It is fortunate that the uric-acid theory has been disproved, for the excessive use of water is not only unnecessary, but highly injurious to the digestive organs, particularly when the fluids are taken at or about meals. Experience has shown that excessive stomach-acidity, which is the most common form of indigestion, is in a large degree dependent on the taking of liquids while eating, and that even in those who are healthy any more than small quantities cannot be looked upon as being wholesome. In dyspeptics liquids seem to act in a hurtful way in several different directions. For example, where persons constantly take liquids while eating the necessity of properly chewing the food is largely done away with; in addition to this the mere presence of water in the stomach seems to tend to the production of increased acidity, for it has often been observed by the writer that even where food was eaten dry indigestion would follow in many dyspeptics if they took water just before or immediately after eating.
The only sensible advice that can be given in this connection is that persons should take no more liquids that they feel a desire for, and they should avoid taking them in any quantity about meal time. What has just been said concerning water applies equally well to milk. When taken alone it very frequently agrees with patients much better than does solid food, but when mixed with the latter is prone to produce indigestion, just as does water. Fermented milk in the form of buttermilk is a very popular beverage in some parts of the world, but it may be well doubted as to whether it deserves the reputation for wholesomeness generally accorded it; being a liquid, and at the same time acid, it is peculiarly prone to increase acidity, and is not tolerated by persons who suffer with sour stomach. It should, however, be said that it, on the other hand, seems to agree particularly well with some people, and has been known when taken alone, at least temporarily, to relieve obstinate forms of indigestion.
Coffee.—The most universal beverage taken at meal time in America is undoubtedly coffee. Each morning countless thousands are cheered and stimulated by its invigorating properties to undertake their daily tasks, but, as is always the case after taking drugs that have such action the system has to pay the penalty in a reaction following later, during which the capacity for work is diminished. It is, however, true that the effect last referred to is not of such importance as to constitute in itself a serious objection to the use of coffee, but other ill results are rather prone to ensue that in many instances change the aspect of the question entirely. In a great many people, particularly after the first vigor of youth has passed, coffee produces anything but pleasant effects, and on some it seems to act as a downright poison. Like all liquids taken at meal time, it predisposes to acid indigestion, particularly when it is sweetened. It is likewise true that when it contains any considerable quantity of cream the liability to dyspeptic disturbances following its use are particularly great—doubtless as a result of the considerable quantity of melted fats that it contains under such circumstances.
From the foregoing it appears then that coffee without either cream or sugar is less unwholesome than when these substances are added to it, but even when it is taken in this way it causes decided symptoms of indigestion in many persons. The writer is not of the opinion that the habitual taking of coffee is to be commended, and would, therefore, not advise its constant use; it, however, must be admitted—as is the case with all other substances that cause indigestion—that in many people, and particularly in those who live out-of-doors and are actively engaged in physical occupations, the use of coffee seems to result in no harm. Like other substances that cause indigestion in a concentrated form, coffee when largely diluted is less apt to produce disturbances of this kind; for example, a beverage consisting of two-thirds of hot skimmed milk and one-third coffee may be taken by many dyspeptics in reasonable amounts without any particular harm. Parents should be warned against allowing growing children to drink coffee; it seriously interferes with the normal chemical changes going on in their bodies, and is almost certain to be followed in later life by nervous dyspepsia.
Tea.—The stimulating principle of tea is chemically so nearly like that of coffee that they are generally considered as being one and the same. That they differ decidedly in their action on the stomach and the body generally there can, however, be no doubt. The stimulating action of tea comes on more slowly than that of coffee, and is correspondingly prolonged. In most persons it is not so apt to produce nervousness, nor is its action in preventing sleep so pronounced. On the stomach it also produces effects that are diametrically opposed to those induced by coffee, since, instead of stimulating, it seems actually to retard the secretion of acids. It is, therefore, probably true that we should look upon tea as a beverage with much less disfavor than we do coffee—though, of course, it should always be remembered that there may be, and unquestionably are, many exceptions to this judgment.
Probably no other daily article of food or drink is so commonly prepared in an improper manner as tea—which is all the more curious when we consider that perhaps none other that requires heat for its preparation is so easily made. It should be brewed by simply pouring boiling water upon the leaves, but the vessel containing the decoction should not be placed over the fire while the tea is being prepared. Of even greater importance is the necessity of allowing the water to remain in contact with the leaves only a few moments—never more than a minute if we wish the tea to be good. The reason for the latter precaution lies in the fact that tea-leaves contain a considerable amount of tannic acid, and, as the longer the water and leaves remain together the more of this substance is extracted from the latter, it is not difficult to see that we should be careful to allow only a brief contact between the two; the presence of this acid is undesirable, not only on account of the fact that it gives to the decoction a bitter and unpleasant taste, but because it has a tendency to cause digestive disturbances. It is seemingly not generally known that there are many varieties of tea, and that some of them are so superior in flavor and bouquet to others that they might well be entirely different substances. The best of all (in the writer's opinion) are those that are composed largely of leaves grown in Ceylon, usually mixed with India tea. If we will demand of our grocer a first-class Ceylon tea we will find that a beverage may be made from it that will appeal quite as much to the palate as a good coffee.
Before dismissing this subject finally, some reference should be made to ice-tea. This beverage is exceedingly palatable when properly prepared, and under such circumstances by no means deserves the disfavor with which it is regarded by many. The latter circumstance is entirely due to two things; first, we find too frequently that it is the habit of house-keepers to pour boiling water on the leaves when the midday meal is cooked and to allow them to soak together until night, and second, the fact that lemon-juice is very commonly added to the tea before being drunk. The ice that the tea contains has little or nothing to do with the dyspeptic disturbances that frequently follow the drinking of cold tea. If we will leave out the lemon and pour off the water after it has been in contact with the tea leaves for something like a minute, it will be discovered that practically all of the ill effects usually ascribed to this palatable beverage have been done away with.
Alcohol.—A discussion of beverages would not be complete without some mention of those containing alcohol. This at once brings us face to face with the bitter controversy on this subject that has been waged so long throughout the United States, and which can only be considered here from the standpoint of the effects of alcohol on the human economy, and to draw corresponding conclusions.
That alcohol, even in very small quantities, reduces the general strength and capacity for work there can be no question, and in addition we find from experiments carefully conducted on the lower animals that the liability to infection by various disease-producing germs is greatly increased by the administration of even minute amounts of the drug. A man then who is a habitual user of alcoholic drinks not only thereby diminishes his capacity to labor effectually, but at the same time renders himself more liable to disease. No more striking example of this could be brought forward than the well established fact that persons who use alcohol are exceedingly prone to consumption—so true is this, indeed, that we might almost look upon the drug as being practically the cause of this disease in most instances. Of course the bacillus of tuberculosis must be present in order for the malady to develop, but we find that the alcohol has prepared a soil for the growth of the germ which would not otherwise exist. This holds with equal force as regards other infectious diseases.
Again, it is true that maladies that result from bad digestion and improper assimilation are frequently produced by the habitual use of alcoholic liquors. Gout and Bright's disease are in the vast majority of cases the indirect off-spring of habitual drinking. It should be noted—and the distinction is of importance—that the affections of a grave character most frequently produced by the alcoholic habit do not ensue as a consequence of what could be rightly called intemperate taking of the drug,—its moderate use more commonly resulting in serious disease than when it is taken in great excess.