It is a trite observation, that medical men are constantly exclaiming against the eating propensities of their patients, and inculcating the practice of temperance. One of the most eminent physicians of the present day says, “I believe that every stomach, not actually impaired by organic disease, will perform its functions if it receive reasonable attention; and when we consider the manner in which diet is generally conducted, both in regard to quantity and to the variety of articles of food and drink which are mixed up into one heterogeneous mass, instead of being astonished at the prevalence of indigestion, our wonder must rather be, that, in such circumstances, any stomach is capable of digesting at all. In the regulation of diet, much certainly is to be done in dyspeptic cases, by attention to the quality of the articles that are taken; but I am satisfied that much more depends upon the quantity; and I am even disposed to say, that the dyspeptic might be almost independent of any attention to the quality of his diet, if he rigidly observed the necessary restrictions in regard to quantity.”[41] The latter opinion, which is in perfect harmony with Dr Beaumont’s observation of the power of digestion being limited by the amount of gastric juice which the stomach is capable of providing—an amount varying with the wants of the system, and consequently with the mode of life—is also forcibly though quaintly supported by a late popular writer, who affirms that “it is your superfluous SECOND COURSES”—“(which are served up more to gratify the pride of the host than the appetite of the guests) that overcome the stomach and paralyze digestion, and seduce children of larger growth to sacrifice the health and comfort of several days—for the baby-pleasure of tickling their tongues for a few minutes with trifles and custards.”[42]
Cornaro, Cheyne, and others, have, most absurdly, attempted to determine a standard quantity of food for all mankind, and have fixed it at the lowest possible limit. The very attempt, however, is inconsistent with the laws of the animal economy; since the supply required must necessarily vary not only according to the age, sex, and constitution of the individual, but according to the mode of life and the circumstances by which he is surrounded: and it would be, therefore, not less injurious than unnatural for any one to adhere to the same invariable proportion.
Mixtures of different kinds of food are strongly condemned by almost all writers on dietetics, as injurious to digestion. They seem to me, however, to produce mischief much more by the inducement to excess in quantity which variety affords, than by the mere mixture of different substances. In a healthy stomach, indigestion is rarely if ever induced by eating several kinds of food at one meal, provided the total amount consumed be not beyond the wants of the system, and do not exceed the due proportion to the quantity of gastric juice which the stomach is able to provide. When only one dish is partaken of, there is less temptation to exceed in quantity than where several are tried.
The first intimations of satisfied appetite are unquestionably the best warning we can have when to stop eating. If we do not go beyond this point, the subsequent sensations are pleasurable and invigorating, and, after a brief interval, we are perfectly disposed to return to active exertion. But, if we eat more than enough, fulness and oppression are almost immediately experienced, and a considerable time must elapse before either mind or body can effectually resume its activity.
Where, from long over-indulgence or other causes, the appetite cannot be safely followed as a guide in regulating the quantity of food, we shall not err very far if we proportion our meals to the amount of the preceding exercise. When this has been active and in the open air, and waste has consequently been considerable, a liberal allowance of food will be more easily digested than perhaps half the quantity would be after a week’s inaction. Hence it is a great error to devour the same quantity of food daily, whatever our mode of life and bodily exertion may be; because “the strong food which the strong action of strong bodies requires will soon destroy weak ones—if the latter attempt to follow the example of the former—instead of feeling invigorated, their stomachs will be as oppressed as a porter is with a load that is too heavy for him—and under the idea of swallowing what are called strengthening nourishing things, will very soon make themselves ready for the undertaker.”[43] And yet nothing is more common than to see persons who have passed from a life of varied activity to one of a purely sedentary nature continue to eat—merely because they have been accustomed to it—as much food as if they were still engaged in constant bodily exertion. Many females of the higher and middle classes, who scarcely ever stir out of doors except to church, nevertheless make as hearty meals twice or thrice a day as if they were undergoing pretty severe exertion; but they sooner or later reap their reward, and after groaning for a time under the burden which they have placed upon their own shoulders, they either obtain relief by the forced adoption of a temperate regimen, or “fall into the hands of the undertaker.”
In towns we often observe the bad effects of over feeding in young female servants recently arrived from the country. From being accustomed to constant exercise in the open air, and to the comparatively innutritious diet on which the labouring classes subsist, they pass all at once, with appetite, digestion, and health in their fullest vigour, to the confinement of a house, to the impure atmosphere of a crowded city, and to a rich and stimulating diet. Appetite, still keen, is freely indulged; but waste being diminished, while nutrition is increased, fulness is speedily induced, followed in its turn by inflammatory disease or fever, which sometimes cuts short life, where, with better management, health might have been preserved for years. In many instances, again, life is saved by the digestive powers being the first to give way, and refusing either to receive or to concoct the same quantity of aliment as before, and the patient then escapes with the minor evils of protracted indigestion. This latter result ensued in an instructive case mentioned by Heidler, where a moderate acquaintance with the laws of the animal economy might have saved months of suffering, and even of danger, to the patient.—“A young woman of a healthy constitution, brought up in all the simplicity of country habits, passed at once, on her marriage, to a less active mode of life, and to a much more elegant table. In a short time she began to complain of irritability, lassitude, various spasmodic sensations, and habitual constipation. Hypochondria was soon added to the other symptoms; her hope of becoming a mother being always deceived, an additional glass of wine, bark, and other tonics, were ordered. The evil increased. The patient became melancholic, and believed that she was always swallowing pins. In the course of the year, she became so emaciated and yellow, that her mother, who had not seen her for eleven months, could scarcely recognise her. After an eighteen months’ course of purgatives, and two courses of Marienbad-water, she entirely recovered.”[44] If the medical adviser first consulted in this case had possessed the slightest acquaintance with the principle I have been explaining, he would no more have regarded wine and tonics as the best remedies for the oppressive languor of excessive feeding, than he would have sought to extinguish a flame by pouring oil into the fire.
The operation of the same principle is equally conspicuous in girls sent from the country to the workrooms of fashionable milliners and dressmakers in the larger towns. Transferred at once from activity in the open air to confinement all day, and often to a late hour at night, at a sedentary occupation, where there is scarcely even the means of changing their position, and much less of enjoying active muscular exercise, and where, consequently, there is little waste, the digestive powers speedily give way, because less food is now required to repair the diminished loss. If the individual adapts her eating to her change of circumstances, she may escape severe disease; but if, as generally happens, from pure ignorance, she continues to eat to the same extent as before, head-achs, sickness, bilious disorder, and indigestion will be among the smallest of her evils, and she will have reason to be thankful if she does not become the victim of confirmed bad health. In establishments of this description, the provision of the means of exercise even by dumb-bells, shuttlecock, or otherwise, in a large room with open windows for a few minutes several times a-day, would not only prevent much suffering, but even repay itself in an economical point of view, by producing an increased aptitude for work, and less frequent absence on account of illness. In these days of wide-spreading philanthropy, considerations of this kind ought to be more attended to.
The necessity of proportioning the supply of food to the expenditure incurred and to the mode of life, is still further illustrated in the case of individuals changing from an agricultural or other employment carried on in the open air in the country, and involving no very great bodily labour, to one of a mechanical kind carried on in an impure atmosphere in a city, and requiring severe and continued muscular exertion. It is a matter of experience, for example, that the stout young men from the country, who are generally selected as apprentices for the laborious occupation of letter-press printing, almost uniformly break down during the first ten or twelve months, and it is only after some years’ training that they are able to withstand the fatigue. The vitiated atmosphere in which they work has some share in producing this result, but the chief cause is undoubtedly the inadequacy of their ordinary diet to repair the great expenditure of muscular energy to which they are habitually subjected, and for which they have not been previously prepared. In the office where this volume is printed, four strong and healthy lads were engaged in the summer of 1835 as pressmen, and put to work along with an equal number of experienced men. Before the following February every one of the former had been laid up from sickness for weeks, although the whole of them are of the most sober and steady habits; while not one of the older and more experienced men felt any inconvenience from his exertions. This very instructive fact is also deserving of attention, as corroborating what I have elsewhere said in regard to the necessity of proper management during the period of transition from youth to manhood—a period during two or three years of which more good or more mischief may be done to the human constitution than during almost any other ten years of life.[45] That, in times past, pressmen have suffered at least as much from their own mismanagement as from the nature of their employment, is rendered probable by their proverbial dissipation. In utter ignorance of the structure and laws of the animal economy, they not unnaturally sought to relieve the exhaustion under which they suffered, by the stimulus of spirituous and other intoxicating liquors, instead of seeking it—where only it can be effectually obtained, and at a cheaper rate—in a more wholesome and nourishing diet. It is gratifying to perceive, however, that in this, as in many other trades, the progress of knowledge is already leading to the prevalence of more rational ideas, and to the consequent formation of better habits.
There is no period of life during which it is of greater importance to follow the intentions of Nature in the regulation of diet, both as to quantity and quality, than during the earliest part of childhood; for at no period is the neglect of them more fatal. Surprise is sometimes expressed at the number of children who are carried off before completing their first or second year; but when we consider the defective education and entire ignorance of the human economy, not only of the nurses and servants to whose care the young are entrusted, but of the parents themselves, our wonder ought to become greater that so many survive than that so many die. There is perhaps not one mother in ten thousand, who, before becoming such, has ever inquired into the nature and wants of the newly born infant, or knows on what principles its treatment ought to be directed; and hence the hurtful and superstitious notions of the human economy which still linger in the nursery, long after they have ceased to prevail in the world of science.
Those whose opportunities of observation have been extensive will agree with me in opinion, that nearly one-half of the deaths occurring during the first two years of existence are ascribable to mismanagement and to errors in diet. At birth the stomach is feeble and as yet unaccustomed to food. Its cravings are consequently easily satisfied, and frequently renewed. A healthy infant seeks the breast with avidity, but sucks little at a time. It leaves an interval for thoroughly digesting the little which it has swallowed; after which its appetite revives, and a fresh supply is demanded in language which no mother can misinterpret. During the first months, appetite ought to be the mother’s guide in offering the breast; and if she know how to read the expression of her infant aright, she will want no other. At that early age there ought to be no fixed time for giving nourishment. The stomach cannot be thus satisfied. In one child digestion may be slow, and the interval be consequently too short; in another it may be quick, and the interval too long. But the active call of the infant is a sign which needs never be mistaken, and none else ought to be listened to.