The treatment by bowel antiseptics has been generally very unsatisfactory. Beta naphthol helps, perhaps, but the most good comes from duodenal extract in some form. Two grains of the dried powder about two hours after each meal in pill or tablet act well. Carnrick’s Secretogen tablets and the much-advertized Jubol are good, and both depend on some extract from the duodenal mucosa. The unpleasant flatulence and the fermentation in the bowel soon disappear, and with them the mucus that is often shed from the coats of the colon. Better assimilation of food goes hand-in-hand with improved health and vigour. Intestinal dyspepsia is more far-reaching in its effects than gastric dyspepsia, but is often ignored.
The questions of food and cooking need most careful consideration. In the affairs of the soul Christ taught “that which cometh out of the man, that defileth the man”; in the affairs of the body, that which goeth into a man, that defileth the man. Both teachings are true and both are purposeful exaggerations and in a sense untrue. Out of the same mouth proceed blessings and cursings and into the same mouth go good food and poisons. The sin lies sometimes in the nature, but more often perhaps in the excess. The word “temperance” has been made to apply far too much to the use of alcohol. As a fact, I believe, far more nowadays are intemperate in eating than in drinking. As the tale of our years increases and as our physical life gets less strenuous and active, we require less food, or at any rate a different kind of food; the strong nitrogenous foods, as meat, become less called for, and if taken beyond our needs become poisons. The imperfect products of assimilation have to be dealt with by our excretory organs, which become overworked and unable to meet the demands. The scavengers cannot clear the dust-heaps. Hence arise kidney disease, faulty liver action, and raised blood pressure. And yet, how many of us seek to restore failing strength by stronger food and more stimulation? In this futility, kind but ignorant friends aid and abet. Think on what a little food a baby lives and grows, and, at the other end of life, on what a simple frugal diet really old people thrive and work.
It is all very well to lay down rules for food, calculated in calories for strong working men and athletes, but in approaching old age every one must become more or less a lawgiver to himself; this especially, if there is any tendency to hyperpiesis, for any food in excess of the body’s needs becomes for the time a poison. What we can digest easily and what with difficulty must be largely a personal question, but the direction should certainly be towards a non-meat regime. The difference of climate makes comparison between the vegetable feeders of the tropics and ourselves of uncertain value, but it is a lesson to see what the Scotch gillie can do on a diet that is mostly oatmeal, milk and cheese. The gluttonous man and the wine bibber seem to get a pleasure out of life that the sober men miss, but we doctors see the other side of the shield, the after-suffering and the failure: the broken law brings its own punishment and there is no escape.
The physiological process of digestion is rather elaborate, and, fortunately for us, somewhat elastic. It is not a question entirely of certain substances in a test-tube exposed to certain digestive agents. This, of course, is the foundation, the basic process, but there is much variation in the nature of the food, in the external conditions of season, of heat and cold, of youth and age, of greater or less physical or mental demands on the food digested, and lastly on the supplies of saliva, of pepsin, of hydrochloric acid and of duodenal and pancreatic secretions. These are all under the control of the autonomous nervous system, which in the stresses of life often breaks down and fails to function properly. In the full tide of youthful energy our digestions seem to respond effectually to many and unreasonable demands, but this is more apparent than real; the bills may be a long time before they are sent in, but they come. The recuperative power of youth is marvellous, but probably never quite complete. After forty years of age it fails more and more, and then bills come in more quickly, while in old age it becomes almost a question of cash on delivery. Realizing this we should, in our own interests, treat our digestive apparatus with deep respect, and not with the scant courtesy we generally show, for on its faithful working depend our life, our health, our happiness and our powers of work. The farmer in his feeding of cattle, the head of a racing stable in his feeding and training of horses is far more scientific and wise than we and most other men are in the management of ourselves. This is why we end our days so often prematurely, or in paralysis and pain.
To go into actual details of diet is a thankless task, and not very helpful to the mass of men; it is better, I think, to point out directions only. If there are symptoms of hyperpiesis, the chief object is to arrange a diet that contains a minimum of protein (especially of animal protein) compatible with life and energy. Most of such cases are leading a life of no great physical strain and will do well on a diet calculated in calories, that contains:
| Protein | 90 |
| Fat | 75 |
| Carbohydrate | 330 = Calories 2,400. |
If this is insufficient, add to the fat or carbohydrate rather than to the protein.
The following tables from Dr. Sprigg’s excellent work classify the common foods according as their energy production is due to protein, carbohydrate or fat. It will be noticed that milk is the only food in the lists which contains a good proportion of all three. Cheese, Brazil nuts and bread contain a fair proportion of at least two of the requisite food-stuffs.
If we take, for instance, the figures of lean beef in the first and second column, viz.:
| Lean beef | 90 + 10 we get its value |
| Chicken | 79 + 21 we get its value |
| Bread | 13 + 6 + 81 we get its value |
| Cheese | 2 + 7 + 2 we get its value |