Under this head, I would lay special stress upon the value to the body of the natural sugars as well as of starch. We are inclined to deprecate the widespread use of candy, especially among children, and there is no doubt that the too lavish use of sugar in such concentrated form does at times do harm; but when eaten as an integral part of the many available fruits its use cannot be too highly lauded, for both young and old. Oranges, grapes, prunes, dates, plums, and bananas are especially to be commended, and in lesser degree peaches, apricots, pears, apples, figs, strawberries, raspberries, and blueberries. In all of these fruits, it is the sugar especially that gives food value to the article, while the mild acids and other extractives, together with the water of the fruit, help in other ways in the maintenance of good health. Where personal taste and inclination are favorably disposed, the first six fruits named can be partaken of freely, and the diet of the young, especially, can be advantageously modified by the liberal use of such articles of food.
Of the other fruits, apples when thoroughly ripe are above reproach if properly masticated, but the raw fruit is somewhat indigestible when swallowed in too large pieces, and may cause trouble to a delicate stomach. A baked apple, on the other hand, is both savory and wholesome, and if served with sugar and cream, for example, constitutes a most healthful and satisfying article of food. Peaches, apricots, and strawberries as ripe fruits are likewise exceedingly valuable, but here personal idiosyncrasy frequently comes to the fore, especially with strawberries, and prohibits their free use. The peculiar acidity of these latter fruits is occasionally a source of trouble, which leads to their avoidance; but this is far less liable to happen with people living on a low proteid diet with its greater freedom from purin derivatives, or uric acid antecedents. Further, there is a tendency on the part of some individuals to suffer from acid fermentation with too liberal use of starches and sugar, but as a rule the advantages of ordinary starchy and natural sugar-containing foods cannot be overestimated. It is certainly wise to give them a conspicuous place in the daily dietary and to encourage their use, especially by children.
As has been stated in several connections, a diet which conforms to the true nutritive requirements of the body must necessarily lead toward vegetable foods. In no other satisfactory way can excess of proteid be avoided, and at the same time the proper calorific value be obtained. This, however, does not mean vegetarianism, but simply a greater reliance upon foods from the plant kingdom, with a corresponding diminution in the typical animal foods. This raises the question of the possible relation of diet to the bacterial processes of the intestine, knowing, as we do, that the latter are of primary importance in the causation of certain forms of auto-intoxication, etc. Recent studies have indicated that the bacterial flora of carnivorous animals is quite different from that of herbivorous animals, and this being so, it is easy to see how a predominance of vegetable or animal food may modify the bacterial conditions of the intestinal tract in man. Dr. Herter[80] has reported the presence in the intestines of cats, dogs, tigers, lion, and wolf of many spore-holding bacilli, as well as free spores and vegetative forms of anærobic organisms; some of which at least are decidedly pathogenic when injected into the subcutaneous connective tissue, leading to serious and even fatal results within twenty-four hours. With herbivorous animals, on the other hand, such as the buffalo, goat, horse, elephant, etc., the predominating organisms are of a different order from those found in the intestines of the carnivora; proving practically non-pathogenic, or only slightly so, when injected subcutaneously, and less disposed to produce putrefactive changes or other chemical decompositions.
In the words of Dr. Herter, “These differences in the appearance and behavior of the bacteria derived from typical carnivora and herbivora suggest that the habit of living upon a diet consisting exclusively of raw meat entails differences in the types of bacteria that characterize the contents of the large intestine. The occurrence of considerable numbers of spore-bearing organisms in the carnivora points to the presence of anærobic putrefactive forms in great numbers. The results of subcutaneous inoculations into guinea-pigs bear out this view and indicate that the numbers of organisms capable of producing a hemorrhagic œdema with tissue necrosis, with or without gas-production, are very considerable. . . . The observations recorded are of much interest in relation to the bacterial processes and nutrition of herbivorous as distinguished from carnivorous animals, and are significant furthermore for the interpretation of bacterial conditions found in man. The question arises whether the abundant use of meat over a long period of time may not favor the development of much larger numbers of spore-bearing putrefactive anærobes in the intestinal tract than would be the case were a different type of proteid substituted for meat.” While it may be said truly that observations of this character are as yet not sufficiently numerous or conclusive to warrant positive or sweeping statements, yet there is a suggestion here well worthy of thoughtful consideration in its general bearing on the nutrition of mankind.
Simplicity in diet, with or without complete abstinence from meat, is often resorted to as a means of relief from bodily ailments, and such cases sometimes afford striking illustrations of the adequacy and benefits of a relatively low intake of food. Cases of this sort, perhaps, are more frequently observed among elderly people, where the daily requirements are not so great as with younger and more active persons, but they offer evidence in support of our main thesis that dietary habits are no guarantee of bodily requirements. I have in mind the details of an exceedingly interesting case reported with much care by Dr. Fenger;[81] the case of a man who at 61 years of age, after a long period of poor health, brought himself quickly into a condition of sound health by a daily diet characterized by extreme simplicity and with an exceedingly low fuel value. The daily diet made use of during the fifteen years the subject was under examination consisted of the following articles:
1889–1892: 1 egg, 1 quart of oatmeal soup, 2 quarts of skim milk, 1 1/2 ounces of red wine, 1/4 ounce of sugar.
1892–1894: 2 eggs, 1 quart of oatmeal soup, 2 quarts of skim milk, 1 1/2 ounces of red wine, 1/4 ounce of sugar.
1894–1900: 3 eggs, 1 pint of oatmeal soup, 2 quarts of skim milk, 1 1/2 ounces of red wine, 1/4 ounce of sugar, 2 ounces of plum and raspberry juice.
1900–1903: 3 eggs, 1 pint of barley soup, 3 pints of sweet milk, 1 pint of buttermilk, 1 1/2 ounces of red wine, 1/4 ounce of sugar, 2 ounces of plum and raspberry juice.
It will be observed that during these fifteen years the subject partook of no meat whatever, and further, that the diet was wholly in fluid form. At the close of this long period, the subject, being then 75 years of age, was reported as well and in good health, with satisfactory physical condition for a person of his years. He was a man of small body-weight, only 42 kilograms, but during this period of voluntary restriction in diet, he suffered no loss. It is perhaps worthy of comment also that all through this lengthy period no salt was taken other than what was naturally present in the simple foods made use of. The point to attract our attention especially, however, is that for fifteen years, during which the quality and quantity of this man’s food was carefully observed, body-weight, general good health, and physical vigor were all maintained, together with freedom from the ills of previous years and with a daily diet characterized by extreme simplicity. The chemical composition of the diet was likewise peculiar, particularly in its exceedingly low fuel value. The following table shows the amounts of proteid, fat, and carbohydrate consumed daily during the four periods designated: