Physiological economy in nutrition, with special reference to the minimal proteid requirement of the healthy man / an experimental study

by R. H. Chittenden

II. EXPERIMENTS WITH VOLUNTEERS FROM THE HOSPITAL CORPS OF THE UNITED STATES ARMY.

The original Detachment from the Hospital Corps of the United States Army detailed to serve in this series of experiments arrived in New Haven September 28, 1903, under the command of Dr. Wallace DeWitt, 1st Lieutenant and assistant Surgeon of the United States Army. The detail was composed of twenty men, of whom fourteen were privates, volunteers for the experiment, the remainder being made up of non-commissioned officers, cook, cook’s helper, etc. The detachment was located in a convenient house on Vanderbilt Square belonging to the Sheffield Scientific School, and there they lived during their six months’ stay in New Haven under military discipline, and subject to the constant surveillance of the commanding officer and the non-commissioned officers.

In selecting the men for the experiment particular attention was paid to securing as great a variety of types as possible, representing different nationalities, temperaments, etc. Naturally, among such a group of enlisted men brought together for the purpose in view many were found unsuited for various reasons, and were quickly exchanged for others better adapted for the successful carrying out of the experiment. Several quickly deserted, apparently not relishing the restrictions under which they were compelled to live. The restriction which constituted the greatest hardship in the eyes of several of the men was the regularity of life insisted upon, and the consequent restraint placed upon their movements in the city when relieved from duty. The following Statement from Dr. DeWitt will explain the causes of removal of the men who dropped out of the experiment during the natural sifting process of the first few weeks and later.

Hospital Corps Detachment U. S. Army,
332 Temple St., New Haven, Conn.,
March 17, 1904.

Professor Russell H. Chittenden,
Director Sheffield Scientific School,
New Haven, Conn.

Sir,—In compliance with your verbal request concerning men of this detachment lost by transfer and desertion and the reasons therefor, I have the honor to inform you that the following men were lost by transfer, at my request, for the reasons set after their respective names:

Private Edward Mcdermott (October 17, 1903). Mentally and morally unsuited.

Private Paul Forkel (October 18, 1903). Physically unsuited.

Private David Acker (October 24, 1903). Physically unsuited by reason of Acute Pulmonary Tuberculosis Bilateral.

Private William C. Witzig (November 17, 1903). Physically unsuited by reason of Cardiac Irritability.

Private Philip S. Myer (December 11, 1903). Physically unsuited by reason of very high grade of Myopia both eyes.

Private first class Charles P. Davis (January 14, 1904). Physically unsuited by reason of Acute Melancholia.

Private Barnard Bates (February 12, 1904). Morally and mentally unsuited by reason of Drunkenness.

In all these men, except Private Davis, the condition for which they were transferred was present when they reported for duty with the detachment.

In the case of Private Davis, his condition of acute melancholia in my opinion was incident to the experiment,—due to the necessary restrictions of liberty and food, assisted by a natural gloomy disposition.

The following men were lost by desertion:

Private first class Samuel R. Curtis (November 3, 1903).

Private first class William Smith (November 5, 1903).

Private Simon Prins (January 23, 1904).

Private Edwin A. Rinard (February 3, 1904).

Of these men Private first class Smith and Private Prins were on duty in the kitchen and were at no time subject to restriction of diet and liberty. Private first class Curtis deserted before the experiment was well under way and can not be attributed to any cause arising out of the investigation. Private Rinard’s desertion was in my opinion due to the restrictions of diet and liberty incident to the experiment. I would say, however, that this man was a worthless character and was discharged “without honor” from the army during a previous enlistment.

Very respectfully,

(Signed) Wallace Dewitt,
1st Lieut. and Asst. Surgeon U. S. Army,
Commdg. Detachment.

As supplementing Dr. DeWitt’s statement it may be mentioned that Rinard reported for the experiment at New Haven on December 11, 1903, and remained here until February 2, 1904. On December 11 he weighed 59.8 kilos, while on February 2, the last day he was here, his body-weight was 60 kilos. Evidently, any restriction of diet he may have suffered had not made any great impression upon his bodily condition.

There were thirteen men of the detachment who really took part in the experiment, and of these all but four were in the original detail. Of these four, two joined in October and two early in November. Of these thirteen, all but two continued to the close of the experiment, April 4, 1904.

The following statement gives the name, age, birthplace, occupation, length of service (U. S. Army), etc. of the thirteen men.

It will be noted that the men range in age from twenty-one years six months to forty-three years, and that representatives of many countries are on the list.

Regarding the duties of the men, i. e., their daily work, the following statement from Dr. DeWitt will give all needed information on this point. The character of the Gymnasium work will be referred to later.

Name.	Age on Oct. 1, 1903 (Years and Months).	Length of Service on Oct. 1, 1903. (Years and Months).	Birthplace.	Occupation before Original Enlistment.	Remarks.
Private first class.
Broyles, Jonah	24-6	3-3	Campbell Co., Tenn.	Scholar	Joined Nov. 13, 1903.
Coffman, William E.	22-1	0-2	Edinsburg, W. Va.	Clerk	Joined Sept. 28, 1903.
Fritz, Charles J.	27-8	3-0	Switzerland.	Gasfitter	Joined Oct. 30, 1903.
Henderson, James D.	25-1	2-0	Marshall, N. C.	Student	Joined Sept. 28, 1903.
Loewenthal, Maurice D.	22-8	0-2	New York, N. Y.	Clerk	Joined Sept. 28, 1903.
Morris, William	21-6	3-8	San Juan, P. R.	Scholar	Joined Sept. 28, 1903.
Oakman, William H.	43-0	1-7	Blackville, S. C.	Bookkeeper	Joined Sept. 28, 1903.
Sliney, William F.	26-7	5-0	Roxbury, Mass.	Painter	Joined Oct. 21, 1903.
Steltz, John J. B.	23-1	0-3	Schuylkill, Pa.	Painter	Joined Sept. 28, 1903.
Zooman, Ben	25-3	1-11	London, Eng.	Hosp. Orderly	Joined Sept. 28, 1903.
Private.
Cohn, Isaac	21-8	0-1	Jerusalem, Pal.	Porter in Drug store	Joined Nov. 13, 1903.
Transferred.
Private first class.
Davis, Charles P.	27-0	0-2	Darlington Co. S. C.	Machinist	Joined Sept. 28, 1903; left Jan. 14, 1904.
Private.
Bates, Barnard	26-8	1-10	San Francisco, Cal.	Painter	Joined Sept. 28, 1903; left Feb. 12, 1904.

Hospital Corps Detachment U. S. Army,
332 Temple Street, New Haven, Conn.,
March 17, 1904.

Professor R. H. Chittenden,
Director Sheffield Scientific School,
New Haven, Conn.

Sir,—In compliance with your verbal request I have the honor to inform you that the duties of this detachment during the tour of duty at this station have been as follows:—

At 6.45 A. M. the men arise and their body-weights are taken immediately, after which they dress and assemble for reveille roll-call.

7.15. Breakfast. After this meal they are all engaged in various duties about the quarters, such as inside and outside police, kitchen police, assisting in measurement of urine and fæces and transportation of the same to the laboratory; cleansing of fæces cans and urine bottles, etc. They are occupied with these various duties until about 9 A. M.

9 A. M. Detachment proceeds to Gymnasium under charge of a non-commissioned officer, and by him reported to the gymnastic instructor.

11 A. M. Detachment returns from Gymnasium.

12 M. Dinner.

1 P. M. Drill, weather permitting, otherwise a walk in charge of a non-commissioned officer, or indoor instruction relative to the duties of a soldier.

2 P. M. Relief from drill; walk, or instruction.

2.30 P. M. Instruction by a non-commissioned officer in their duties as nurses, etc.

3.30 P. M. Relief from instruction.

5 P. M. Supper.

5.30 P. M. Retreat roll-call.

10 P. M. All men in bed.

This routine is the same for every day in the week except Saturday and Sunday. On Saturday drill and instruction in the afternoon are omitted, and on Sundays the men are also free from gymnasium work.

In addition to the duties mentioned above, a special detail of two men is made every morning to assist in the weighing and serving of the food, and from time to time details are sent to the laboratory and reported to Dr. Mendel for such work connected with the investigation as he might assign them.

Very respectfully,

(Signed) Wallace DeWitt,
1st Lieut. and Asst. Surgeon U. S. Army,
Commdg. Det. H. C.

Here we have a group of men, thirteen in number, quite different in type from the preceding group; men accustomed to living a vigorous life under varying conditions, and who naturally had great liking for the pleasures of eating. Further, they were men who had no personal interest whatever in the experiment or in the principles involved. To be sure, they had volunteered for the work, and the objects of the experiment had been fully explained to them. Like good soldiers they no doubt desired to obey orders, and they doubtless preferred to see the experiment a success rather than a failure, but they had not that interest that would lead them to undergo any great personal discomfort. This point should be kept in mind, since it has a distinct bearing upon the possibility of establishing physiological economy of diet in persons who would not willingly incommode themselves or suffer personal inconvenience.

The experiment commenced on October 4, 1903, and for a period of six months every detail bearing upon the nutrition and condition of the men under the gradually changed conditions was carefully observed. Every precaution to preserve the health and good spirits of the men was taken. Pure distilled water was sent to the quarters each morning, magazines and other periodicals were supplied through the courtesy of friends, occasional visits to the theatre were indulged in; in fact all that could be done to counterbalance any possible depressing influence from the partial restraints of the experiment was arranged for.

Showing a group of the soldiers at work in the gymnasium.

Regarding the details of the work; the twenty-four hours’ urine was collected by each man, also the fæces for each day, and these were subjected to chemical analysis with a view to following out the various changes in the amount and character of the proteid metabolism going on in the body as measured by the output of total nitrogen, uric acid, and phosphoric acid in the urine, and by the amount of nitrogen in the fæces with reference to the degree of digestion and utilization of the proteid foods ingested.

During the first two weeks the ordinary army rations were given to the men; later a gradual change was made, accompanied by a reduction in the amount of proteid food, with some reduction likewise in the total fuel value of the food. All the food placed before each man was carefully weighed, and at the close of every meal any uneaten food was weighed and the amount subtracted from the initial weights. During the balance periods, when the income and output of nitrogen were carefully compared, the food materials were weighed with greater care and large samples of each article were taken for analysis, to determine the exact content of nitrogen. Every figure for nitrogen shown in the tables was verified by at least a duplicate chemical analysis so as to avoid any possibility of error.

It is not necessary to give here any detailed description of the changes made in the character of the diet, since on [pages 288 to 326] may be found the daily dietary from October 2, 1903, to April 4, 1904,—each meal of the day,—showing the amount and character of the food given the men during the six months period. It should be stated, however, that at no time were the men placed on a cereal diet or on a truly vegetable diet. The object in view was simply to study the possibilities of a general physiological economy in diet, with special reference to the minimal proteid requirement of the healthy man. To be sure, in doing this meats, owing to their high content of proteid, were very much reduced in amount and on many days no meat at all was given, but as the dietary is looked through it will be seen that the main change was from a heavy meat diet (rich in proteid) to a lighter diet, comparatively poor in proteid, with an increasing predominance of vegetable and cereal foods. Condiments are also noticeable in the diet, together with the ordinary accessories, coffee and tea. Variety was also considered as a necessary factor, not to be overlooked, as contributing largely to the maintenance of a proper physiological condition.

From a study of the tables which follow, showing the chemical composition of the daily urine, it will be seen that during the first sixteen days, viz., from October 4 until October 20 or 21, when the men were on the ordinary army ration with opportunity to eat an abundance of meat, the daily urine frequently contained 16 to 17 grams of nitrogen, showing a metabolism of over 100 grams of proteid on such days. Sliney, indeed, averaged for four days an output of 18.19 grams of nitrogen, while Coffman, Henderson, and Zooman showed an average daily excretion of about 15 grams of nitrogen each for the sixteen days from October 4.