an acute attack the diet should be confined to milk, vegetables, and
fruits.

[Sidenote: Diabetes]

This is the result of a serious disturbance of nutrition. Since its
presence is made manifest by the appearance of sugar in the urine,
it is considered among the derangements of the kidneys. However,
one should not be apprehensive of diabetes if the urine test for
a day shows sugar. This may be due to an excess of carbohydrates,
particularly of sugar, in the diet a day or two previous and all
trace of it may disappear in a day or two. If continued tests show an
excess, nutritional disturbances are indicated. The treatment is almost
entirely dietetic.

The most usual form of diabetes is _diabetes mellitus_. It is supposed
to be due to a disturbance in the metabolism of sugar. It may be aided
by defective pancreatic ferments, the lack throwing more work on the
liver in the metabolism of sugar.

The difficulty which confronts the dietitian is to prescribe a diet
restricting the carbohydrates which will keep up the body weight and
not disturb the nutritive equilibrium. The patient has a craving for
sugars and starches, but the system cannot make use of them, and the
heat and energy must be supplied by fats.

The diet must consist largely of protein and fat. One danger lies in
the tendency of acetic and other acids to accumulate in the blood,
which affects the nervous system.

While, as a rule, the craving for certain foods is an indication that
the system needs the elements contained in them, the desire of the
diabetic patient for sugars and starches _must not_ be indulged more
than absolutely necessary, because of the inability of the system to
utilize them.

There is often a distaste for fat, but its use is imperative when it is
well borne, because the weight and general vitality must be maintained.
If all carbohydrates are eliminated from the diet, the system will
often suffer severely. Therefore the dietitian must determine the diet
suited to the individual case, since complicated conditions may exist
and the diet for one patient will work harm to another. The fleshy
patient can stand a rigid diet, eliminating sugars and starches, much
better than one who is thin and emaciated. A thin, weak patient often
cannot endure too rigid a diet.

The following list of foods contain least carbohydrates: clear soup of
meat without vegetables, all acid fruits, eggs, clams, and lobsters,
fresh fish of all kinds, fresh meat of all kinds, and most smoked meat,
olive oil, butter, peas, beans, all fresh vegetables (except carrots,
parsnips, squash), onions, artichokes, cauliflower, cabbage, and
asparagus.

Fats may be supplied in the yolks of eggs, cream, butter, cheese,
bacon, and oily nuts, as butternuts, Brazil nuts, almonds, hazel nuts,
walnuts, pecans; all should be well chewed.

In beginning a diet, the change must not be too sudden. Potatoes, when
they agree, may be used in small quantities as a substitute for bread.
At least a week’s time should be allowed for the elimination of all
sugar and starch. Begin by eliminating sugars and next bread, cereals,
anything made with flour, and potatoes.

Sometimes it is necessary to begin with an all milk diet for a day or
two.

Van Noorden gives the following diet, free from carbohydrates, which
has been in general use in Europe and America.

_Breakfast_

 Tea or coffee, 6 ounces.

 Lean meat (beefsteak, mutton chop, or ham), 4 ounces.

 Eggs, one or two.

_Lunch_

 Cold roast beef, 6 ounces.

 Celery, or cucumbers, or tomatoes with salad dressing.

 Coffee, without milk or sugar, 2 ounces.

_Dinner_

 Bouillon, 6 ounces.

 Roast beef, 7-1/2 ounces.

 Green salad, 2 ounces.

 Vinegar, 2-1/2 drams.

 Butter, 2-1/2 drams.

 Olive oil, 5 drams, or spinach with mayonnaise, large portion.

_Supper, 9 P. M._

 Two eggs, raw or cooked.

Van Noorden includes alcohol, in whisky, in his diet and most
physicians follow the theory that alcohol aids in the digestion and
absorption of fats; the need is recognized since fats must be supplied,
yet the sweet wines and beers contain sugar while the sour wines
contains acids, which may disturb digestion.


_DERANGEMENTS OF LUNGS AND BRONCHI_

[Sidenote: Asthma]

In this affection the free entrance of air into the lungs as well as
its free exit is hampered by a condition of the bronchial muscles, the
mucous membrane of the bronchi, and the muscles of the diaphragm. The
muscles contract spasmodically without due or proper relaxation. This
causes a congestion and swelling of the mucous membrane of the bronchi
which still further hamper the ingress and egress of air.

Any digestive derangement which causes the formation of gas distends
the stomach and intestines, interferes with the free action of the
diaphragm, and prevents the free movement of the abdominal muscles.

The chemical action of the undigested and fermenting substances in the
digestive tract irritates the nerves and may cause the spasm of the
muscles. Digestive derangements will often cause the onset of an attack
of asthma in those afflicted with this disorder.

The correction of the conditions in the stomach and intestinal tract
will often ameliorate the attacks. Care must be taken not to overload
the stomach and intestines, to eat easily digested foods which agree in
the particular case. All food found to cause any digestive disturbance
should be avoided.

Constipation must be remedied by gentle exercises and massage of
the abdomen as free elimination removes material which might aid in
inciting an attack.

Many asthmatics are comparatively comfortable during the day, the
attacks coming on toward evening or during the night. In this case, the
evening meal should be light and easily digested, the heavy meal being
taken at noon.

Hot stuffy rooms increase the disorder and plenty of fresh air should
be secured both by night and by day.

Many of these individuals make no exertion, fearing to bring on an
attack.

Exercise, particularly of the lungs in breathing, should be gradual
at first and be increased as improvement is shown. Exercises directed
to expansion of the deeper cells of the lungs and to equalize the
circulation throughout the entire system will call the excess of blood
from the bronchial tubes and in many cases will cause the difficulty
to disappear. A forceful, equalized circulation, with regulation of
digestion, will do more for asthma than any known agency.

[Sidenote: Tuberculosis]

Derangements in digestion, common in this affection, are due to several
conditions.

The increased temperature is caused by the efforts of the system to
counteract the poisons produced by the action of the bacillus. The
increase in temperature in the stomach lessens the secretions and the
peristaltic action, causing the food to ferment and to be vomited or to
pass practically undigested into the intestine, thus throwing an excess
of work on the intestinal secretions.

The bacilli-laden sputum, if swallowed, is apt to produce disorders of
the stomach. This still further complicates the question of digestion.

Malnutrition, because of these derangements, increases the unfavorable
outlook for the patient in this disease. Hence the diet, especially in
chronic cases, is of great importance.

When means are ample, the question is much simplified, because by
travel, change of scene, and pleasant surroundings the appetite is
stimulated and greater variety in the diet can be gained. For those in
moderate circumstances, save when free sanatoriums exist for the care
of the tuberculous, it is most difficult to keep the diet from becoming
monotonous and wearisome.

The appetite, especially in young people, is apt to be capricious, and
it is important that the food be served daintily to tempt the patient
to eat.

Growing children crave sweets and as these furnish energy they may be
allowed to tuberculous children, in moderation, if they seem to be well
assimilated. Any interference with digestion, however, must be guarded
against.

It is better to give food in smaller quantities and oftener in order
to guard against disturbed digestion from overloading the stomach. For
this reason also it is better to give the heartiest food during the
forenoon when the temperature is lowest.

Milk, butter, cream, olive oil, bacon, and cod-liver oil furnish the
fat needed by the system in the most easily digested form and should
be taken freely, if there is no irritation in the stomach which will
prevent their assimilation. Variation in their use will often secure
greater tolerance.

In chronic cases in which there is little or no fever, the fats are
generally well assimilated and are beneficial.

The disease causes great wasting, and fats are especially important in
counteracting this tendency. They may be given in alternation or be
omitted from the diet for a day or two to avoid turning the patient
against them.

If diarrhea exists fats must be given guardedly and if fats produce
diarrhea they must be lessened or omitted until the diarrhea is
controlled.

If one gains in flesh the chances are very strong that the case has
been wrongly diagnosed, or that the disease, if present, is being
overcome.

Milk, when it agrees, should form a large part of the diet. A glass may
be taken with meals and two glasses between meals. The milk should be
sipped slowly; lime water or carbonated water may be added to aid milk
digestion.

Buttermilk, made by means of buttermilk tablets, from milk from which
the cream has not been removed, or buttermilk mixed with one-fourth
cream, kumyss, or cream and water, if relished, may take the place of
milk.

Eggs are also important aids in the diet, especially the yolk, because
of the fat and iron it contains. If they disagree they may be taken
with a few drops of lemon juice, orange juice, or grape juice, as these
partially digest the egg.

The beaten and strained whites are very easily digested, and in that
form may be taken in quantity of from six to twelve a day.

Tender, juicy meats, especially beef and mutton, may be taken, also
meat juices and beef soups.

Highly seasoned foods should be avoided.

Fresh fish, clams, and oysters are permissible. Cereals, especially
the coarse ones, that stimulate the bowel movements, if constipation
exists, are valuable; oatmeal, rice, and corn-meal mush are especially
good; also Graham or bran bread, and zwieback made with bran. If there
is diarrhea bran should not be used.

Easily digested vegetables are of value, especially if cooked in little
water so that most of the salts and other nutrients, which are so
frequently boiled out of the vegetable, are retained. Baked apples or
raw fruits, especially oranges, may be taken the first thing in the
morning, or used as a dessert. Grapes, peaches, and other fruits in
season may be taken in moderation.

Tea and coffee are best omitted.

The following constitutes a typical menu in ordinary cases. It must be
varied to suit the individual case.

  _Breakfast_:  Fruit, cereal, two eggs (poached or boiled) with or
                without a few slices of bacon; two slices of toast or
                bread, one-half ounce of butter, and a glass of milk.

  _10 a.m._:    Two or three eggs beaten in a glass of milk.

  _Luncheon_:   Fish, chop, or steak, or some tender meat, one-half
                ounce of butter, one or two slices of bread, baked
                potato, or a dish of rice or hominy, green vegetables,
                or a salad of lettuce or tomato with olive oil, a
                dessert of custard or junket or some other nutritious
                dish, and a glass of milk.

  _3 p.m._:     Milk and eggs, meat broth and egg, milk and egg
                custard, or Graham crackers and milk.

  _Dinner_:     Soup if desired, a glass of milk, a liberal helping of
                some special meat, roast beef, lamb, or mutton,
                chicken or turkey, potatoes, or a farinaceous vegetable,
                and a green vegetable, dessert, and a small
                piece of cheese.

This menu approximates the number of calories desirable in cases of
tuberculosis that have not advanced to a stage in which complete rest
is necessary. In that case a liquid or semiliquid diet is given.

When it is necessary that the diet be less expensive, beans, lentils,
and eggs may take the place of meat at some meals, and oleomargarine
may be substituted for butter. Milk and eggs, however, in the quantity
advised, should be taken if possible.

If signs of overfeeding appear, due to the lessened activity of the
digestive organs, shown by biliousness, coated tongue, etc., the food
may be lessened in quantity until the condition is corrected.

If the tongue becomes coated the mouth should receive the care directed
on page 95.

In all cases of weak lungs and chronic lung trouble, the diet should
consist of easily digested foods. Those that cause flatulence should
be avoided, as the distended stomach presses on the diaphragm and
interferes with proper breathing and with the heart action.


_DERANGEMENTS OF THE NERVES_

No disturbance in any part of the body requires less medicine than a
disturbance in the nerves. The correction must come through general
hygienic treatment and directing the mind to optimistic thoughts.

Regular exercise, alternated with regular rest periods, the formation
of the habit of complete nerve relaxation, the general regulation of
an easily digested, nutritious diet, with deep breathing exercises,
are the best remedies. The patient should be out of doors as much as
possible and, unless too weak, should be employed at light work for
mental diversion.

       *       *       *       *       *

[Sidenote: Neurasthenia]

In cases of Neurasthenia, or “tired nerves,” all vital organs are more
or less affected, because the nerves do not properly direct digestion,
absorption, assimilation, or elimination.

The excessive use of stimulants, tea, coffee, or alcohol, is often
an exciting cause, because of overstimulation of an already exhausted
nervous system.

Complete rest of body and mind must be secured.

The diet should be light and of easily digested foods, but must be
nutritious and taken regularly and systematically. Each case needs
individual treatment, and the diet must be that most easily assimilated
by the individual.

_A free, correct breathing of fresh air, day and night, is imperative._

It is important also to thoroughly masticate all food and drink freely
of water.

A change of thought, induced by a change of scene or companions, is
helpful.

One of the most essential treatments of neurasthenia is to surround
the patient with love and tenderness, but the patient should be led to
avoid self-pity. This sets up a disagreeable trend of thought which
relaxes nerve and vital forces and disturbs nutrition. Sympathy, good
cheer, and an attitude of courageous optimism are the best nerve tonics.

Due to the weakened condition of the nerves, troubles which at other
times seem trifles are as mountains and very real. Patience and
intelligent sympathy, not apparent pity, are the best of medicines.

The tone of the nervous system is quickly altered by the state of
mind of the individual. The reaction is a double one, constituting
a “vicious circle.” The nerves, disordered from worry, excessive
fatigue, or other drains on the vitality, as a persistent pessimistic
outlook on life, do not stimulate the natural digestive processes. The
faulty digestion may fail to prepare a sufficient amount of food for
use by the system. The nerves are thus underfed, which still further
increases their inability to send motor and secretory impulses to the
digestive and eliminative organs. Emaciation, general debility, and
anemia may result.

Hence the importance, in the relief of any nervous condition, to see
first that the attitude of mind be calm and quiet with the substitution
of thoughts of hope and cheer for those of gloom and depression. The
afflicted one must make a brave struggle because the tired body affects
his thoughts as well as his thoughts his body.

There is no one food or set of foods which directly affect any nervous
trouble unless this trouble be localized by disturbance in some
particular organ. Then the effort must be to correct the difficulty in
that organ.

Rest is imperative.

If thin, a fat-building diet should be followed to store
energy-building reserve in the nerve centers.

In many cases of nerve debility the nerves seem to be stronger in the
latter part of the day. When this is the case the hearty meal should be
eaten at this time.

[Sidenote: Neuralgia]

The condition of the blood is affected by the lack of its necessary
ingredients, which may occur through faulty digestion as well as
through improper diet. The resultant anemia of the nerves may produce
neuralgic pains in any one or several of the tissues and organs, as the
stomach, the intestines, the muscles, or the liver, etc. Neuralgia of
the liver is sometimes mistaken for gallstone colic.

When underlying conditions of disease have been excluded by means of
careful tests of the urine and blood, the diet becomes of importance
and may result in the disappearance of the pain.

These pains occur chiefly in those who take little exercise and use
improper food, which does not give the correct proportion of the needed
elements to the system.

Exercise, as the body is usually weak, should be begun moderately but
as soon as possible be made brisk and active to stimulate the vital
organs to a more perfect performance of their function.

Plenty of oxygen must be secured by day and night and thorough
elimination be maintained.

The diet must be nutritious and richer than is ordinarily taken. Milk,
butter, cream, bacon, olive oil, and all fatty food should be freely
used if assimilated. Beefsteak, roast beef, fresh vegetables, and eggs
are valuable. Cocoa or chocolate, a glass of milk with a beaten egg, or
a cup of broth into which an egg has been beaten may be regularly taken
between meals.

If the digestion is feeble, light foods should first be taken and
increased as the system becomes able to assimilate more hearty food.

Coffee, tea, highly spiced foods, alcohol, fried food, rich pastry, and
much candy or sweet stuffs should be avoided.

Pain referred to the liver, if not caused by gall-stones, usually
indicates overwork of that organ, and fats, sweets, and starches should
be avoided to give the liver rest.

Pain referred to the stomach is often caused by tobacco smoking or
improper food, as too much candy or preserves, or too strong tea or
coffee. Attention to the diet will usually relieve this variety of
pain. If the pain comes on when the stomach is empty, due to a disorder
of the nerves, the food should be lessened in quantity, be light,
easily digested, and taken at shorter intervals.

Many conditions of the system due to dietetic errors which result in
impoverished blood are accompanied by pains in the stomach. These are
often neuralgic.

Poor assimilation of foods or indigestion produces pain because the
tone of the nervous system is affected from the poor blood.

Neuralgia of the stomach often occurs in anemic conditions associated
with constipation. In these cases a good, nutritious, but easily
digested diet and better elimination will often cure, but as the
changes in the blood and nerves are slow, one must be patient and
persistent.

There is no better nerve tonic than pure air, exercise, cheerful
thoughts, and rest.

Sweets, fried food, rich sauces, pastry, and highly seasoned food
should be avoided.

When neuralgia of the stomach, due to an underlying condition such
as rheumatism, gout, or diabetes occurs, the diet appropriate to the
condition will often affect the cure of the neuralgia.

[Sidenote: Chorea]

The diet is of the greatest importance in this difficulty, as it is
usually accompanied by anemia. Rest and a very nourishing and easily
digested diet are essential. Sometimes a complete rest in bed and a
milk diet, or a diet composed largely of milk, is the best means of
treatment.

If possible the patient should be isolated and in the care of a trained
nurse who is naturally cheerful and bright.

Children are especially liable to this malady. They are usually anemic
and care should be exercised that they be not overworked in school and
that they retire early and get from ten to twelve hours’ sleep.

Their eyes must be kept from strain and the nervous system not allowed
to become tense from too much excitement, as teasing by playmates or
the family, etc.

They should be given the diet for Anemia on page 249.


_DIET IN SKIN DISEASES_

An improper diet or a lowered nerve tone are often shown by the
condition of the skin.

When the waste of the system is not being properly eliminated through
the other excretory organs the skin is required to throw off more than
its normal amount.

The muddy complexion in biliousness or the congestion of the facial
capillaries in the alcoholic are familiar examples.

Overeating, especially of food too rich or too concentrated, causes
fermentation from non-digestion, or imperfect oxidation, due to too
large an amount of nutriment for the amount of oxygen furnished to the
tissues.

An inactive skin results in an accumulation of fat in the sebaceous
glands with clogging of the ducts; germ infection in these clogged
glands often results in pimples and boils. An excess of acid in
the secretion of the sweat glands irritates the skin and causes
eruptions.[15]

Chronic skin troubles are always increased and made more troublesome
when there are errors in the diet, and they are often benefited and in
some cases cured when the dietetic errors are corrected.

Skin troubles often occur when for any reason the nervous system is
run down, because the weakened nerves cause the tissues or organs they
supply to become inactive. The skin thus becomes affected with the rest
of the body and derangements of its function appear. Increasing nerve
tone will result in a disappearance of the skin disorders. This takes
time.

All rich food and highly seasoned preparations, veal, pork, tea,
coffee, pastry, too much sweets and fats, and any fruits and vegetables
that cause flatulence should be avoided.

A diet of fruit, water, and Graham bread for three or four days, every
week or two, daily exercise and deep breathing of pure air will usually
clear the skin.

The skin of the face is materially cleared by the use of facial
exercises which promote its activity and the elimination of waste.
Exercises for increasing the tone of the skin and the muscles are as
essential for the face as for the body.

In all skin troubles alcohol must be prohibited.

       *       *       *       *       *

[Sidenote: Urticaria (Hives)]

This is characterized by distressing itching and may be caused by any
article of food which disagrees. A more or less irritant food or one
difficult of digestion, such as strawberries, shellfish, pork, cheese,
and sausage, are the foods which most usually produce it, if taken into
an inactive stomach. When the intestines are in a sluggish condition
the stomach does not act well, and any food which does not digest
promptly is liable to excite an attack.

It is remedied, by eating very lightly, by fasting for a day or two,
by drinking _much_ water, exercising, breathing deeply, and securing
activity of the bowels. Care must be taken to avoid foods known to
disagree.

[Sidenote: Eczema]

The cause of this disorder is often difficult to ascertain, but it is
aggravated or relapses occur when too much or too rich food is eaten.
The skin is not able to dispose of all the material sent to it.

It often occurs in those who are excessive eaters of meat.

The diet may have to be confined to fruit, bread and milk, or crackers
and milk for a few weeks.

Meat, if allowed, should be taken sparingly and not oftener than once
a day—better only every other day. Beef and chicken are the preferable
meats. If no improvement occurs, or if it be slight, meat should be
omitted altogether. Eggs may be substituted for meat. A little fresh
fruit, if thoroughly ripe, may be taken, but all made desserts must
be avoided and very little sweets used. Cracked wheat, or other wheat
cereal, with a little cream, may be eaten.

Oatmeal may provoke an attack because of the amount of fat in it. Foods
may cause an attack in one case that have no detrimental action in
another.

Skin eruptions, eczema-like, often occur if for any reason the diet has
been too limited, as in the semi-starvation seen in poor children. In
these cases a more nutritious diet will often cure.

Bananas, apples, cabbage, or fried foods, often cause a temporary
attack or aggravate an existing condition.

The food must be thoroughly masticated, must be taken at regular
times, and not in excess. As this condition sometimes accompanies other
diseases, any underlying condition must be sought, but all diet should
be as simple as the needs of the system will bear. The foods which are
found to increase the irritation of the skin are the ones to be avoided
in each case.

[Sidenote: Pruritus (Itching)]

The all-prevalent American habit of eating fried food often produces
an intense itching of the skin in various parts of the body. It occurs
often in those who eat food highly seasoned with pepper or other
condiments. The articles of food causing the overstimulation must be
avoided, and all fried food, pastries, or food containing much fat,
must be greatly lessened or omitted altogether.

Itching is sometimes caused during the change of seasons due to the
effect of the changing temperature on the nerves of the skin. To rub
the skin with oil for two or three days to soften the dead cells and
to aid their removal from the surface will secure a better circulation
in the skin and help to eliminate the cause of the itching. A free
drinking of water, fresh air, and exercise will help the condition.

[Sidenote: Acne]

The rapidly changing system of the growing boy and girl is especially
liable to disorders, due to improper eating, irregular habits, worry,
lack of rest, or improper food. Eruptions, especially on the face,
appear as a result. The sebaceous glands are especially active, and any
alteration in the structure of the blood, due to deranged digestive
processes and defective elimination by the skin, causes too great an
amount of deposit in the fat glands. Their contents become hardened
and infected by germs, with consequent irritation and reddening, and
the condition known as acne is the result.

Once well established it is difficult to cure, but it often rapidly
improves under a simple diet, rested nerves, cheerful, kind thoughts,
and better digestion and elimination.

The food should be thoroughly masticated. Young people are prone to
eat too hastily, and thus not thoroughly mix the food with saliva. If
careful attention is paid to mastication of the food, water at meals
is an aid to digestion. Water should be taken freely between meals, on
rising and before retiring, for its diuretic and laxative effect.

All candy, and sweets, hot breads, corn bread, pastry, soups with much
fat, rich hashes and sauces, fried food, pork, and veal should be
eliminated from the diet.

A badly blotched face is an embarrassment, and no restriction in the
diet should be deemed a hardship as a means to an improved digestion,
increased mental vigor, and improved health.

A pimple on the face should be treated as antiseptically as a boil. The
pus from a pimple which has “come to a head” should not be allowed to
infect the surrounding skin. Infection may take place from towels or
wash cloths used by one afflicted with acne. Care should be exercised
to sterilize the surrounding skin by peroxide of hydrogen or alcohol
before a pimple is opened and its contents should be taken up with
absorbent cotton. A pimple should never be severely squeezed as the
skin will be irritated and other pimples may result.

Often the infection from one pimple is spread by the hands or by the
wash cloth. Care should be taken to avoid this.

_Exercise directed to the facial muscles and to the liver and digestive
organs, deep breathing, plenty of oxygen by night and day, wholesome
thoughts, plenty of sleep, and simple food, will eliminate or improve
most skin difficulties. Care should be taken, by frequent bathing and
friction baths, to aid the eliminative work of the skin._

       *       *       *       *       *

[Sidenote: Rheumatism]

Since the medical profession is unable to determine just what
rheumatism is, it is difficult to prescribe a diet. The theory so long
believed that it is caused by an excess of uric acid in the system is
no longer held by most of the advanced physicians. Uric acid, however,
sometimes accompanies the disease.

Some authorities hold that it is a nerve difficulty; others that it is
caused by an excess of lactic acid; others hold that it is caused by
infection from the tonsils and the gums.

Assuming that it is due to the failure of the system to promptly
eliminate its waste, whether this failure to eliminate be through
a weakened condition of the nerves, and the consequent failure to
properly direct the body activities, the correction of the difficulty
must lie in building up the general vitality and in aiding the system
in its elimination.

Hot sweat baths, a free use of water, and a free use of fruits and
fruit juices, particularly the citrus fruits, such as lemons, oranges,
limes, etc., are desirable in moderation, because they increase
the alkalinity of the blood, and because of their diuretic effect.
Lemonade, orangeade, and all fresh fruits and vegetables are diuretic.

The diet should be cut down in quantity. If an excess of uric acid
exists, meat may be eliminated and the suggestions given in the diet
for Gout may be followed.

The food must be plain and well cooked, not highly seasoned, and the
amount must be confined to the needs of the system as shown by the
general condition.

Regular exercise, until the body is thoroughly heated, deep breathing
of pure air day and night, and a copious drinking of water are
necessary.

       *       *       *       *       *

[Sidenote: Leanness]

No definite diet can be given here for flesh building, because a lack
of sufficient fat to round out the figure is due to faulty digestion or
assimilation.

It may be that the strength of the muscles and nerves of the stomach,
liver, and intestines should be built up by exercises and deep
breathing, and it may be that the habit of nerve relaxation must be
established. When the nerves are tense much nourishment is consumed in
nervous energy and the nerves to the digestive organs and muscles being
disordered, they interfere with digestion and assimilation.

It is apparent that the cause of the lack of flesh must first be
corrected. Merely to give a fat-building diet may overload deranged
digestive organs with sugars, starches, and fats, further weakening
them.

Often leanness is due to inability to digest the starches or
sugars, and when this is the case the condition must be remedied by
strengthening the digestive organs through exercises for the muscles
of the stomach and intestines, exercises to create a free activity
of the liver and to strengthen the nerves controlling digestion.
Deep breathing habits to insure sufficient oxygen to put the waste
in condition for elimination are necessary. Most often sufficient
food is eaten, but due to nerve tension or to sluggish circulation,
particularly through the vital organs, it is not assimilated.

Usually, however, bodily flesh may be increased by increasing the
liquids and the carbohydrate consumption and also the fat if these are
assimilated.

If habits of life, overwork, improper food, unhealthy thoughts, nerve
exhaustion, excessive nerve tension, or disease are responsible, they
must first be corrected. Often the nerve tension must be relaxed by
change of habit of both body and mind before the flesh will accumulate.

There must be no mental strain, and plenty of sleep must be secured.

If they can be assimilated, the diet should contain soups, butter,
milk, cream, cocoa, chocolate, well-cooked cereals, as oatmeal, bread,
tapioca, or rice puddings with cream and sugar, bread, potatoes,
leguminous foods, as peas and beans, cake, honey, especially sweet
fruits, carrots, parsnips, and other vegetables; meat not oftener than
once a day.

Vinegar and too much spice, pastry, coffee, and tea should be avoided.

The free drinking of liquid is most important.

       *       *       *       *       *

[Sidenote: Obesity]

Obesity is caused by a disturbed balance of nutrition occasioned,
often, by more food being taken than the body requires. The resultant
fat is deposited in and among the tissues.

It is most often seen in those in middle life of sedentary habit who
continue to eat as heartily as ever without using a little thought to
determine the actual body needs for food.

An excess of fat is often seen in light eaters, however. This is
usually due to a weakness of nerve tissue, which does not direct the
regular activities of the body—digestion assimilation, elimination,
etc.—with sufficient force to burn up the normal amount of fat in
automatic activities.

In all cases breathing is usually faulty, oxidation is incomplete, and
little exercise for the vital organs is taken. Anemia may exist in such
individuals.

The body fat is formed from various elements in foods, and a food which
may cause obesity in one individual may not produce it in another. Fat
meats, alcoholic drinks, or the excessive use of starches and sugars
may cause it. The food at fault in each case must be determined and
largely reduced or eliminated from the diet.

Many obesity cures are in existence, and have had considerable vogue
from time to time. Anti-fat remedies are dangerous, as they lower the
vitality of the system and render it liable to be attacked by disease.
All such remedies act by decreasing the appetite and causing impairment
of the digestion.

The rational method is to limit both the amount of food and the liquid
to be taken, to increase oxidation by deep breathing and exercise.
By restricting the carbohydrates and fats consumed the body calls on
that stored in the tissues. In obesity, unless there is an underlying
condition of disease, the amount of water should be limited while
reducing and none should be drunk with the meals. Soup, milk, and all
juicy fruits and all foods made from cereals should be taken sparingly;
sugar must usually be forbidden and fat in the food limited to a
little butter. One need not starve under this treatment for the diet
may be varied enough to prevent monotony even though restricted.

Fresh green vegetables, fruit, and lean meat should form the main
ingredients of the diet, but if gastric disturbances arise the diet
must be varied to correct them. Meat should be eaten but once a day.

Extremes in diet should be strictly avoided; a sudden restriction of
diet produces changes in the blood which may do harm. For this reason
the amount of food taken should be gradually but steadily reduced
and one article after another eliminated until the system becomes
accustomed to the reduction.

_Thorough elimination must be secured through exercise and deep
breathing._

All alcoholic liquors must be omitted.

_All diets for obesity must be prescribed for the individual condition.
A diet suited to one person may be entirely unsuited to another. For
this reason, and because of the danger of one following a diet which
may be unsuited to the condition, diets for obesity are not given here._

_Exercise and deep breathing must constitute an appreciable part of
reduction methods to cause a combustion of the fat liberated._ These
are the natural, scientific means of reduction.

_If one reduces by diet alone the excess of fat may not come from the
part desired._ One is likely to show the results first in the face and
neck. One should exercise the parts desired to be reduced so as to
oxidize the fat stored about these particular tissues.

A large number of the obese are afflicted with rheumatism, sluggish
livers, sluggish action of the intestines, and weak nerves, and the
diet must be governed accordingly.

The regulation of food for reduction of flesh must also be governed
by age, sex, by the manner of breathing, and by the amount of daily
exercise. The food must be regulated in accordance with the quantity of
carbohydrates and fats daily consumed in heat and energy.

A rational study of the needs of the system and a persistent following
of the indicated regimen will result in a steady reduction, renewed
vitality, and a sense of “being fit.” The better elimination secured by
exercise and increased oxygen will aid the muscles to release the fat
which may have caused them to become flabby.

Reduction must not be accomplished too suddenly, but it can be gained
by a little self-denial and determination.

One who carries too much fat is much more liable to gout, rheumatism,
apoplexy, high blood pressure, asthma, and bronchial affections.

       *       *       *       *       *

[Sidenote: Feeding the Convalescent]

When an individual is recovering from an illness the appetite often
becomes excessively active, and his demands for food, if yielded to by
the family or attendant, may produce digestive derangements from which
recovery is slow.

On the other hand, too much food is often urged on the convalescent
from a mistaken idea that large quantities of food are necessary in
order to rebuild the enfeebled system.

Care must be taken not to return too rapidly to a solid diet when a
liquid diet has been followed for some time. The digestive system
shares in the general weakness and must not be overloaded.

The more easily digested foods, as ice cream, milk, tapioca, crackers
and cream or cream toast, cream soups and meat broths thickened with
bread crumbs rolled from toasted bread, custards, stewed fruits, corn
meal, mush, in some conditions, cornstarch blancmange, boiled rice, and
poached eggs may be given.

Later, when meat is added to the diet it should be scraped or finely
minced so as to give the stomach as little work as possible until it
regains its tone.

Potatoes, if allowed, should be baked or mashed.

Sweetbreads in cream, sponge cake or lady fingers with light cream may
also be allowed.

At least a week should be taken in returning to a solid diet and the
orders of the physician must be strictly followed. Pickles, nuts, or
solid meats should not be allowed. They will often occasion a return of
fever and possibly a relapse.

After typhoid fever or other lingering illness, the appetite is usually
much increased, but great care must be exercised not to allow solid
food before the condition of the stomach and intestines shows that
danger is past. It is usual not to allow solid food in typhoid fever
for two weeks after the fever has disappeared.

It is possible to make great variety in the diet even if it be light
and easily digested and common sense must govern in the kind as well as
the quantity of food allowed the convalescent.

Scraped beef or scraped chicken may be seasoned, lightly pan broiled,
and made into a sandwich. The first solid meat may be creamed
sweetbread, a bit of broiled tenderloin steak, or breast of chicken.

It is better to give small amounts both because of the lessened work
of digestion and because large amounts of food often destroy rather
than aid the appetite.

If the appetite is capricious, or lacking, it needs to be stimulated
by food appetizingly prepared and daintily served. A sloppy tray with
half-cold tea or coffee will often cause complete loss of appetite.

The face and hands of an invalid should always be bathed before a meal;
the fresh feeling induced is often an aid to the appetite. The mouth
should be carefully cleansed after eating in order that no fermenting
food particles may be carried into the stomach to cause disturbance
there. Swabbing the mouth with cotton dipped in an alkaline wash or
rinsing the mouth with listerine and water or peroxide of hydrogen and
water will add greatly to the comfort of the sick, especially when the
tongue is coated and the mouth bitter.

Great care should be taken not to allow bread crumbs to fall into or
under the bedclothes, as a small bread crumb is often a source of great
discomfort. The skin is especially sensitive and a small bread crumb
may so disturb the mind as to cause a patient, otherwise doing well, to
become restless and disturbed.

The invalid frequently forgets to ask for water and the attendant
should see that a sufficient amount of water is taken. A glass of water
should be placed where it is within easy reach and it should not be
allowed to become warm. Cool water is one of the prime requisites in
the invalid’s dietary.


FOOTNOTES:

[15] For treatment of pimples, see _Let’s Be Healthy_, by Susanna
Cocroft.




CHAPTER XI

RECIPES FOR FOODS FOR INVALIDS AND SEMI-INVALIDS


The purpose is not to give such recipes as are found in ordinary
cookbooks, but simply to suggest foods useful for invalids, for
semi-invalids, or for chronic, abnormal conditions of digestive organs.

_Water._ Pure and carbonated; mineral waters containing iron, sulphur,
lithium, etc.

Hot drinks should be served at a temperature of from 122 to 140 degrees
F. When water is used as a hot drink it should be freshly drawn,
brought to a boil, and used at once. This sterilizes and develops a
better flavor.

Cold water should be thoroughly cooled, but not iced, unless ice water
is sipped very slowly and held in the mouth until the chill is off.
Water is best cooled by placing the receptacle on ice rather than by
putting ice in the water.

_Fruit Juices._ Under fruit juices are: grape juice, apple juice,
currant juice, pineapple juice, orangeade, and lemonade.

They are especially grateful to fever patients and are often used
to stimulate the appetite. They are particularly valuable for the
acids which they contain, which aid the action of the kidneys and the
peristaltic action of the digestive tract; they also increase the
alkalinity of the blood.

Apples contain malic acid, lemons citric acid, and grapes tartaric
acid. The ferment in the ripe pineapple juice aids in the digestion of
proteins.[16]

 _Lemonade._ Wash and wipe a lemon. Cut a slice from the middle into
 two pieces to be used in the garnish before serving; then squeeze the
 juice of the rest of the lemon into a bowl, keeping back the seeds.
 Add sugar and boiling water; cover and put on ice to cool; strain and
 pour into a glass.

 _Fruit Lemonade._ To change and vary the flavor, fresh fruit of all
 kinds may be added to strong lemonade, using boiling water as directed
 above.

 _Egg Lemonade._ Beat an egg thoroughly, add 2 tablespoonfuls of sugar,
 2 tablespoonfuls of lemon juice, and gradually pour in one cup of cold
 water. Stir until smooth and well mixed. Serve thoroughly cold. This
 drink is very easily digested, the lemon having partly digested the
 egg; 2 tablespoonfuls of sherry or port may be added.

 _Bran Lemonade._ Mix one-quarter cup of wheat bran with 2 cups of cold
 water. Allow this to stand overnight and in the morning add the juice
 of a lemon.

 _Pineapple Lemonade._ Mix one-half cup of grated pineapple with the
 juice of 1 lemon and 2 tablespoonfuls of sugar; add one-half cup of
 boiling water, put on ice until cool, then add 1 cup of ice-cold
 water. Strain and serve.

 _Grape Lemonade._ To 1 cup of lemonade, made as directed above, rather
 sweet, add one-half cup of grape juice.

 _Effervescing Lemonade._ To the juice of 1 large lemon add a lump or
 two of sugar which has been rubbed on the rind. Pour on it half a pint
 of cold or ice water. Add half a teaspoonful of bicarbonate of soda
 after it has been placed in the tumbler.

 _Orangeade._ One orange, 1 teaspoonful of sugar, three-quarters of a
 coffee cup of water. Wash and wipe the orange. Squeeze the juice into
 the sugar. Add the cold water which has previously been boiled. Strain.

 _Apple Water._ Slice 1 pound of apples, put in a jar with one-fourth

of a pound of brown sugar. Pour over apples and sugar 1 gallon of
boiling water. When cool put the apples through a colander. Bottle but
do not cork. Keep in a cool place. May be poured over toasted bread.

_Mixed Fruit Drink._ Mix one-quarter cup of grated pineapple, the juice
of half a lemon, the juice of half an orange, 1 cup of boiling water,
and sugar to taste. Put on the ice until cool. Strain and add more cold
water and sugar according to taste.

_Pineapple Juice._ Pour one-half cup of pineapple juice over crushed
ice and serve in a dainty glass. This is especially helpful in cases
of weak digestion and in some throat troubles—as stated above, the
pineapple aids protein digestion.

_Lemon Whey._ Heat 1 cup of milk in a small saucepan, over hot water,
or in a double boiler. Add 2 tablespoonfuls of lemon juice; cook
without stirring until the whey separates. Strain through cheesecloth
and add two teaspoonfuls of sugar. Serve hot or cold. Garnish with
small pieces of lemon.

_Wine Whey_ may be made in the same way, using one-quarter cup of
sherry wine to 1 cup of hot milk.

_Grape Juice, Apple Juice, and Currant Juice_ are tonics and make a
dainty variety for the sick room. They should be used according to
their strength, usually about one-third juice to two-thirds water. They
should be kept cold and tightly corked until ready to serve.

_Grape Lithia._ Add 4 ounces of Lithia-water to 1 ounce of grape juice
and 2 teaspoonfuls of sugar.

_Grape Nectar._ Boil together 1 pound of sugar and one-half pint of
water until it begins to thread. Remove from the fire and when cool add
the juice of 6 lemons and 1 quart of grape juice. Let stand overnight.
Serve with ice water, Apollinaris, or plain soda water.

_Tea Punch._ Pour boiling lemonade, sweetened to taste, over tea
leaves. Allow the liquid to stand until cool. Then strain and serve
with shaved ice and slices of lemon. This makes a delicious cooling
drink for hot weather.


LIQUID FOOD

Under this heading such liquids are given as are actual foods.

_Milk._ Milk is a complete food and a perfect food for infants, but not
a perfect food for adults. It may be used as

  Whole or skimmed;
  Peptonized; boiled;
  Sterilized; pasteurized;
  Milk with lime water, Vichy or Apollinaris;
  With equal parts of farinaceous liquids;
  Albuminized milk with white of egg;
  Milk with egg yolk, flavored with vanilla, cinnamon, or nutmeg;
  Milk flavored with coffee, cocoa, or meat broth;
  Milk punch; milk lemonade;
  Kumyss; kefir or whey, with lemon juice, as above.

 _Milk and Cinnamon._ Boil in one pint of new milk sufficient cinnamon
 to flavor it and sweeten with white sugar.

_Egg Preparations._ These consist of:

  Albumin water (diluted white of egg), flavored with fruit juice;
  Egg lemonade; egg orangeade;
  Egg with meat broth;
  Egg with coffee and milk;
  Chocolate eggnog.

Often the white of egg, dissolved in water or milk, is given when the
yolk cannot be digested because of the amount of fat which it contains.

When one is inclined to biliousness, the egg is better digested if
beaten in wine.

The albuminous or egg drinks are best prepared cold.

 _Eggnog._ To make eggnog, separate the white and the yolk, beat the
 yolk with three-quarters of a tablespoonful of sugar and a speck
 of salt until creamy. Add three-quarters of a cup of milk and 1
 tablespoonful of brandy. Beat the white until foamy, add to the above
 mixture, and serve immediately. A little nutmeg may be substituted for
 the brandy. The eggs and milk should be chilled before using. Eggnog
 is very nutritious.

 _Egg Broth._ Beat the yolk of 1 egg, add 1 tablespoonful of sugar
 and a speck of salt. Add 1 cup of hot milk and pour it on gradually.
 Flavor with nutmeg.

 Dried and rolled bread crumbs may be added, or beef, mutton, or
 chicken broth may be used in place of the milk, and the sugar may be
 omitted. The whole egg may be used if desired.

 This is very delicious made with beef broth, instead of hot milk.
 Pineapple juice or coffee may be used.

 _Coffee Eggnog._ 1 egg, 1-1/4 teaspoons of sugar, one-half scant cup
 of milk or cream, one-half scant cup of coffee.

 _Egg Malted Milk._ Mix 1 tablespoonful of Horlick’s Malted Milk with
 1 tablespoonful of crushed fruit and 1 egg; beat for five minutes.
 Strain and add 20 drops of acid phosphate, 1 tablespoonful of crushed
 ice, and three-quarters cup of ice water. A grating of nutmeg may be
 used for flavor.

 _Grape Yolk._ Separate the white and the yolk of an egg, beat the
 yolk, add the sugar, and let the yolk and sugar stand while the white
 of the egg is thoroughly whipped. Add 2 tablespoonfuls of grape juice
 to the yolk and pour this on to the beaten white, blending carefully.
 Have all ingredients chilled before blending and serve cold.

 _Albuminized Milk._ Beat one-half cup of milk and the white of 1 egg
 with a few grains of salt. Put into a fruit jar, shake thoroughly
 until blended. Strain into a glass and serve cold.

 _White Wine Whey._ To half a pint of milk boiling add 1 wineglassful
 of sherry. Strain through a cheesecloth. Sweeten with powdered sugar
 to taste. For a child give a tablespoonful every 2 or 3 hours.

 _Albumin Water._ Albumin water is used chiefly for infants in cases of
 acute stomach and intestinal disorders, in which some nutritious and
 easily assimilated food is needed. The white of 1 egg is beaten and
 mixed with a pint of water, which has been boiled and cooled.

 _Albuminized Grape Juice._ Put 2 tablespoonfuls of grape juice into a
 dainty glass with pure chopped ice. Beat the white of 1 egg, turn into
 the glass, sprinkle a little sugar over the top, and serve.

 _Cream of Tartar Water._ Dissolve a teaspoonful or a teaspoonful and a
 half of cream of tartar in a pint of boiling water, flavor with lemon
 peel and sugar. Strain and drink when cold.

_Farinaceous Beverages._ These are all made by slowly cooking cereals,
such as barley, rice, oatmeal, etc., in a large quantity of boiling
water from two to three hours, straining off the liquid, and seasoning
to taste. They are particularly valuable when only a small amount of
nutriment can be assimilated. Since the chief ingredient is starch,
long cooking is necessary to make soluble the starch globules, so that
it can be more readily digested. Since these drinks are given only in
case of weak digestion, it is important that they be taken slowly and
held in the mouth until they are thoroughly mixed with the saliva.

 _Barley Water_ (Infant feeding). Mix 1 teaspoonful of barley flour
 with 2 tablespoonfuls of cold water, until it is a smooth paste. Put
 in the top of a double boiler and add gradually 1 pint of boiling
 water. Boil over direct heat five minutes, stirring constantly; then
 put into a double boiler, over boiling water, and cook fifteen minutes
 longer. This is used as a milk diluent for normal infants and to check
 diarrhea.

 For children or adults use one-half teaspoonful of barley or rice
 flour, 1 cup of boiling water, and one-quarter teaspoonful of salt.
 Cream or milk and salt may be added for adults, or, lemon juice and
 sugar, according to the condition.

 Barley water is an astringent and used to check the bowels when they
 are too loose.

 _Barley Water_ (Bartholow). Wash 2 ounces of pearl barley with cold
 water. Then boil it for five minutes in some fresh water and throw
 both waters away. Then pour on 2 quarts of boiling water and boil it
 down to a quart. Stir and skim occasionally. Flavor with lemon rind.
 Add sugar to taste but do not strain unless the patient requests it.

 _Rice Water or Mucilage of Rice._ Thoroughly wash 1 ounce of rice with
 cold water. Then soak for three hours in a quart of water kept at a
 tepid heat, stirring from time to time, and afterwards boil slowly
 for an hour and strain. This is useful in dysentery, diarrhea, and
 irritable states of the alimentary canal. It may be sweetened and
 flavored in the same way as barley water.

 _Flaxseed Tea._ One-half cupful of flaxseed to 1 quart of boiling
 water. Boil thirty minutes and let stand near the fire to thicken.
 Strain, add lemon juice and sugar to taste.

 _Rice Water._ Wash 2 tablespoonfuls of rice, add 3 cups of cold water,
 and soak thirty minutes. Then heat gradually and cook one hour until
 the rice is tender. Strain through muslin, reheat, and dilute with
 boiling water or hot milk to the consistency desired. Season with
 salt; sugar may be added if desired and cinnamon, if allowed, may be
 cooked with it as a flavor. One teaspoonful of stoned raisins may be
 added to the rice, before boiling, if there is no bowel trouble.

 _Oatmeal Water._ Mix 1 tablespoonful of oatmeal with 1 tablespoonful
 of cold water. Add a speck of salt and stir into it a quart of boiling
 water. Boil for three hours, replenishing the water as it boils away.
 Strain though a fine sieve or cheesecloth, season, and serve cold.
 Sufficient water should be added to keep the drink almost as thin as
 water.

 _Toast Water._ Toast thin slices of stale bread in the oven; break up
 into crumbs; add 1 cup of boiling water and let it stand for an hour.
 Rub through a fine strainer, season with a little salt. Milk, or cream
 and sugar may be added if desirable. This is valuable in cases of
 fever or extreme nausea.

 _Sago Soup._ Stew 2 ounces of the best sago in a pint of water until
 it is quite tender. Mix with half a pint of good boiling cream and the
 yolks of two fresh eggs. Put into it 1 quart of essence of beef. Mix
 thoroughly. The beef essence must be heated separately and mixed while
 both mixtures are hot. This must be served warm.

 _Crust Coffee._ Dry crusts of brown bread in the oven until they are
 hard and crisp. Pound or roll them and pour boiling water over. Let
 soak for fifteen minutes, then strain carefully through a fine sieve.


_MEAT JUICES_

Meat juice may be prepared in three ways:

(1) Broil quickly, or even scorch, a small piece of beef. Squeeze out
the juice with a lemon squeezer, previously dipped in boiling water.
Catch the juice in a hot cup. Season and serve. If desirable to heat it
further, place the cup in hot water.

(2) Broil quickly, cut up and put the small pieces into a glass jar.
Set the covered jar in a pan of cold water. Heat gradually for an
hour, never allowing the water to come to a boil. Strain and press out
the clear, red juice, season, and serve. One pound of beef yields 8
tablespoonfuls of juice.

(3) Grind raw beef and place in a lightly covered jar with 1 gill of
cold water to a pound of beef. Stand it on ice overnight and squeeze
through a bag. Strain, season, and serve.

 _Meat Tea._ Meat tea is made by using a pound of meat to a pint of
 water. Grind the meat, place in a jar, and cover with the cold water.
 Set the jar in an open kettle of water and cook for two hours or more,
 not allowing the water to boil. Strain by squeezing through a bag,
 skim off the fat, and season.

 _Meat Broth._ Meat broth is made from meat and bone, with or without
 vegetables. The proportion is a quart of water to a pound of meat.
 Cut the meat into small pieces, add the cold water, and simmer until
 the quantity is reduced one-half. Strain, skim, and season with salt.
 Chicken, veal, mutton, and beef may be used in this way. It may be
 seasoned with onions, celery, bay-leaves, cloves, carrots, parsnips,
 rice, barley, or tapioca. Stale bread crumbs may be added.

 _Mutton and Chicken Broth._ Cut up a chicken or a pound of mutton,
 because it is free from fat, put into cold water to cover, and let
 stand on ice two or three hours. Cook over a slow fire until the meat
 falls from the bone. Strain, cool, skim off the fat, salt to taste,
 and allow to cool. This may be served hot or cold.

 _Broth for the Sick._ To 1 pound of chopped lean meat of any kind,
 except pork or veal, add 1 pint of cold water or one pint and a half
 on ice. Let stand in a covered glass fruit jar for from four to six
 hours, cook for three hours in a closed jar placed in a kettle of
 water, strain, cool, skim off the fat, clear with a beaten egg, season
 to taste. This may be given warm or cold.

 _Beef Tea and Oatmeal._ Two tablespoonfuls of oatmeal and 2 of cold
 water, mix thoroughly. Add a pint of good beef tea which has been
 brought to the boiling point. Boil together for five minutes. The
 oatmeal must have been previously cooked for a long time. It may be
 taken from that prepared for the morning meal.

       *       *       *       *       *

 _Soups._ Clear soups are made by cooking raw meat or vegetables, or
 both together, slowly, for a long time, then straining the liquid. The
 flavor may be changed by browning the meat or vegetables in butter
 before adding the water.

       *       *       *       *       *

 Cream soups are made in the proportion of 1 quart of vegetables (such
 as corn, peas, beans, tomatoes, celery, or asparagus) to 1 pint of
 water and adding 1 pint of milk. Cook the vegetables thoroughly in
 water and mash through a colander. To this water and pulp add a
 cream sauce made in the proportion of 4 tablespoonfuls of flour, 4
 tablespoonfuls of butter, and 1 pint of milk, for vegetables poor in
 starch or protein. Add 2 tablespoonfuls of flour, 2 tablespoonfuls of
 butter, and a pint of milk for those rich in protein. Season to taste.

 Tomato acid should be counteracted by the addition of one-eighth
 tablespoonful of soda before the milk is added.

 Potato soup may be flavored with onion or celery, or both.


_SEMI-SOLID FOODS_

The following lists of foods are given for ready reference:[17]

 _Jellies._

  (a) Meat jellies and gelatin; veal, beef, chicken, mutton.

  (b) Starch jellies, flavored with fruit; cornstarch, arrowroot, sago,
  tapioca.

  (c) Fruit jellies and gelatin.

 _Custards._

  (a) Junkets of milk, or milk and egg (rennet curdled), flavored with
  nutmeg, etc.

  (b) Egg, milk custard, boiled or baked.

  (c) Cornstarch, tapioca, boiled custard.

  (d) Frozen custard (New York ice cream.)

 _Gruels._ (Farinaceous.)

  (a) Milk gruels.
  (b) Water gruels.

_Jellies.—Meat Jellies_ are made in two ways:

 (1) Cook soup meat (containing gristle and bone) slowly for a long
 time in just enough water to cover. Strain and set the liquid away in
 a mold to cool and set. If desired, bits of shredded meat may be added
 to the liquid before molding.

 (2) Use meat broth and gelatin in the proportion of 1 tablespoon
 gelatin to three-quarters of a cup of hot broth. Pour into mold and
 set on ice.

 _Starch Jellies._ Starch jellies are made by cooking in a pint of
 fruit juice or water until clear, 2 tablespoonfuls of tapioca,
 arrowroot, sago, cornstarch, or flour. Sweeten to taste.

 If water is used, fresh fruit may be used either in the jelly or in a
 sauce poured over the jelly.

 _Fruit Jellies._ These are made:

 (1) Of fruit juice and sugar in equal quantities, cooked until it will
 set when cooled;

 (2) Of fruit juice and gelatin in the proportion of 1 tablespoon of
 gelatin to three-fourths of a cup of fruit juice, or one-half box
 gelatin to 1-1/2 pints of juice. Sugar to taste. Made tea or coffee,
 or cocoa or lemonade may be used in the same proportion.

_Custards._ These are made with (1) milk, (2) milk and eggs, (3) milk,
egg, and some farinaceous substances as rice, cornstarch, tapioca. In
the first the coagulum is produced by the addition of rennet, in the
other two by the application of heat.

 _Plain Junket._ Dissolve in a cup of lukewarm milk (never warmer),
 a tablespoon of sugar or caramel syrup. Add a quarter of a junket
 tablet, previously dissolved in a tablespoon of cold water. Stir a
 few times, add vanilla, nuts, or nutmeg if desired. Pour into a cup
 and set aside to cool and solidify. This may be served plain or with
 whipped cream, or boiled custard.

 _Egg-Milk Custard._ When eggs are used for thickening, not less than
 four eggs should be used to a quart of milk (more eggs make it richer).

 _Snowballs._ Heat 1 pint of milk with sugar to taste. Beat the whites
 of 3 eggs stiff, then beat in 1-1/2 tablespoonfuls of powdered sugar.
 Drop by spoonfuls into the hot milk, turn in three minutes, and take
 out. Beat yolks of the eggs, pour the hot milk over them, and allow to
 thicken. Do not boil. Arrange snowballs in dish and pour custard over.
 Serve cool.

 _Boiled Custard._ One pint of milk, 2 eggs, one-half cup of sugar,
 one-half saltspoon of salt. Scald the milk, add the salt and sugar,
 and stir until dissolved. Beat the eggs very thick and smooth. Pour
 the boiling milk on the eggs slowly, stirring all the time. Pour the
 mixture into a double boiler, set over the fire, and stir for ten
 minutes. Add flavoring. As soon as a thickening of the mixture is
 noticed remove from the fire, pour into a dish, and set away to cool.
 This custard makes _cup custard_, the sauce for such puddings as _snow
 pudding_, and when decorated with spoonfuls of beaten egg-white, makes
 _floating island_.

 _Baked Custard._ Proceed as in boiled custard, but instead of pouring
 into a double boiler pour into a baking dish. Set the dish in a pan
 of water, place in the oven, and bake until the mixture is set in the
 middle.

 _Farinaceous Custards._ Make like boiled custard, using one less egg
 and adding one-quarter cup of farina, tapioca, cornstarch, arrowroot,
 or cooked rice to the hot milk and egg.

 _Sago_ should be soaked overnight before using.

 _Tapioca_ should be soaked one hour before using.

 _Coffee Custard._ Scald one tablespoon of ground coffee in milk and
 strain before proceeding as for boiled custard.

 _Chocolate Custard._ Add one square of grated chocolate to the milk.

 _Caramel Custard._ Melt the dry sugar until golden brown, add the hot
 milk, and when dissolved proceed as before. Bake.

 _Milk for Puddings or Stewed Fruit_ (Ringer). Boil a small piece of
 lemon rind and 2 cloves in a pint of milk. Mix half a teaspoonful of
 arrowroot in a little cold milk and add it to the boiled milk. Stir
 until about the consistency of cream. Beat up the yolks of 3 eggs in a
 little milk. Beat into the hot milk taken off the fire and as it cools
 add the eggs and a tablespoonful of orange flower water, stirring it
 constantly until quite cool. Keep in a very cool place until required
 for use.

 _Bread Jelly._ Pour boiling water on stale bread and allow it to soak
 until soft. Pour off the water, add fresh water to cover, and boil
 until stiff and until it becomes jelly-like when it cools. It may be
 eaten with milk or cream.


_SOLID FOODS_

(Suitable for Invalids)

 _Toasts._

  (a) Cream toast.
  (b) Milk toast.
  (c) Water toast.

 _Creams._

  (a) Plain.
  (b) Whipped.
  (c) Ice cream.

 _Oils._

  (a) Plain olive, cotton seed, or nut.
  (b) Butter.
  (c) Emulsion, as mayonnaise.
  (d) Cod-liver oil, plain or emulsified.

 _Cereals._

  (a) Porridges and mushes—Oatmeal, corn meal, wheat, rice, etc.

  (b) Dry preparations—Shredded wheat biscuit, corn flakes, puffed
  rice, puffed wheat, triscuit.

 _Breads._

  (a) Plain—White, Graham, nutri-meal, whole wheat, brown, rye, etc.

  (b) Toasts—Dry, buttered, zwieback.

  (c) Crackers—Soda, Graham, oatmeal, Boston butter, milk.

  (d) Biscuits—Yeast biscuits (twenty-four hours old), baking-powder
  biscuit, beaten biscuit.

_Egg Preparations._

  (a) Boiled, poached, scrambled, baked.
  (b) Omelets.
  (c) Souffles of meat and of potatoes.

_Meats._

  (a) Beef or mutton—Broiled or roasted.
  (b) Chicken, turkey, or game—Broiled or roasted.
  (c) Fish—Broiled, boiled, or baked.
  (d) Oysters—Canned, stewed, etc.
  (e) Clams—Chowder, broiled, or baked.

_Vegetables._

  (a) Potatoes—Baked, boiled, creamed, or escalloped.
  (b) Sweet potatoes, baked or boiled.
  (c) Green peas, plain or creamed.
  (d) Lima beans, plain or creamed; string beans, plain or
  creamed; cauliflower, plain or creamed; carrots;
  parsnips.

_Fruits._

  (a) Fresh—Oranges, grapes, melons, etc.
  (b) Stewed—Apples, plums, apricots, pears, berries, etc.
  (c) Baked—Apples, bananas, pears.
  (d) Canned—Peaches, apricots, plums, pears, etc.
  (e) Preserved—Peaches, plums, quinces, etc.

_Gruels._ Gruels are a mixture of grain or flour with either milk
or water. They require long cooking and may be flavored with sugar,
nutmeg, cinnamon, or almond.

 Take the meal or flour (oatmeal, 2 tablespoons, or corn meal, 1
 tablespoon, or arrowroot, 1-1/2 tablespoons). Sift it slowly into
 1-1/2 cups boiling water, simmer for an hour or two. Strain off the
 liquid; add to it 1 teaspoon of sugar, season with salt, and add 1 cup
 of warm milk.

 _Water Gruel._ If water gruel is desired, let the last cup of liquid
 added be water instead of milk.

 _Cream Gruel._ A cream gruel may be made by using rich cream instead
 of milk or water.

 _Barley Gruel._ Barley gruel (usually a water gruel) is prepared as
 follows: Moisten 4 tablespoons of barley flour in a little cold water
 and add it slowly to the boiling water. Stir and boil for twenty
 minutes.

       *       *       *       *       *

 _Toasts._—_Cream Toast._ Toast the bread slowly until brown on both
 sides. Butter and pour over each slice enough warm cream to moisten
 (the cream may be thickened slightly and the butter may be omitted).

 _Milk Toast._ One tablespoon of cornstarch or flour; one cup of milk,
 salt to taste, and boil. Butter the toast and pour over it the above
 white sauce.

 _Water Toast._ Pour over plain or buttered toast enough boiling water
 to thoroughly moisten it.

       *       *       *       *       *

_Souffles of Fruit, etc._ The distinguished feature of a souffle is a
pastry or pulpy foundation mixture, and the addition of stiffly beaten
egg-white. A souffle may or may not be baked.

 _Plain Souffle._ Two tablespoons flour; 1 cup of liquid (water, milk,
 or fruit juice); 3 or 4 eggs; sugar to suit the fruit. If thick fruit
 pulp is used, omit the thickening. Beat the egg-yolks until thick.
 Add sugar gradually and continue beating. Add the fruit (if lemon
 juice add some rind also). Fold in the well-beaten whites. Bake in a
 buttered dish (set in a pan of hot water) for thirty-five or forty
 minutes in a slow oven.

 _Fresh Fruit Souffle._ Reduce the fruit to a pulp. Strawberries,
 peaches, prunes, apples, bananas, etc., may be used. Sweeten the pulp.
 Beat the egg-white to a stiff froth, add the fruit pulp slowly. Chill
 and serve with whipped cream or soft custard.

 _Chocolate Souffle._ Two tablespoons flour; 2 tablespoons butter;
 three-quarters cup of milk; one-third cup of sugar; 2 tablespoons hot
 water. Melt the butter, add the flour, and stir well. Pour the milk
 in gradually and cook until well boiled. Add the melted chocolate, to
 which the sugar and hot water have been added. Beat in the yolks and
 fold in the whites of the eggs. Bake twenty-five minutes.

 _Farina Souffle._ Cook the farina (4 tablespoons) in a pint of boiling
 water. Stir this with the egg-yolks, add sugar or salt, and later fold
 in the egg-whites, flavor, and set away to cool.


FOOTNOTES:

[16] Many of the recipes given for fruit beverages are adapted from
_Practical Dietetics_ by Alida Frances Pattee, Publisher, Mt. Vernon,
N. Y.

[17] _Nutrition and Dietetics_, by Dr. W. S. Hall, D. Appleton & Co.,
New York.




CHAPTER XII

INFANT FEEDING


One of the fundamental problems of to-day, as it was of yesterday and
will be of to-morrow, is the correct feeding of infants and children.

Every civilized country faces the same problem, largely because the
artificial feeding of infants has become so prevalent.

Unfortunately, many women who must labor outside of the home must
resort partially, if not entirely, to artificial feeding of their
infants. Usually on account of the inconvenience of breast feeding and
the strain on the mother, the infant is given artificial food, often
improperly prepared. Although infant mortality is high among the poorer
classes, it is marvelous that so many of these infants survive.

It is an encouraging fact, however, that women among the well-to-do and
educated classes are appreciating the importance of breast feeding and
that the number of these who are not only willing but anxious to nurse
their infants is increasing.

The mother should be firm in her decision to nurse her child and be
encouraged to persevere in efforts to secure the proper development of
the breasts before the birth of the child, that the quantity as well as
the quality of the milk may be adequate.

The fact that nearly one-fourth of the civilized race dies during the
first year of life is astounding. This mortality is due directly or
indirectly to nutritional disturbances that could in a great measure be
prevented if the babies were properly nursed at the breast or if the
artificial feeding was carefully regulated.

Of six hundred and forty-one infants under observation by Dublin, in
Fall River, Mass., five hundred and sixty-five were breast-fed and
seventy-six bottle-fed. After the first week there were one hundred and
six deaths. In seventy-four of these the infants were breast-fed, and
in thirty-two, bottle-fed; nearly one-half of the bottle-fed babies
died and only 10 per cent. of the breast-fed babies. The breast-fed
child, therefore, has five chances to live where the bottle-fed child
has one.

One fundamental principle on which all of the leading specialists in
the study of the baby agree, is that the milk of the healthy mother is
the only ideal baby food. Every mother should be made to realize the
importance of nursing her baby for at least nine or ten months, unless
circumstances beyond control make it impossible or inadvisable.

Proper care of the breasts and of the general health during the
expectant period will usually secure a sufficient flow of milk for the
child’s needs.

The mental attitude of the mother has much to do with the secretion of
milk; therefore she should cultivate the habit of kindly, cheerful,
healthful thoughts. She should keep her circulation and vitality up to
par.

She should take regular exercise and be out in the fresh air daily.

During the first two or three days the child receives little
nourishment from the breast, simply a few ounces daily of a yellowish
substance known as colostrum, which is supposed to have a laxative
effect on its bowels.

It is, however, usual to put the child to the breast at regular
intervals of about four hours after the first day, to stimulate the
milk secretion, which should be quite free on the third day; it,
however, may be slow in coming for a day to two longer.

A teaspoonful or two of warm boiled water, or of a five per cent.
solution of milk-sugar may be given every few hours, in fact it is
considered advisable by some physicians, in order to lessen somewhat
the loss in weight which takes place during the first week.

If the free flow of milk is delayed beyond forty-eight hours, some
nourishment must be given. A little modified cow’s milk is best. The
preparation of this will be taken up under Artificial Feeding.

The mother should not permit herself to become easily discouraged
about her ability to nurse her child, for even though the supply at
first seems very deficient and it is necessary to give the baby other
nourishment, it should be put to the breast at regular intervals, as
the sucking by the child stimulates the secretion of milk. The flow of
milk often increases when the mother becomes more active.

When the milk flows freely, the contents of one breast is sufficient
for one nursing, and the breasts should be used alternately, that is
one breast at one feeding and the other at the next.

Nursing should not last longer than from ten to twenty minutes. Too
rapid nursing is apt to cause vomiting. If it is necessary to check the
flow of milk somewhat, it can be done by pressing the breast slightly
between the fingers.

There is a warmth, a purity, and a vitality to the mother’s milk that
is impossible to secure in any artificial food no matter how carefully
and skilfully prepared. It is also germ-free.

Some women seem unable to nurse their babies for more than two or three
months and it is sometimes thought that it is not worth while for a
woman to nurse her baby unless she can do so for a considerable time.
This, however, is a great mistake, because there is no time in the
baby’s life when it is more important for it to have breast milk than
in the beginning. This is the time when the baby’s digestion is most
easily disturbed and most difficult to correct. Every day or week that
a baby gets breast milk gives it a better start.

It has been thought that it is dangerous to use both breast and
artificial feeding. This idea is erroneous. The artificial food cannot
make the breast milk hard to digest, while the breast feeding seems to
make the artificial food digest more readily. This may be due in part
to the ferments which the breast milk contains, but more probably is
due to the fact that the baby is able to utilize the proteins of human
milk to build tissue when it cannot so readily utilize the proteins of
the artificial food.

       *       *       *       *       *

[Sidenote: Wet Nursing]

Wet nursing is resorted to less frequently now than in the past on
account of better methods for artificial feeding.

If the mother is unable to nurse the child herself and the conditions
are ideal, that is the wet nurse a healthy, happy woman with a thriving
baby of her own, and very particular in the care of her person, this is
better than artificial feeding.

[Sidenote: Contra-Indications to Nursing]

Total absence of milk, after earnest efforts to stimulate its secretion
necessitates artificial feeding.

If the mother has chorea, epilepsy, or tuberculosis in any form, it is
best to resort to artificial feeding; also if the mother has syphilis
and the baby is free from it. In these conditions the child must often
be taken from the mother to avoid infection.

If the mother has had serious complications in pregnancy or
parturition, the physician must decide on the advisability of natural
or artificial feeding.

In case of nephritis, except perhaps in a very mild form, the milk is
toxic and therefore nursing from the breast should be prohibited.

Sometimes in acute contagious disease it is safer to nurse the baby
than to subject it to the dangers of artificial food. However, when the
mother’s temperature exceeds 101 or 102 degrees, the milk will probably
possess toxic qualities and disagree with the infant.

       *       *       *       *       *

[Sidenote: Anatomy and Physiology of the Infant]

Every nursing mother should acquaint herself with the process of the
infant’s digestion, as many of the infantile difficulties are caused by
overfeeding or underfeeding, due to ignorance on this subject.

The alimentary tract of the new-born infant differs in many ways from
that of the adult.

As compared with other mammals, the human infant is the most helpless
and undeveloped and therefore the most delicate and easily affected.
It is practically dependent on its mother for nourishment which will
completely supply its needs.

The capacity of the stomach, after careful study, has been placed at
from 1 to 2 ounces at birth, 2 to 3 ounces at the end of the first
month, 6 ounces at the 6th month, and from 9 to 10 ounces at the end
of the first year. This is simply an average guide, as stomachs vary
somewhat in size. Quantities somewhat larger than the foregoing are
sometimes fed, but some of the food has passed beyond the pylorus
before the last of it is taken. Digestion begins as soon as the food
enters the stomach.

The secretion of bile begins within 12 hours after birth, increases
rapidly, and is fully established within a week or ten days.

The pancreatic ferments which digest starches and sugar are present
in the new-born, although scanty; the sucking movements of the child
when nursing exercise the salivary glands so that saliva is secreted;
but starch digestion is not completed in the mouth, hence starch and a
greater proportion of sugar than is in the mother’s milk are difficult
for the infant to digest.

The intestines, when compared with the length of the body, are
relatively long in infants, but the muscular coat is comparatively
weak; digestion is therefore relatively slow and more subject to
derangement by substances that influence peristalsis.

The fact that infants vomit with comparatively little effort, the food
overflowing from an overloaded stomach, is due to the relatively feeble
closure of the cardiac orifice.

The stomach contents are kept germ-free by the secretion of
hydrochloric acid and the upper intestine is nearly free from bacteria
in breast-fed infants, because of the antibacterial nature of the
intestinal secretion. In some digestive disturbances this safeguard
fails and bacteria develop rapidly.

[Sidenote: Intestinal Disturbances]

Intestinal disturbance in the breast-fed infant is most often caused by
overfeeding, the infant often nursing too frequently, thereby emptying
the breasts and securing a high fat ratio. Frequent nursing does not
give the stomach time to empty and thus digestive disturbances are apt
to occur. Therefore, as a means of relieving intestinal trouble in the
infant, nursing at regular intervals and not too frequently, is of much
importance.

When digestive disturbance has occurred it is best to stop nursing for
twenty-four hours, giving the infant weak barley gruel sweetened with
saccharin. At the end of twenty-four hours let the infant nurse at the
breast for from three to five minutes, this being preceded by a small
drink of water.

As the bowel condition improves, the time at the breast may be
gradually lengthened.

The mother should watch her diet to avoid too much rich food, and foods
that seem difficult to digest, as certain articles of food in the
mother’s diet often causes gastric disturbances in the infant.

She should also carefully watch her thoughts, keeping them well poised
and upon kindness, love, and peace. Worry or unkind thoughts will
affect the mother’s milk and disturb the child’s digestion very quickly.

Fits of temper in the child also disturb its digestion.

       *       *       *       *       *

[Sidenote: Times of Feeding]

Regular nursing habits should be insisted on, as indigestion, colic,
and diarrhea often result from irregular nursing.

Some authorities discourage night feeding as unnecessary with a normal
baby, but most physicians agree that the child should be aroused
during the day in order not to miss a feeding, as it will fall asleep
again directly after nursing and will soon get into the habit of
awakening at feeding time.

The following table from Holt may be used as a guide in breast-feeding:

  ——————————————————+———————————+——————————————+——————————————
                    | Number in |  Intervals   |Night nursing
         Age        |twenty-four|during the day|between 9 P.M.
                    |   hours   |    hours     |  and 7 A.M.
  ——————————————————+———————————+——————————————+——————————————
  1st day           |     4     |      6       |      1
  2d day            |     6     |      4       |      1
  3d to 28th day    |    10     |      2       |      2
  4th to 13th week  |     8     |      2-1/2   |      1
  3d to 5th month   |     7     |      3       |      1
  5th to 12th month |     6     |      3       |      0
  ——————————————————+———————————+——————————————+——————————————

There may be some slight deviations from this if the child is ill
and small for its age. It is a good general rule to feed the child
according to the age with which its weight corresponds.

There can be no regular rule followed for all. Some authorities hold
that fifteen- to twenty-minute feedings at four-hour intervals during
the day, with one feeding at night, are sufficient, but it depends on
the child. Some babies’ stomachs are smaller than others, and some do
not nurse regularly, but play and are inattentive to the nursing. In
either event the child will not get sufficient nourishment at four-hour
intervals. The intelligent mother can determine what is best.

       *       *       *       *       *

[Sidenote: Water]

In breast-feeding, as well as in most of the formulæ for
bottle-feeding, there is an allowance for an amount of fluid that,
under ordinary circumstances, satisfies the baby’s requirements.
Additional water is often necessary, especially during the hot weather
when the body heat is regulated through evaporation from the skin.
The most effective means of promoting perspiration is the giving of
water. This, however, should not be done to excess. Eight ounces
for a 10-pound baby, given in divided doses during the day, will be
sufficient.

It is best to give the water when the stomach is nearly or quite empty.
It should be boiled and cooled and should be given by the bottle as the
child will then take at intervals all that its thirst requires, and the
danger of choking as a result of too hasty swallowing is avoided.

       *       *       *       *       *

[Sidenote: Normal Development in the Breast-Fed]

The growth and general condition of the child will, of course, be
influenced by the quality and quantity of the milk. The birth weight of
7 to 7-1/2 pounds is usually doubled by the end of the fifth month and
trebled by the end of the year. The average gain is from 5 to 8 ounces
a week during the first few months and from 2 to 4 ounces a week the
last few months of the year.

If the mother’s milk is deficient in any way, the child becomes fretful
and loses weight, or the weight remains stationary. In such cases
the physician usually examines the milk to determine its quality and
advises some means of improving it, or in some way adding to the baby’s
food the element in which the mother’s milk is lacking.

The physical condition of the mother often affects the baby’s
nourishment, and besides resorting, temporarily, to means for improving
the quality of the milk, she should build up her general vitality
through regular exercise for the spine and the vital organs, deep
breathing of fresh air, and regular rest.

While a scanty food supply will diminish the flow of milk, overloading
the stomach at meal time and taking quantities of rich food between
meals, as so many nursing mothers, think is necessary, usually does
little to increase the quantity or improve the quality of the milk, but
often results in an accumulation of superfluous flesh and disturbed
digestion, which quickly affects the child.

Sometimes a more restricted diet together with specially directed
exercises to relieve any digestive disturbance and correct
constipation, and relaxing exercises for the nerves, will do more than
anything else to improve the quality of the milk.

Mothers should particularly avoid becoming overtired.

When the milk is good, but the quantity deficient, massage of the
breasts three or four times a day for five or ten minutes will increase
the supply. One effective means of increasing the secretion of the
mammary glands is the mechanical stimulus of suction. If a robust baby
can be put to the breast for a time it may develop an ample flow of
milk for a puny infant whose powers of suction are feeble.

A good malt extract with meals sometimes tends to increase the flow
of milk. When the quality and quantity of the milk are deficient, the
physician usually advises a very nourishing diet and a tonic. This
nourishment does not of necessity require an excessive amount of liquid.

When the quantity is sufficient, but the quality poor, it is usually
necessary to wean the baby, if it is several months old, although
mother’s milk, even if below standard in quality, is better for the
infant than cow’s milk, at least during the first few months.

Nervousness, sleeplessness, worry, and grief have a decided effect on
the milk supply and on the baby. Nervous mothers are apt to have an
abundance of milk one day and little the next day; frequently the milk
will disappear suddenly.

       *       *       *       *       *

[Sidenote: Weaning]

When it is possible, the baby should be weaned gradually. Although
there is no set time for weaning, it is not advisable to feed the child
exclusively from the breast after the eighth or tenth month. Bunge
holds that human milk contains too little iron at this period and the
babies are apt to become pale and undernourished.

When additional feeding is decided on, the physician should prescribe
the preparation. A bottle a day should be substituted for the breast
feeding at first and, gradually, additional bottle feedings, until,
after about a month the breast is entirely withdrawn.

After the eighth month and until the age of twelve months, as a general
rule, cow’s milk should be diluted and sweetened by mixing eight
ounces of barley water and thirty-two ounces of milk, adding an ounce
of cane-sugar or milk-sugar, and dividing the whole into five 8-ounce
portions.

Additional food may be given to the healthy child after the eighth
or ninth month. Orange juice or other fruit juice one or twice a
day should be given about an hour before feeding. A teaspoonful may
be given at first and the amount gradually increased to about two
tablespoonfuls a day.

Orange juice is a specific in conditions of scurvy resulting from
improper feeding. The child usually improves rapidly after it begins to
take the juice.

Beef juice, meat broths, or strained vegetable soup may be given in
increasing amounts up to 5 or 6 ounces daily.

Zwieback and whole wheat or Graham crackers are permissible in small
amounts after the ninth month. After nine months the healthy baby
should also have a soft-boiled egg occasionally, also baked apple and
well-cooked, mashed spinach or carrots.

Food should be given only at regular intervals and nothing but water
between feedings.

Starch-digesting ferments are present at birth in sufficient amounts
to digest the sugar in milk, but they do not develop sufficiently to
digest starches until about the twelfth month, so white bread, crackers
made from white flour, potatoes, rice, etc., should not be given the
child under a year.

       *       *       *       *       *

[Sidenote: Artificial Feeding]

When artificial feeding is necessary, the physician must decide
what modification is best for the baby. One can only determine by
experimenting upon the actual percentages of fat, proteins, and sugar
which each baby needs, following, in general, the proportions contained
in mother’s milk, because while many babies thrive on a food of this
composition, some do not. The formulæ given are simply a guide, as the
proportions may need to be changed, or may need to be made weaker in
some cases and stronger in others.

The composition of human milk, however, is a guide to the infant’s
digestive ability. This must be determined by a careful study of the
_individual baby_ as every baby is a problem by itself.

As previously mentioned, no artificial food is the same as human milk,
although it may contain the same proportions of the different elements,
and it is often difficult, especially during the first few months, to
prepare a combination on which the child will thrive.

Cow’s milk, properly prepared, is the nearest available substitute for
human milk. It must be modified, as the digestion of the calf at birth
is equal to that of an infant at eight or nine months.

Farmers have in recent years become more particular about the care of
their cows and cleanliness in milking because the educational campaign
with regard to the danger to human life from tuberculous animals has
caused a greater public demand for good, clean milk.

Many infectious diseases are conveyed by milk, and impure milk is a
large cause of the extraordinarily high mortality of early infancy.
With the improvement of the milk supply, the decline in the infant
death-rate has been wondrously gratifying.

Manufacturers have taken advantage of the fact that the public has
become a little afraid of cow’s milk and have extensively advertised
their prepared foods, claiming them to be the best substitute for
mother’s milk. However, experiments have proven that these statements
for the most part are misleading, the composition of the foods not
being suited to the actual requirements of the infant. Some prominent
physicians think that infant mortality has been increasing since
prepared foods have been used so extensively.

One leading authority states that “clean, fresh cow’s milk, properly
modified, is the best substitute available. It is to be preferred to
any prepared food, no matter how sweeping may be the manufacturers’
claim for it.”

The most striking thing about the prepared foods is their tremendous
excess of carbohydrates, either cane-sugar or sugar derived from starch
by the process of malting. Condensed milk, in particular, contains much
too large a percentage of cane-sugar for the child.

Another authority states:

 An excess of sugar is likely to damage the organism by the production
 of poisonous substances in the body. This is particularly true in
 those infants who are already suffering from indigestion. An excess of
 sugar in such a baby is likely to render him severely and dangerously
 sick and result in catastrophe.

[Sidenote: Bacteriology]

The study of the bacteriology of the alimentary tract of the new-born
infant reveals a most interesting fact and explains why artificial
feeding is often so difficult and dangerous.

In the intestinal canal at all times many varieties of vegetable
organisms (bacteria) are present. These are called floral organisms.
Some of these aid digestion while some others increase disturbance in
the intestines, particularly if in excess, or if digestive derangements
occur.

The flora which predominate are those peculiar to the infant which is
properly digesting human milk. This accounts for the uniform action of
the bowels in breast-fed infants. As soon as the child gets milk from
the breast, the intestinal flora assume this definite form.

When cow’s milk or any other food is given, the intestinal flora
change. When the change is made too suddenly, these new flora which
live on the digested products of human milk gradually disappear and
the action of the new flora often causes intestinal derangements which
the infant is not strong enough to overcome.

       *       *       *       *       *

[Sidenote: Composition of Human Milk]

If artificial feeding must be resorted to, the composition should
resemble mother’s milk as nearly as possible. It is impossible to
duplicate it exactly and even though the elements and the proportion
of them are the same, the bacterial flora will be different and
consequently the effect also.

If the breasts are emptied regularly, human milk varies little in
composition after the first few weeks. According to Holt there is an
average in mother’s milk of

  Fat         4%
  Sugar       7%
  Protein   1.5%
  Salt      0.2%
  Water    87.3%

[Sidenote: Adaptation of Cow’s Milk]

When the baby has been fed at the breast for several months, pure cow’s
milk sometimes agrees very well, if overfeeding is avoided.

The amount of milk taken every twenty-four hours by a healthy infant is
usually about 1-1/4 ounces to the pound of the baby’s weight.

A normal infant of twelve pounds would be taking between twelve and
eighteen ounces of milk in its twenty-four hour mixture.

Budin recommends one-tenth of the body-weight daily of milk and reports
excellent results in infants after the fifth or sixth month, weighing
from thirteen to fifteen pounds.

Most infants under the age of nine months are more or less incapable of
digesting cow’s milk undiluted. If artificial food is resorted to from
the start, practically all physicians agree that the milk should be
diluted or otherwise modified during the first few months at least.

Milk diluted with water is often given, one part of milk to two parts
of water. This reduces the protein to about the amount found in breast
milk.

It is necessary to keep up the proportion of protein, as this alone
contains the important food element, nitrogen. From one-half to
three-fourths of an ounce of milk-sugar is added to the twenty-four
hours’ supply of food to approximate the seven per cent. found in
breast milk.

The proportion of milk and milk-sugar is gradually increased and the
water decreased, so that at the end of the first or second month the
baby gets equal parts of milk and water and about an ounce more of
milk-sugar. This process is continued until, near the end of the first
year, the child is on whole milk. The sugar is lessened as the water is
omitted.

If, after a few months, it is desired to give a baby starch in its
food, cereal waters made of barley, rice, wheat, or oatmeal may be used
in place of plain water.

As cow’s milk leaves the stomach more slowly than mother’s milk, longer
intervals between feeding seem advisable. When the breast-fed infant
receives nourishment every two and one-half to three hours, an infant
given a cow’s-milk preparation would be fed every three and one-half or
four hours.

The most important thing is to prevent both overfeeding and
underfeeding as these are often the greatest factors in producing
infantile disturbances. A too rapid gain in weight, (from 8 to 12
ounces a week), which often occurs in artificially fed infants, is not
a good sign.

Milk prepared according to the formula desired by the physician can now
be secured from milk laboratories in all of our larger cities. However,
the milk is apt to spoil in transit, and to secure its freshness when
one is not in or near a large city, it is best to prepare it at home.
Any intelligent mother or nurse can do this very satisfactorily if the
physician gives definite instructions.

Its careful preparation is quite as important as the correct formula.

Mineral (calcium) and protein are bone and other tissue builders, and
it is a significant fact that cow’s milk contains about twice as much
protein and a little more than twice as much of the mineral as mother’s
milk, indicating that the growth of the human infant is to be slow.
The calf requires about four years for full growth and the human being
twenty-one years. Both human and cow’s milk, however, contain an equal
amount of fat, the heat-producing element, as Nature intended that the
infant should be warm and active.

It seems almost impossible to get milk from the cow as clean and
free from bacteria as it should be and therefore sterilization and
pasteurization are resorted to almost universally. Various substances
such as formaldehyd, boric acid, and salicylic acid are used by dealers
to preserve the milk. These all have a deleterious effect on the child.
Therefore the safety of the child demands that the mother choose a
reliable dairy. The milk may be analyzed occasionally to make sure of
its purity.

[Sidenote: Top-Milk]

A very popular milk preparation and one frequently prescribed by
physicians is the top-milk method as originated by Dr. Holt.

Top-milk is that at the top of milk bottles in which milk has been
allowed to stand for five or six hours.

The cream at the top contains the most fat. For instance, in a quart of
milk that has been permitted to stand, the

  Upper  4 ounces contain 20 per cent. of fat.
    ”    6   ”       ”    16  ”    ”   ”   ”
    ”    8   ”       ”    12  ”    ”   ”   ”
    ”   10   ”       ”    11  ”    ”   ”   ”
    ”   12   ”       ”     9  ”    ”   ”   ”
    ”   14   ”       ”     8  ”    ”   ”   ”
    ”   16   ”       ”     7  ”    ”   ”   ”
    ”   20   ”       ”     6  ”    ”   ”   ”
    ”   24   ”       ”     5  ”    ”   ”   ”

To remove the top-milk, the first ounce is taken out with a spoon and
the remainder with a Chapin milk dipper which contains one ounce.

The following formula is considered a good top-milk mixture, although
it is not supposed to meet the needs of all infants and would therefore
have to be modified in some cases and made stronger in others.


TOP-MILK MIXTURE

  Top-milk (upper 8 ounces)  2-1/2 ozs.;
  Bottom-milk                1 oz.;
  Limewater                  1/2 oz.;
  Milk-sugar                 1 measure (1/2 oz.);
  Water, sufficient to make  8 ozs.

The sugar is dissolved by boiling it in the quantity of water to be
used for the mixture. If not perfectly clear, it is strained through
cheesecloth.

The one thing to be particularly guarded against is overloading the
stomach with rich food. On account of the high percentage of fat,
digestive disturbances often occur when top-milk is used. Some infants
can dispose of an abundance of fat from the beginning and most of them
can after six or nine months, but many infants have difficulty in
digesting fat. The condition called “fat rickets” may exist, though the
child may seem to thrive and increase in weight. Its flesh, however, is
not hard and firm as it should be in health.

The cream from Guernsey and Jersey cows is usually too rich for infants
and therefore the best milk for the baby is that from Holstein or grade
cows. The mixed milk from various cows is usually best.

The physician can determine from the stools if the fat ratio is too
high, in which case it is best to use top-milk lower in percentage of
fat, and lengthen the feeding intervals to four hours.

       *       *       *       *       *

[Sidenote: Certified Milk]

If the additional expense of certified milk can be met, it is advisable
to use it in preparing the baby’s food, as it is reasonably constant in
its composition and is prepared under the most hygienic conditions, in
accordance with the requirements of the American Association of Medical
Milk Commissions.

All utensils used in preparing the baby’s milk must be absolutely
clean. Bacteria develop very quickly in milk and, therefore, the
bottles, nipples, etc., should be kept as germ-free as possible by
being boiled daily, and the nipples, when not in use, should be kept in
a solution of boracic acid (one-fourth ounce boracic acid to one-half
pint of water).

The artificially fed baby does not usually thrive as well as the
breast-fed infant. It does not gain in weight as fast and the teeth are
slower in coming. The general condition of the baby, and a steady, even
if slow gain in weight, will indicate whether the food is agreeing.

Every baby, however, is a law unto itself and it sometimes requires
considerable study to determine what is the best food. Even with the
utmost care a cow’s-milk preparation cannot be made identical with
mother’s milk and sometimes an entirely different mixture must be
resorted to.

However, no mother should attempt to experiment on her baby or permit
herself to be misled by the advertisements of so-called Baby Foods. It
is only when these are used in the right proportion and in combination
with other ingredients that they can be suited to the requirements of
the infant.

       *       *       *       *       *

[Sidenote: Milk Modifications]

Malt used in place of milk-sugar or cane-sugar will greatly assist the
absorption of fat and decrease the tendency to fermentation and colic.
It is being extensively used in milk modifications.

It is best to use the dextrin-maltose preparations that do not contain
sodium chlorid, as it is rarely advisable to add this salt to the
infant’s food.

Some physicians have been securing very satisfactory results with a
preparation containing whey. Whey is a thin, watery fluid, looking very
much like skimmed milk; its caloric value is about 300 per quart, 9 per
ounce, barely one-half that of whole milk. It is therefore adapted only
to temporary feeding, while its low fat content is of great value in
cases of fat dyspepsia.

To secure the whey, 5 grams (1 teaspoonful) of rennet should be used
to each quart of milk. The mixture must be kept at a temperature of
about 100 F. until it separates into a liquid and a solid portion. It
is then strained through cheesecloth. Practically all the casein is
left on the cloth, the fluid being the whey. The curd should be broken
up before straining, in order to obtain, as nearly as possible, the
casein. However, about two-thirds of the milk fats remain in the curd.
The whey, besides the whey proteins, thus contains only about one-third
of the fats, but nearly all of the milk-sugar and salts. The whey still
contains the rennet and, to destroy this, the whey must be heated to at
least 140 F. for thirty minutes.

The average composition of whey according to Wachenheim is as follows:

  Proteins     0.8 per cent.
  Fats         1.0  ”    ”
  Milk-sugar   4.5  ”    ”
  Salts        0.7  ”    ”
  Water       93.0  ”    ”

Sometimes sugar is the primary cause of intestinal fermentation, due to
the concentration of the whey and the relative proportions of casein
and sugar in the mixture.

According to Finkelstein and Meyer, to prepare a food which will combat
intestinal fermentation there must be:

 A diminution in the quantity of milk-sugar, a diminution of the
 salts through dilution of the whey, and an increase in the casein,
 with varying, and, under certain circumstances, not inconsiderable
 amounts of fat. After improvement has begun, an easily assimilable and
 consequently little fermentable carbohydrate should be added.

They developed a food to meet these requirements to which they gave the
name of “_Eiweissmilch_.” This food is prepared as follows:

       *       *       *       *       *

Heat one quart of whole milk to 100 F.; add four teaspoonfuls of
essence of pepsin, and stir. Let the mixture stand at 100 F. until the
curd has formed, then strain. Press the mass of curd through a rather
fine sieve two or three times by the means of a wooden mallet or spoon.
Add one pint of water to the curd during this process. The mixture
should now look like milk and the precipitate must be very finely
divided. Add one pint of buttermilk to this mixture.

Finkelstein and Meyer used buttermilk in the preparation of this food:

(1) Because of the small amount of milk-sugar which it contains;

(2) To obtain the good effects of the lactic acid;

(3) Because buttermilk can be kept for a longer time.

The composition of this food is:

  Fat         2.5%
  Sugar       1.5%
  Protein     3.0%
  Salts       0.5%

One quart of this milk contains about 360 calories.

They call attention to the low caloric value of this food and to the
necessity of increasing it as soon as possible by the addition of
dextrin-maltose mixtures.

They claim that it is worthy of employment in all the disturbances of
nutrition in infants, which are accompanied by diarrhea, of no matter
what kind. The use of this food has been extended by others to all
sorts of conditions including the feeding of healthy infants and the
newly born, and good results are claimed for it.

To use a food low in sugar and salts and high in protein in the
fermentative conditions caused by sugar, is rational. In these
conditions the substitution of the dextrin-maltose mixtures for lactose
is also good.

Not all disturbances of nutrition accompanied by diarrhea, however,
are due to the same cause and should not be treated in the same way.
No method of feeding can be applicable to both the sick and the well,
nor can all babies be given the same food without regard to their
individual digestive ability.

The main principles of this method of treating intestinal fermentative
conditions may be used and, at the same time, the disadvantages of a
routine food may be avoided, by applying the modification of milk by
the percentage method as given by Moise and Talbot.

       *       *       *       *       *

[Sidenote: Sterilizing and Pasteurizing]

To sterilize the milk it should be heated to 212 F., that temperature
being maintained for ten minutes or longer.

Many physicians consider pasteurization the better process. In this the
milk is heated to from 150 to 165 F. and kept at that temperature for
from twenty to thirty minutes. Boiling produces chemical changes, such
as converting the milk-sugar into caramel, etc., while pasteurizing
does not.

After pasteurization or sterilization, the milk should be quickly
cooled to a temperature of 40 F. or lower and kept, until used, in
bottles corked with non-absorbent cotton.

Sterilized or pasteurized milk does not keep as well as raw milk
probably on account of the change in the ferments which destroy
bacteria; therefore the baby’s milk should be pasteurized fresh every
day.

Freeman’s pasteurizer is a very satisfactory and simple device. It
consists of a metal pail into which is fitted a rack with a separate
cylinder for each bottle. This holds just enough cold water to surround
the bottle and keep it from cracking through a sudden change of
temperature. The pail, containing a certain amount of water, is placed
on the stove, the water is heated to the boiling point, the pail being
then removed. The rack of bottles containing the milk preparation, with
corks of non-absorbent cotton, is placed in it and the lid applied.
The apparatus is placed away from a direct current of air for about
forty-five minutes.

As the water in the pail cools, the milk in the bottles grows warm
until both are at the same temperature. After forty-five minutes, cold
water is turned into the pail to cool the bottles rapidly. They are
then kept on ice until again warmed ready for use.

This is the simplest and best way to pasteurize milk and the expense is
small.

Improvised apparatus may be used, but it requires much more labor and
is not as satisfactory.

All milk should be sterilized or pasteurized before being used as a
food for infants.

The following table shows an analysis of milks and infant foods helpful
in the selection of a food to supply deficiencies indicated by a
chemical analysis of the infant.


COMPARATIVE ANALYSIS OF MILKS AND INFANT FOODS (COMPILED)

(Percentage of Composition of the Dry Substance)

  ———————————————+—————————+—————————+—————————+—————————
                 |         |         |         |
                 |Mother’s | Cow’s   |Borden’s |Horlick’s
    COMPONENTS   |  Milk   |  Milk   | Malted  | Malted
                 |         |         |  Milk   |  Milk
                 |         |         |         |
  ———————————————+—————————+—————————+—————————+—————————
  Protein        |14.00    |27.00    |15.10    | 13.83
  Fat            |31.00    |31.00    | 9.20    |  7.90
  Cane-Sugar     |  None   |  None   |  None   |  None
  Other Soluble  |         |         |         |
   Carbohydrates |         |         |         |
   (Lactose,     |         |         |         |
   Maltose, etc.)|52.00[18]|36.00[18]|69.77[19]| 66.56
  Starch         |  None   |  None   |  None   |  None
  Ash (Mineral   |         |         |         |
   Content)      | 2.00    | 5.00    | 3.46    |  3.42
  ———————————————+—————————+—————————+—————————+—————————

  ———————————————+—————————+———————————+—————————+—————————
                 |Borden’s | Nestle’s  |Mellin’s | Eskay’s
                 |Condensed|   Food    |  Food   |  Food
    COMPONENTS   |  Milk   |   (Milk   |  (Milk  |  (Milk
                 | (Eagle  |Substitute)|Modifier)|Modifier)
                 | Brand)  |           |         |
  ———————————————+—————————+———————————+—————————+—————————
  Protein        | 10.10   |  12.40    | 12.10   |  6.82
  Fat            | 12.10   |   4.15    |  0.25   |  3.58
  Cane-Sugar     | 59.1    |  22.10    |  None   |  None
  Other Soluble  |         |           |         |
   Carbohydrates |         |           |         |
   (Lactose,     |         |           |         |
   Maltose, etc.)| 16.0[18]|  35.00[19]|84.00[19]| 56.78[20]
  Starch         |  None   |  25.70    |  None   | 30.42
  Ash (Mineral   |         |           |         |
   Content)      |  2.4    |   1.62    |  3.78   |  1.00
  ———————————————+—————————+———————————+—————————+—————————


The following table from Holt shows at a glance the comparative average
composition of human and cow’s milk:


HUMAN AND COW’S MILK COMPARED

  —————————+————————————+———————————
           | Human Milk | Cow’s Milk
  —————————+————————————+———————————
  Fat      |     4%     |    4%
  Sugar    |     7%     |    4.5%
  Proteins |     1.5%   |    3.5%
  Salts    |     0.2%   |    0.75%
  Water    |   87.30%   |   87.25%
  —————————+————————————+———————————
    Total  |  100.00%   |  100.00%
  —————————+————————————+———————————

       *       *       *       *       *

[Sidenote: Gruels]

Barley, rice, oatmeal, corn meal and soy-bean flour are generally used.
If the grains of the cereals are used, they must be cooked from three
to four hours.

As a rule, cereal gruels are made by cooking the flour and water for
from fifteen to twenty minutes. Two ounces to the quart is about as
strong as plain gruels can be made.

_Dextrinized_ gruels may be made as high as eight ounces to the quart.
Four level tablespoonfuls of the cereal flour weigh one ounce.

As the soy bean contains no starch, it does not thicken when cooking.

About 1 level tablespoonful to 3 ounces of soy-bean flour are used to
the quart. One or 2 tablespoonfuls of barley, oat, or wheat gruel may
be added before cooking to increase the nutritive value. One ounce of
soy-bean flour, or 2 ounces of barley flour, to 1 quart of water makes
a very good standard gruel. It contains 2 per cent. protein, 0.6 per
cent. fat, 5.1 per cent. carbohydrates, giving a food value of ten
calories per ounce, just one-half the value of milk. In certain forms
of intestinal trouble in which cow’s milk is not assimilated, this
gruel is valuable used with condensed milk.

Malted gruels are made by adding 1 teaspoonful of good malt extract
or diastase to a cereal gruel after it has been cooled. It should be
stirred in very thoroughly.

       *       *       *       *       *

[Sidenote: Vomiting]

In artificial feeding “spitting” is usually an annoying symptom that
does not indicate anything more serious than an overloaded stomach.
This condition is usually relieved by lengthening the feeding intervals
to four hours.

On the other hand, vomiting usually indicates something more serious in
a bottle-fed baby, especially if it is very persistent. It is usually
a sign that cow’s milk, or the preparation of it, is not agreeing with
the infant. It also indicates a digestive disturbance that should be
treated only by the physician, who will probably change the formula.

Occasional vomiting is sometimes due to too rich food and too frequent
feeding. Lengthening the feeding hours and decreasing the amount of fat
in the mixture will usually eliminate the trouble.

       *       *       *       *       *

[Sidenote: Colic]

This is the most common of all of baby’s troubles. It is often due to
too rapid feeding either from the breast or bottle, and when there is
a tendency to colic, the feeding should be slower. The baby should not
be fed while it is suffering from colic, even though it seems that the
drinking of warm milk relieves it temporarily. Hot water should be
given every half-hour or hour until relieved. If the baby seems cold,
hot water slightly sweetened, and a hot bath, should be given at once.
A hot-water bottle may be placed near it as well.

In colic there is severe pain in the abdomen, which is swollen and
hard. Sudden and violent crying is usually a symptom of colic, which
often ceases very suddenly after the emission of gas from the mouth or
bowels.

If the baby seems exhausted, the physician should be summoned at once,
but these suggestions may be helpful until the physician arrives.

When colic is very frequent in a bottle-fed baby, the food should be
modified.

       *       *       *       *       *

[Sidenote: The Stools in Infancy]

The character of the stools depends primarily on the composition of the
food. They are varied according to the digestive powers of the infant,
and according to the amount and rapidity of absorption of the products
of digestion. The amount of absorption depends to a considerable extent
on the rapidity with which the contents pass through the intestinal
tract.

       *       *       *       *       *

The nature of the food, of course, influences the character of the
stools. The examination of the stools is of the greatest aid in
determining whether or not any given food element is properly digested
and assimilated, and, in many diseased conditions, in telling what
element is at fault. This, however, can only be determined by analysis,
but a little information on this subject will be of value to the mother
or nurse.

During the first few weeks or months of life, the breast-fed infant
has three or four stools daily. These are of about the consistency
of thick pea soup and are golden yellow. The number of stools
gradually diminishes to two or three in the twenty-four hours, and the
consistency becomes more salve-like.

It is not uncommon for thriving breast-fed babies to have a large
number of stools of diminished consistency and of a brownish color; in
such instances, the examination of the breast milk will show that the
proteins are high.

It is best not to pay too much attention to the stools if the baby is
gaining in weight and appears well. It is not unusual to find many soft
fine curds and sometimes mucus in the stools of healthy breast-fed
babies.

It is not only unnecessary, but decidedly wrong to wean a baby simply
because the stools are abnormal, if it is doing well in other ways. The
breast-fed infant will often go weeks or months without a normal stool
and yet thrive perfectly. On the other hand, if a baby has such stools
when it is taking cow’s milk it is a decided evidence of malnutrition.

Infants that are thriving on cow’s milk have, as a general rule, fewer
movements in the twenty-four hours than do breast-fed babies and these
movements are firmer in consistency.

       *       *       *       *       *

[Sidenote: Constipation]

Constipation seems to be the chief difficulty in artificial feeding,
due usually to the poor absorption of fat, or the low percentage
necessary to prevent indigestion. If the constipation is not severe,
the substitution of oatmeal for barley water in the mixture will
usually relieve the trouble.

If the constipation is severe, causing occasional attacks of colic
or straining at stool, it is sometimes advisable to give a little
higher percentage of fat in the mixture, but this should be done very
cautiously and usually on the advice of the physician.

If, however, this does not relieve the trouble, the best plan is to
substitute one of the dextrin-maltose mixtures for milk-sugar or
cane-sugar. The malt itself is not especially laxative but it prevents
the excessive fermentation which usually occurs when the bowels are
very costive.

       *       *       *       *       *

[Sidenote: Diarrhea]

Two, three, or more green and loose evacuations, even though they
may contain whitish particles of undigested fat, are of no great
significance in the breast-fed infant, but should be regarded as danger
signals in bottle-fed babies.

Even a mild attack of diarrhea is usually a symptom of fat-dyspepsia
which, if taken in time, may usually be promptly checked.

A dose of castor-oil at the beginning of the attack may relieve any
irritation that might have caused the trouble.

It is best to omit all food for at least twenty-four hours. Plain water
should be given very freely and occasionally barley water, if the baby
is hungry. After that it is best to start with a mixture low in fat.
Skimmed milk or boiled milk free from all fat, diluted with cereal
water, may be given at regular intervals.

Should slight diarrheal attacks continue, or should the stools be of a
diarrheal character, the wisest plan is to substitute a dextrin-maltose
mixture for the sugar, as malt decidedly favors fat absorption.

In almost every case of infantile diarrhea it is advisable to consult
the physician, especially if there is considerable restlessness and
rise in temperature.

Diarrhea is more frequent in summer among bottle-fed babies, as the
heat often promotes the growth of germs in the milk. Therefore to
sterilize or pasteurize milk during the heated months is especially
necessary.

A chill, due to insufficient clothing, will sometimes cause diarrhea.
The abdomen, arms, and legs should be kept warm by close-fitting
garments of soft wool.

       *       *       *       *       *

[Sidenote: Anemia]

In treating anemia in infants, as in adults, the cause should be
removed by correcting any errors in diet and treating any other
physical deficiencies.

The cause of infantile anemia is an insufficient absorption of iron
from the food.

The amount of iron in both human milk and cow’s milk is small and is
insufficient for the needs of the growing infant. However, Nature has
deposited enough iron in the liver of the new-born infant to last until
it can digest foods which contain iron in sufficient amounts. The iron
in human milk is apparently more easily retained than that in the milk
of animals.

The iron content of human milk is dependent on the general condition
of the mother. It is higher in healthy individuals and lower in those
under par.

Anemia in infants is apt to become severe and often take on a
pernicious form. A prolonged intestinal disturbance often brings on
anemia, and not infrequently anemia is due to a deficiency of protein
in the food.

The treatment consists largely of additions or changes in the diet,
depending on the age of the infant. Purées of vegetables that contain
much iron, such as spinach and carrots, and also fruit juices, are
valuable and in proper proportions can be added to the diet after
the age of six months. It is best that the physician decide on the
advisability of this as it will depend on the general condition of the
infant.

       *       *       *       *       *

[Sidenote: Rickets]

Rickets, a chronic impairment of nutrition, affects not only the bones,
but all of the tissues of the body, particularly the nervous system.
Artificial feeding is the chief cause of rickets on account of the poor
absorption of fats, and often because of protein starvation.

Prepared foods, on account of their large percentage of starch and
their lack of protein and butter-fat are frequently the cause of
rickets.

In addition to its fuel value, milk-fat contains the elements which
promote growth.

As previously stated, the infant requires a certain percentage of
protein, fat, and mineral for the blood and tissue building and the
growth of the bones. In artificial feeding, the preparations given are
often deficient in these important elements.

Climate and poor hygienic surroundings sometimes cause rickets in
breast-fed babies, probably on account of the lowered vitality of the
mother and the child and consequently poor digestion and assimilation,
but it is most frequently found in babies improperly fed.

Dr. Winfield S. Hall says:

 Fresh milk, appropriately modified and in proper amount, together
 with such other food as is indicated for the age and weight, is the
 important point in the treatment of rickets. Fresh air, day and night,
 sunshine and outdoor life, are only next in happiness. Cod-liver
 oil, especially with the addition of phosphorus, is a very valuable
 addition to the treatment.

       *       *       *       *       *

[Sidenote: Scurvy]

Rickets is a chronic condition, while scurvy is an acute disease.

This difficulty is considered as entirely due to improper feeding and
therefore must be overcome by a change of diet. Recovery is usually
very rapid when the child is properly fed.

Pains and tenderness about the joints, particularly of the legs, are
the usual symptoms, causing the baby to cry when it is lifted or moved
about. The gums sometimes become swollen and bleed. In almost every
case it is found that infants suffering from scurvy have been on a
continuous diet of prepared foods like malted milk, condensed milk, or
boiled milk which Dr. Hall terms “dead food,” presumably on account of
a lack of the life-giving proteins and butter-fat.

When boiled milk has been used, the change should be made to
pasteurized milk or raw milk if it can be secured clean and fresh. If
prepared foods have been given, the amount should be greatly decreased
and replaced by a cow’s-milk preparation in which a small percentage of
the prepared food may be included, or, better still, omitted entirely,
if a cow’s-milk preparation including a good substantial gruel will
agree.

In scurvy, orange juice or other fruit juices should be given, from 1
to 4 ounces a day, according to the age. Orange juice is particularly
valuable, 2 or 3 teaspoonfuls being given before each feeding.

A lack of fresh air often aids in producing scurvy.

       *       *       *       *       *

[Sidenote: Feeding during the Second Year]

After the baby has reached the age of one year, we often feel that it
is not necessary to be so careful of its diet. However, the number of
deaths due to digestive disturbances caused by improper feeding during
the second year is significant.

After the child is a year old it should be given solid food _very
gradually_ to develop its digestive functions as well as its teeth. A
soft-boiled egg or a little beef juice may be added to the diet. Until
the appearance of the anterior molar teeth, however, the child’s diet
should be confined largely to milk. A thin slice of buttered bread or
a little plain rice or rice pudding, a soda cracker or bread crumbs in
milk may be given. The year-old child may also begin to drink cow’s
milk. One or two glasses a day may be given, until the child is at
least 13 or 14 years old.

Good judgment should be used in feeding children, as habits and tastes
are being formed, and whether they are normal or abnormal will depend
on the kind of food given and when.

Four meals a day, at regular intervals, and nothing but water between
these intervals, is considered the best plan.

Dry toast, zwieback, and crackers may be gradually added to the diet,
also well-cooked cereals, like cream of wheat, rice, and oatmeal. The
oatmeal should be strained the first few months it is given. Very
little sugar should be added to the cereals, as children very quickly
cultivate a desire for sweets, rejecting other more nourishing foods,
and too much sugar is apt to disturb the digestion. It is best during
the first few months that no sugar be added to cereals.

The amount of whole milk, or milk diluted with barley or oatmeal
gruel, should be limited to one quart when the other foods are given.

Beef juice (from one to two ounces), mutton broth, chicken broth, and
cereal broths may be given after the age of one year; not more than two
ounces at first, gradually increasing in a few months’ time to four
ounces. This is best given at the beginning of the noon feeding. These
broths have little nutritive value, but usually stimulate the appetite
for other foods.

The child must build muscle, bone, and sinew, and more protein is
required as soon as he begins to walk. Milk, eggs, and cereals will
furnish this. The heavier protein diet is best given at eighteen months
to two years, in eggs, cooked soft. An egg may be given every other
day, soft boiled for about two minutes, or coddled for four minutes. At
the age of two years an egg may be given every day. These soft-cooked
eggs are best when mixed with broken dry toast or broken whole wheat or
Graham crackers, because if dry food is served with them they will be
better masticated, hence more saliva be mixed with them.

The habit of thorough mastication should be cultivated at this period.

Oatmeal, thoroughly cooked, and shredded wheat, with cream and sugar,
ripe fruit, bread and butter, milk, soft-cooked eggs (poached or
boiled), constitute a rational diet at this age.

Bread is better broken in milk because the chewing movements mix the
saliva with the milk and smaller curds are formed as the milk enters
the stomach.

Custard may after two years be added to the diet, also baked or mashed
potato, plain boiled macaroni, also a little butter on the potato,
toast, or bread.

Also after the age of eighteen months, a small quantity of very lean
meat, like scraped or chopped beef or lamb, or finely minced chicken,
may be given once a day.

Also well-cooked and mashed vegetables like peas, spinach, carrots, and
asparagus tips. For the first few months these should be strained.

Some fruit should also be given each day, orange juice, apple sauce, or
the pulp of stewed prunes; the latter especially is valuable when the
bowels are inclined to be constipated.

Tea, coffee, and cocoa are absolutely objectionable, and before the age
of two years no kind of candy should be given.

One of the most important things to teach the child, when it is taking
foods other than milk, is thorough mastication, not only to assist the
proper growth of the teeth, but to prevent the digestive disturbances
that invariably occur from the bolting of food, and children are
especially liable to do this.

Dry toast and zwieback compel mastication and strengthen the gums.
These should be given in the hand, a piece at mealtime and occasionally
between meals, if the child seems hungry. The child will then gradually
get into the habit of chewing other solid foods when they are given.

If the child is hungry between meals, he should be fed at a regular
period, midway between breakfast and luncheon and between luncheon and
the evening meal. The food should be dry (toast or a dry cracker) to
induce thorough and slow mastication.

Many object to “piecing” between meals, but if this piecing be done
at hours as regular as his meal hour, and the food be dry and well
masticated, it will readily digest and will not interfere with his
meals. The growing child needs more frequent meals than the adult.
His stomach is not so large, he is active in outdoor exercise, and
eliminates waste freely. He also requires much heat and energy. The
active child at outdoor play uses almost as much energy as the laboring
man.

Many mothers are in doubt as to whether the baby’s food should be
salted. It is necessary to add a very little salt to the food for the
baby; broths should be seasoned slightly and a pinch of salt added to
potatoes and eggs. Cereals and vegetables are cooked in water to which
a little salt has been added.

Experienced observers of children and their ailments and diseases have
said that more babies are killed by overfeeding than by underfeeding.
Especially in summer, when the child’s condition reflects that of
the mother, too much food will cause indigestion, irritation of the
stomach, and diarrhea.

Often the child is fretful because it is too warm or is thirsty. It
will often be benefited by giving it less food and more water. This
fretful mind affects the child’s digestion just as it affects the
digestion of the mother.

If a healthy child refuses good, wholesome food because it wishes some
other than what is offered it, it is not hungry and doesn’t need the
food.

The growing child craves sweets, but a child should not be given
candy whenever it wants it during the day. Candy or sugar is quickly
converted into heat and is best eaten immediately following a meal.
Sugar may be spread on bread for the four o’clock lunch or a little
candy may be eaten at this time. Two or three pieces of candy an inch
square are sufficient.


FOOTNOTES:

[18] All lactose (milk-sugar).

[19] Mostly maltose (a hard, crystalline sugar formed by the action of
malt on starch).

[20] Mostly lactose.




APPENDIX

MEASURES AND WEIGHTS


A few tables of measures may be helpful here because accurate
measurements are necessary to insure success in the preparation of any
article of food.

All dry ingredients, such as flour, meal, powdered sugar, etc., should
be sifted before measuring.

The standard measuring cup contains one-half pint and is divided into
fourths and thirds.

To measure a cupful or spoonful of dry ingredients, fill the cup or
spoon and then level off with the back of a case-knife.

In measures of weight the gram is the unit.

A “heaping cupful” is a level cup with two tablespoonfuls added.

A “scant cupful” is a level cup with two tablespoonfuls taken out.

A “saltspoon” is one-fourth of a level teaspoon.

To measure butter, lard, and other solid foods, pack solidly in spoon
or cup and level with a knife.


TABLE OF MEASURES AND WEIGHTS[21]

   4 saltspoons                       = 1 teaspoon, tsp.
   3 teaspoons                        = 1 tablespoon, tbsp.
   4 tablespoons                      = 1/4 cup or 1/2 gill.
  16 tablespoons (dry ingredients)    = 1 cup, c.
  12 tablespoons (liquid)                            = 1 cup.
   2 gills                                           = 1 cup.
   2 cups                                            = 1 pint.
   2 pints                                           = 1 quart.
   4 quarts                                          = 1 gallon.
   2 tablespoons butter                              = 1 ounce.
   1 tablespoon melted butter                        = 1 ounce.
   4 tablespoons flour                               = 1 ounce.
   2 tablespoons granulated sugar                    = 1 ounce.
   2 tablespoons liquid                              = 1 ounce.
   2 tablespoons powdered lime                       = 1 ounce.
   1 cup of stale bread crumbs                       = 2 ounces.
   1 square Baker’s unsweetened chocolate            = 1 ounce.
     Juice of one lemon                              = (about) 3 tbsp.
   5 tablespoons liquid                              = 1 wineglassful.
   4 cups of sifted flour                            = 1 pound.
   2 cups of butter (packed solidly)                 = 1 pound.
   2 cups of finely chopped meat (packed solidly)    = 1 pound.
   2 cups of granulated sugar                        = 1 pound.
   2-2/5 cups of powdered sugar                      = 1 pound.
   2-2/3 cups brown sugar                            = 1 pound.
   2-2/3 cups oatmeal                                = 1 pound.
   4-3/4 cups rolled oats                            = 1 pound.
   9 or 10 eggs                                      = 1 pound.
   1 cup of rice                                     = 1/2 pound.


APOTHECARIES’ WEIGHTS[22]

  20 grains                     = 1 scruple, ℈
   3 scruples                   = 1 drachm, ʒ
   8 drachms (or 480 grains)    = 1 ounce, ℥
  12 ounces                     = 1 pound, lb.


APOTHECARIES’ MEASURES[22]

  60 minims (M)        = 1 fluid drachm, fʒ
   8 fluid drachms     = 1 fluid ounce, f℥
  16 fluid ounces      = 1 pint, o or pt.
   2 pints             = 1 quart, qt.
   4 quarts            = 1 gallon, gal.


APPROXIMATE MEASURES[23]

  One teaspoonful            equals about 1 fluid drachm.
  One dessertspoonful        equals about 2 fluid drachms.
  One tablespoonful          equals about 4 fluid drachms.
  One wineglassful           equals about 2 ounces.
  One cup (one-half pint)    equals about 8 ounces.


METRIC MEASURES OF WEIGHT[23]

In measures of weight the gram is the unit.

  1 gram          1.0 gm.
  1 decigram      0.1 gm.
  1 centigram     0.01 gm.
  1 milligram     0.001 gm.


FOOTNOTES:

[21] _Practical Dietetics_, Alida Frances Pattee.

[22] _Practical Dietetics_, Alida Frances Pattee.

[23] _Practical Dietetics_, Alida Frances Pattee.




INDEX


  Absorption of food, 145

  Achlorhydria, 258

  Acne, 295

  Adulteration of foods, 118

  Age, 165
    Diet in, 230
    Affecting digestion, 165

  Albumin, 10

  Albumin water, 309

  Albuminoids, 12, 56

  Alcohol, 184

  Alkalies, 45

  Almond oil, 25

  Anemia, 37, 245-250

  Appetite, affecting digestion, 160, 161, 163, 164

  Apples, 47, 49, 51

  Apricots, 47

  Arrowroot, 20

  Asparagus, 43, 44

  Asthma, 282

  Athlete, diet for, 228


  Baking soda, 136

  Balanced diets, 232

  Bananas, 48, 49-50

  Barley, 74

  Barley water, 310

  Beans, 43, 82, 85-86

  Beef, 53, 54

  Beets, 39, 41

  Beverages, 103-109

  Bile, 144

  Biliousness, 267

  Biscuits, 68

  Blackberries, 48

  Blood, affecting digestion, 157

  Bouillons, 57

  Boy or girl, diet for, 226-228

  Bread, 66

  Bread and crackers, 61, 62
    Graham bread
    Rye bread
    Wheat bread
    Graham crackers
    Oatmeal ”
    Oyster ”
    Soda ”

  Breakfast foods, 72-80

  Breathing, 3

  Blight’s disease, 272

  Brussels sprouts, 43

  Business man, diet for, 224

  Butter, 89

  Buttermilk, 89, 101


  Cabbage, 44

  Caffein, 106

  Calcium, 4, 6, 34, 36, 59

  Calories, 127-129

  Candy, 15-16

  Carbohydrates, 13

  Carbon, 4, 122

  Carbon dioxid, 20

  Carbonaceous foods, 4, 9, 10, 38-53

  Carbonaceous foodstuffs, 13-25

  Carbo-nitrogenous foods, 9, 61-102

  Carrots, 39, 41

  Casein, 90

  Cassava, 20

  Catarrh of intestines, 264

  Catarrh of stomach, 253

  Celery, 43, 44

  Cells, formation of, 1, 2

  Cellulose, 45

  Cereal coffees, 80-81

  Cereals, 61-80

  Cheese, 89, 100

  Cherries, 47

  Chicken, 57

  Chlorin, 4

  Chocolate, 108

  Chorea, 291

  Circulation affecting digestion, 181

  Citrates, 45

  Citric acid, 45

  Citrus fruits, 216

  Clams, 55

  Classification of foods, 38-102
    Carbonaceous, 38-53
      Fruits, 45
      Green vegetables, 42
      Roots and tubers, 38
    Carbo-nitrogenous foods, 61-102
      Cereals, 61
      Legumes, 82
      Milk, 89
    Nitrogenous foods, 53-59
      Eggs, 58
      Meat, 53

  Cocoa, 108

  Cod-liver oil, 24

  Coffee, 106-107

  Condiments, 109-111
    Capers
    Catsup
    Cinnamon
    Ginger
    Horseradish
    Mustard
    Pepper
    Salt
    Spices
    Tabasco sauce
    Worcestershire sauce

  Constipation, 96, 97, 262

  Convalescent, feeding the, 302

  Cooking, 185-199

  Corn, 71

  Cornstarch, 10

  Cotton-seed oil, 24

  Crabs, 55

  Cranberries, 48

  Cream, 89

  Cucumbers, 43

  Currants, 48, 52

  Custards, 314, 315


  Dates, 48

  Diabetes, 279

  Diet, in abnormal conditions, 242-304
    In age, 230, 231
    For athlete, 228
    For boy or girl, 226-228
    For business man, 224
    For laboring man, 229-230
    In sedentary occupation, 222-224
    In traveling, 213
    Mixed, _versus_ vegetable, 210

  Diets, 216-231

  Digestion, 133-150
    Intestinal, 143
    Salivary, 135
    Stomach, 140

  Dilatation of the stomach, 259

  Diuretic foods, 126

  Dysentery, 265

  Dyspepsia, 250


  Economy in food, 148

  Eczema, 294

  Effervescing waters, 109

  Eggnog, 60, 308

  Egg preparations, 308

  Eggs, 58

  Elimination, 2, 130-133

  Energy, 2, 13, 120-129

  Enteritis, 264

  Epithelium, 136

  Exercise, 2

  Exercise and breathing affecting digestion, 171-174


  Fatigue, 174

  Fats, 13, 21-25, 58, 59
    Almond oil
    Butter
    Cod-liver oil
    Cotton-seed oil
    Cream
    Meat fat
    Nut oils
    Olive oils

  Figs, 48

  Fish, 54, 55, 58

  Flaxseed tea, 276

  Flour and meals, 62-65, 73, 74
    Bran
    Corn
    Gluten
    Graham
    Nutri meal
    Oatmeal
    Wheat
    Whole wheat

  Food elements, 3, 8, 9

  Foodstuffs, 8-10

  Frequency of meals affecting digestion, 169

  Fruits, 45-53
    Bland, 47
      Dates
      Figs
      Prunes
      Raisins
    Sweet, 47
      Apples
      Bananas
      Blackberries
      Blueberries
      Grapes
      Peaches
      Pears
      Plums
      Raspberries

  Fruit juices, 305

  Fruit sugar (levulose), 14, 15


  Gallstones, 269

  Gastritis, 253

  Gelatinoids, 12, 56

  Glucose, 10, 15, 16, 40

  Gluten, 5, 10

  Glycerin, 22

  Glycogen, 16, 21, 151

  Gooseberries, 47

  Gout, 277

  Grapefruit, 46

  Grape juice, 307

  Grapes, 48, 50

  Greens, 43

  Gruels, 314, 317

  Gum-chewing, 139


  Ham, 54

  Heat and energy, 3, 120-129

  Hives, 293

  Honey, 10, 15

  Hydrochloric acid, 34, 35, 46, 140

  Hydrogen, 4

  Hyperchlorhydria, 257

  Hypochlorhydria, 257


  Ice-cream, 115

  Improperly balanced diet, 221

  Indigestion, 250
    Mental effect on, 135
    Nervous, 252

  Infant feeding, 320-356

  Influence of mind, 177-178

  Insufficient diet, effect of, vii

  Intestinal disorders, 262

  Intestinal indigestion, 143

  Intestines, work of, 141-148

  Invalids, foods for, 305

  Iron, 4, 37, 59

  Itching, 295


  Jellies, 313, 314

  Junket, 102, 314


  Kidneys, derangements of, 271
    Affecting digestion, 155, 160

  Kumyss, 98


  Laboring man, diet for, 229-230

  Lactose, 15

  Leanness, 298

  Legumes, 63, 82-87
    Beans
    Lentils
    Peanuts
    Peas

  Lemonade, 60, 108, 306

  Lemons, 46, 48

  Lentils, 82

  Lettuce, 43

  Levulose, 15

  Lime, 7

  Lime water, 96

  Limes, 46

  Liquid foods, 307

  Liver, derangements of, 266
    Affecting digestion, 151-152, 159
    Work of, 151-152

  Lobster, 55, 58

  Lungs, 153, 154, 155, 160


  Macaroni, 62, 69, 203

  Magnesium, 4, 34, 45, 46, 59

  Malates, 45

  Malic acid, 45

  Maltose, 15, 143

  Maple sugar, 15

  Meat broths, 312

  Meat juices, 311

  Metabolism, 1, 130-133

  Milk, 308
    Albuminized, 309
    And milk products, 89-102
    Malted, 92-93

  Mind, influence of, 177

  Mineral salts, 6, 34-37
    Waters, 30

  Mollusks, 55

  Mould, 68

  Mouth, 138

  Mulberries, 48

  Muscles, work of, 152, 160

  Mussels, 58

  Mustard, 110

  Mutton, 54


  Nasal passages, 138

  Nephritis, 272

  Nerves, work of, 153, 154, 160

  Neuralgia, 289

  Neurasthenia, 287

  Nitrogen, 4, 5, 6, 10, 11

  Nitrogenous foods, 9, 10, 53-60
    Foodstuffs, 10-13

  Nut oil, 24

  Nuts, 87-88


  Oats, 61

  Obesity, 299

  Olive oil, 24, 25

  Onions, 39, 40

  Orangeade, 60, 306

  Oranges, 45, 46, 48

  Organs and conditions affecting digestion, 151-184
    Age, 165
    Appetite, 160
    Blood, 157
    Circulation, 181
    Exercise and breathing, 171
    Fatigue, 174
    Frequency of meals, 169
    Influence of mind, 177
    Intestines, 156
    Kidneys, 155
    Liver, 151
    Lungs, 153
    Muscles, 152
    Nerves, 153, 154
    Regularity of eating, 168
    Season and climate, 164
    Skin, 155
    Sleep, 177
    Tobacco and alcohol, 184
    Ventilation, 174

  Overeating, effect of, vi

  Oxidation, 124, 125

  Oxygen, 4

  Oysters, 55, 58


  Pancreatic juices, 20, 34

  Pancreatin, 99, 223

  Parsnips, 38, 39, 41

  Pastry, 194

  Peaches, 47

  Peanuts, 83

  Pears, 48

  Peas, 43, 82, 85, 86

  Pectin, 45

  Pepsin, 140

  Peristalsis, 142

  Phosphates, 11

  Phosphorus, 4, 36, 59

  Pineapples, 48, 52

  Plums, 47

  Poisoning from food, 113-118

  Potassium, 4, 34, 36, 46, 51, 59

  Potatoes, 39-40

  Poultry, 54

  Predigested foods, 78

  Preservation of foods, 111-113

  Prolapsus of stomach, 259

  Protein, 4, 6, 9, 10, 11, 53-60

  Prunes, 48

  Pruritus, 295

  Ptyalin, 136

  Purposes of food, 1-3
    Produce heat and energy
    Rebuild tissue

  Pylorus, 142

  Pyorrhea, 138


  Quinces, 52


  Raisins, 48

  Raspberries, 48

  Recipes for invalids and semi-invalids, 305

  Regularity of eating affecting digestion, 168

  Rennin or rennet, 90, 140, 141

  Repair of waste, 130-133

  Rheumatism, 297

  Rhubarb, 43, 44

  Rice, 61, 69

  Rye, 61


  Saccharin, 15

  Sago, 10, 20
    Soup, 311

  Saliva, 20
    Affecting digestion, 158

  Salivary digestion, 135

  Salts, 6, 34-37
    Calcium (lime), 34, 36
    Iron, 34
    Magnesium, 34
    Potassium, 36
    Sodium, 34, 35, 36

  Sausage, 54

  Season and climate, 164

  Sedentary occupation, diet in, 223-224

  Shrimps, 55

  Skin, work of, 155, 156

  Skin diseases, 292

  Sleep, 177

  Soap, 22

  Sodium carbonate (baking soda), 136

  Sodium chlorid (salt), 4, 34, 35, 36, 46, 136

  Souffles, 318

  Soups, 313

  Spaghetti, 69

  Spinach, 43

  Starch, 20-21, 136

  Steapsin, 144

  Stomach, 158

  Strawberries, 48

  Sucrose, 14, 15

  Sugar, 10, 14, 19
    Cane sugar (sucrose), 14, 15
    Fruit sugar (levulose), 14, 15
    Sugar of grapes or corn (glucose), 15, 16
    Sugar of malt (maltose), 15
    Sugar of milk (lactose), 15, 16

  Sulphates, 11

  Sulphur, 4, 11, 36, 59

  Syrups, 10

  Sweat-baths, 2

  Sweetbreads, 54


  Tables of use in making up balanced diets, 232

  Tannin, 49, 104

  Tapioca, 10, 20

  Tartaric acid, 45

  Tartrates, 45

  Tea, 104

  Terrapin, 55

  Theobromin, 108

  Tired, meaning of, 131

  Toasts, 318

  Tobacco, 184

  Tomatoes, 43, 44

  Traveling, diet in, 213

  Trypsin, 141

  Tuberculosis, 283

  Turnips, 39, 41


  Ulcer of the stomach, 260

  Uremia, 275

  Uric acid, 46
    Excess of, 276

  Urticaria, 293


  Veal, 54

  Vegetable marrow, 43

  Vegetables, green, 43-45

  Ventilation, 174

  Villi, 146

  Vitamins, 70

  Volatile oil, 40, 41

  Water, 25-34

  Watercress, 43

  Watermelons, 48

  Wheat, 61, 63

  Whey, 101

  Wheys, 307

  Whortleberries, 48


  Yeast, 67




  Transcriber’s Notes

  pg 12 Changed: the tissues themselves wll be consumed
             to: the tissues themselves will be consumed

  pg 262 Changed: the condidition brings a result similar
              to: the condition brings a result similar

  pg 321 Changed: and in thirty-two, bottled-fed
              to: and in thirty-two, bottle-fed




        
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