Carnivore Diet

ZOMOTHERAPY IN TUBERCULOSIS.

By Lawrason Brown, M.D.,

RESIDENT PHYSICIAN, ADIRONDACK COTTAGE SANITARIUM, SARANAC LAKE, N. Y.

Some months ago two French scientists, Richet and Hericourt, 1 announced most favorable results in the treatment of tuberculosis with raw meat or its juice. They began two years ago to publish their observations, and during the last year both have written glowing accounts of the efficiency of this treatment. They have long been experimenting upon dogs, endeavoring to find some curative agent for tuberculosis; but all to no avail until they began to feed their dogs exclusively upon raw meat. Their dogs, 129 in number, may be divided into three groups. The first, composed of 30, received no treatment; the second, numbering 58, was treated by different methods, while the third, 41 in number, was fed on raw meat. At first the amount was unlimited, but later they found that 10 to 12 grammes per kilogramme of body weight of the animal was sufficient The first and second groups lived, on an average, 52 days, while the dogs fed on raw meat lived, on an average, 227 days; in other words, the period of life was very nearly five times longer in the dogs fed with raw meat. From their experiments they conclude that cooked meat in any quantity is inefficacious, that meat deprived of its serum is moderately efficacious, and that muscle serum is as efficacious as raw meat. Raw meat they found also to act prophylactically.

The explanation of the action of the raw meat, although discussed at the Paris Conference in 1900, is still unsettled. Richet at that time attributed the beneficial effects to some body in the meat-juice that prevented the development of tuberculous granulations. According to Maragliano, meat acts as a stimulant, and therefore promotes the formation of an antitoxin in the body. More recently Richet has advanced a “ metatxophic antitoxic action." The tuberculized animal, he says, dies by a slow and progressive intoxication of the nervous system. The active elements of the muscle serum preserves the nerve cell from a tuberculous intoxication.

Richet and Roux’ have obtained favorable results in experimental meningeal tuberculosis in dogs. Twenty dogs were inoculated with tubercle bacilli in the spinal canal between the atlas vertebra and the occiput. Eleven of these were fed on raw meat and three survived, two of which were injected with tuberculin and did not succumb, as did one of the dogs which survived after being fed on cooked meat. Nine dogs were fed on cooked meat, and all died.

Chantemesse,’ who first looked upon raw meat as a stomachic, has later taken an opposite view on account of his own observations. He injected two dogs with tubercle bacilli. One he fed upon raw meat; the other with cooked meat. The first remained sound and well; the second died.

Salmon 4 divided a number of dogs into three groups. The first, which received raw meat and was then injected, died as quickly as the controls. A Eecond group, injected and then fed on raw meat, gained in weight and lived a fairly long time. In the third group treatment with raw meat was not begun until the disease had advanced considerably, and there was much loss of strength. On these raw meat exerted no influence. This author also calls attention to the fact that a dog which has apparently recovered from tuberculous peritonitis may still show at autopsy numerous fresh nodules in the peritoneum and internal organs and an extending tuberculosis.

Frankel and Sobemheim 1 have published their results obtained by zomotherapy in tuberculous dogs and rats. Nine dogs and four rat were injected with carefully estimated quantities of an emulsion oi tubercle bacilli. Four dogs and two rats, fed on a mixed diet, were used as controls, and the remainder fed on raw meat. The dogs all died in six weeks. These authors suggest that Bichet and Hericourt’a results may be due to the fact that a non-virulent tubercle bacillus was used in the injections.

The literature on zomotherapy in human tuberculosis is more extensive, but no more conclusive. Duhoureau 8 mentions the case of his son, who, from smaller doses than those given by Hericourt, derived much benefit. Hericourt advises 600 to 700 grammes of raw meat, or the juice of 1000 to 1300 grammes of raw meat, per diem. In a recent article Hericourt 7 has collected statistics in zomotherapy in human tuberculosis. Besides eleven cases treated by himself, he reports twelve cases treated by others. These cases may be tabulated as follows:

It is but natural that anyone acquainted with pulmonary tuberculosis should, if the cases have not been selected, regard these uniformly good results somewhat skeptically.

Hericourt quotes, in addition, several favorable reports. Dr. Petit-Clerc" mentions three cases in the second stage of pulmonary tubercu¬ losis who recovered under treatment by raw meat and fresh air. Dr. Sarge 9 has seen a case of pulmonary tuberculosis in the third stage recover under zomotherapy. Garnault 10 reports two cases in the second and third stages of pulmonary tuberculosis who apparently recovered under raw meat and iutratracheal injections of orthoform. Josias and Roux" have followed zomotherapy as treatment in six cases of pulmonary tuberculosis in children, three of whom were in the second stage and did very well, and three in the third stage, who did not do so well. Three cases of meningeal tuberculosis were treated without favorable results.

At present the prevalent opinion is that Richet’s method is only a better means of offering nourishment and of enabling a larger quantity of food to be given. The resistance of gouty persons toward tuberculosis is, Weber 12 thinks, probably due partly to the meaty food. He recognizes, however, that due proportions of vegetables and fruits are of great importance. In some cases a fair amount of butchers’ meat will stimulate the appetite enormously for all kinds of food, and render digestion more vigorous. Meat albumin, in contradistinction to milk albumin, writes Ross, 13 quickly and readily manifests its better qualities in the early observable improvement in the sufferer, and the benefit so obtained is not so easily undone as in the case of casein albumin. The cause, he thinks, is due to the fact that the adult has more muscle, and so needs more muscle-juice, or the muscle-juice contains more iron. Possibly, he says, the meat-juice contains some antitoxic substance. Browning the meat, he thinks, has little effect upon the real properties of serum.

Myosin albumin returns a maximum of nutrient for a minimum of effort, peptonizes readily, and is promptly absorbed, throwing little or no stress and irritating overaction on the stomach. But Bernheim 1 * warns us that the benefit of alimentation is not measured by the quantity of food ingested, but by the quantity digested. The raw-meat treatment of Richet and Hericourt is, in effect, really suralimentation, but suralimentation in'such a form that the majority of patients can stand it. “ When, under the pretext of recovering the albuminoids, one submits the tuberculous patient to an exclusive meat diet, when one declares the carbohydrates—vegetables, sugar, cereals, etc.—to be secondary, the patient is deprived of an element primordially essential to repair, is given only an insufficient diet of phosphates, has his hyperacidity increased, and in place of increasing the artificial arthritism, which would be of value, a state of affairs is favored which would increase the susceptibility to the bacillus.”

On account of the great expense, but few patients can carry out the raw-meat treatment as suggested by Hericourt, who advises that the juice of six pounds of rare beef, free from fat, bone, and cartilage, be taken daily. However, smaller quantities can be used advantageously. Two patients who took the full amount for several months made good recoveries. In one of these the disease was advancing quite rapidly. Many patients have been given beef-juice extracted from meat slightly browned, and it seemed to exert a very beneficial but no specific action.

In reviewing the experimental work done on this subject one is struck, as Frankel remarks, by its meagreness. Chantemesse, Salmon, and Frankel are apparently the only observers to repeat Riehet’s work. Frankel obtained opposite results, Salmon’s results were inconclusive, while Chantemesse, from experiments upon two dogs, upholds Richet. For this reason at the suggestion of Dr. Trudeau, and largely under his guidance, the following experiments were carried out:

From the foregoing experiments on the treatment of experimental tuberculosis by raw meat, the following conclusions may be drawn.

1. That raw meat has no perceptible effect on the duration of experimental tuberculosis in dogs if the bacilli are virulent and a sufficient number injected intravenously.

2. That raw meat has no effect on the prolongation of the duration of experimental tuberculosis in dogs, even if the bacilli are attenuated, provided a reasonable quantity be injected intravenously.

3. That under the same conditions dogs fed on a mixed diet with no raw meat may live a much longer time.

Regarding the use of meat in pulmonary tuberculosis, it may be said:

1. That meat is highly essential in the dietetic treatment.

2. That much meat with a judicious admixture of carbohydrates, fats, etc., is essential to the treatment.

3. That rare meat is better than meat well cooked.

4. That meat-juice is of great value in suralimentatioo, as myosin albumin is easily digested by most patients—even the dyspeptic, and it affords a“ maximum of nutrient for a minimum of effort.” (In a few patients meat-juice causes diarrhoea and meteorism.)

5. That meat-juice can be taken when patients can take no other form of meat, i. e., when there exists a marked repugnance to all solids.

6. That the juice from raw meat seems slightly, if at all, more beneficial than the juice from meat slightly browned.

7. That the disadvantages of preparing and preserving raw meat-juice more than offset its advantages. (Patients who object to juice from raw meat will willingly take that from meat browned.)

8. That meat-juice is of value, as it can be administered in the form of jellies, ices, etc.

Infant nutrition, Dr. Marsh argued, could perhaps show its effects well into adult life. A child was usually at the breast for as long as three years. Marsh had seen cases of more than six years — so had Leavitt; and so have I, since. At the age of a few days Eskimo babies started receiving, along with their mothers' milk, food masticated by the parent and passed directly from mouth to mouth. Thus she fed the child on what she herself liked best — always, of course, lean and fat meats, except in case of famine, when vegetables might be included and when the child and mother fared alike — neither of them well but the child a little better than the parents. 

Chapter 12 contains a great deal of information about Eskimo's Way of Life.

In reply to a further query, the rector wrote again from Sitka on September 16, 1958. He confirmed that he had lived at Anvik all but three of the years between his birth in 1895 and his first journey in 1908 when he went out to become a graduate of Middlebury College, Vermont. “I returned to Anvik as a missionary in 1922 and lived there until 1948, except for furloughs and the four years I was in Fairbanks.

“The native people of the Anvik area are Athapaskans. During my youth the main parts of their food were meat (caribou, rabbits, grouse, waterfowl, beaver, porcupine, black bear and lynx) and fish (salmon, whitefish, shellfish, loche and lampreys). The loche has a large liver which is said to be even richer in vitamins than ordinary cod liver. The Indians also ate raw foods such as berries, wild rhubarb, and a root which they called ‘mouseberries’ because it was gathered and hoarded by field mice.

“They obtained fat from caribou, black bear, and beaver tails. The lampreys were rich in oil, which was highly prized. They also bought seal oil from the Eskimos. Even in my boyhood they supplemented their native diet with white man's food, including lard ...

“The usual way of cooking meat was either boiling or frying. As a boy I was once invited by a party of Indians to eat bear meat with them. It was boiled and well done ... I do not know that any flesh foods were eaten raw, except for dried fish ...”

Neither does the published literature on the forest Indians report that any flesh foods were customarily eaten raw by the forest Indians of Alaska or northern Canada. Indeed, the name “Eskimos” is believed by many to have been derived from an Algonquin expression meaning “they eat their meat raw.”

When I went down north along the Mackenzie, in 1906 and 1908, I now and then heard talk of how horrified the Athapaskans had been when they first saw white men of the Northwest Company and Hudson's Bay Company eating the customary British underdone roast meats. In 1910, when we met the Athapaskans northeast of Great Bear Lake — Dogribs, Slaves, and Yellowknives — we found that they were still mildly horrified to see the Hudson's Bay Company Canadian Joseph Hodgson and the Old Country British John Hornby and Cosmo Melvil, who were then living among them, eating rare caribou steaks and roasts.

In a presentation of evidence regarding the views of frontier doctors on the incidence of cancer, it is of consequence to make clear that early testimony regarding the rarity or absence of malignancies is as clear and strong for the forest Indian north as for the grassland Eskimo country. Some of the early medical missionaries — notably Dr. Hutton in Labrador — have inclined to credit a diet of raw flesh with that former absence of cancer in which they believed. To emphasize this point let me quote again Dr. Hutton's book Health Conditions (1925), Page 35:

“Some diseases common in Europe have no t come under my notice ... Of these diseases the most striking is cancer ... In this connection it may be noted that cookery holds a very secondary place in the preparation of food — most of the food is eaten raw ...”

If only Eskimos are considered, in relation to the alleged former absence of cancer, and of these only the Labradorians, then the logical deduction for one who believes nutrition to be fundamental in relation to malignancy, is that actual rawness of food may be the crucially important cancer-inhibiting factor. But the force of this logic diminishes as we go westward from Labrador, among the Eskimos. Without cancer's appearing at all, cooking grows steadily more important as we move west. From Dr. Hutton's and other accounts, the Labradorians, east of Hudson Bay, were the greatest raw-flesh eaters of the whole Eskimo world. West of the Bay the boiling of flesh increases; and inland from the Bay, among the Caribou Eskimos, the roasting of caribou supplements the boiling. At Coronation Gulf, near where Dr. Jenness and I spent the first years during which the Copper Eskimos ever associated closely with Europeans, the years 1910 to 1915, there was considerable summer use of roasting, though the winter cooking, if any, was by boiling. Among the Mackenzie Eskimos, as described from the 1860's by Father Emile Petitot and from the early 1900's by myself, boiling and roasting were both considerable. These methods were even a bit more common in northern Alaska, as described by John Simpson in the 1850's and Murdoch in the 1880's. In southwestern Alaska as described by Dr. Romig in the manuscript he submitted to our Encyclopedia Antarctica, for the last decade of the nineteenth century and the first one of the twentieth, the cooking of flesh foods reached its Eskimo high point.

Yet the mission testimony, starting from Labrador, remains equally clear, from east to west: the medical missionaries all looked for cancer, and they never found it among the “primitive,” though they did find it among the “modernized.”

Thus clarification is important for whoever expects a nutritional key to this Eskimo cancer situation. Among the Athapaska and western Eskimos cooking was hardly ever carried to the point of “well done,” or “boiled to pieces.” Instead the native meats resembled our fashionable roasts, which have a well-done layer on the outside, medium done just under that, and the center pink or red. And so it was with the forest Indians — at least with those Athapaskans from Great Bear Lake to just west of the Mackenzie, with whom I hunted and lived — though they insisted on some cooking, they were in practice as careful as Eskimo cooks to see that the centers of most pieces were pink.

To sum up the raw and cooked-food elements of northern medical missionary theorizing about cancer:

During the time when large numbers of non-Europeanized northern natives were allegedly free of cancer, there was little cooking of flesh foods beyond the degree which we call medium. Among grassland and coastal Eskimos raw flesh eating ranged from a great deal in northern Labrador to a good deal in southwestern Alaska. Only among forest Indians were raw flesh foods avoided, and even among these there was little use of overcooked flesh.

Vegetable foods, where eaten at all, were always raw, among prairie and woodland natives alike. Among Eskimos, vegetable foods were important only in the farthest west — along the west coast of Alaska, among the Aleutians, and along the south coast of Alaska. In the most northerly region from Baffin Island, Canada, to Point Barrow, Alaska, vegetable eating was negligible, except in time of famine. Among woodland Indians, vegetables were negligible with the Athapaskans from the west shore of Hudson Bay to beyond the Mackenzie. In Alaska the eating of raw vegetables by forest Indians increased westward along the northern belt and then increased still more southward, into the country of the Tlingit.

During the time when the medical missionaries reported cancer difficult or impossible to find among large numbers of primitive natives, there was no usual cooking of any vegetables, whether among grassland or forest natives. The cooking of vegetables is part of that Europeanization which is considered by some missionaries to be responsible for the introduction of cancer, or for the change from its being hard to find to its being impossible not to notice.

The European-style application of intense heat to food through frying was new to all northern North American natives.

All this was conversational stock in trade on the river in 1906; and, to a slightly lesser extent, also during my second journey, in 1908. There were humorous tales of amateur dentistry against toothache, and far from humorous ones of scurvy through which teeth came loose and finally dropped out, as death approached.

Speaking of the Klondikers, everybody was saying what the bishop had been the first to tell me — that, so far as scurvy was concerned, those tenderfeet were best off who brought the least food with them. For the Athapaskans would not see them die of hunger; and they fed the tenderfeet on medium-cooked fresh fish and game, to the general benefit of their health and the complete avoidance of scurvy.

No one, that I can remember, was seriously worried about cancer; nor was I myself particularly interested. As intimated, I now remember about malignant disease from my first journey chiefly that Bishop Reeve thought it to belong to a group of ills which had behind them nutritional issues. But I do remember noticing more talk of cancer as we approached the Eskimo country, to the effect that the New England whalers, who wintered among the Eskimos east and west of the Mackenzie delta, could find no more cancer among them than missionaries and fur traders had been able to find among the Athapaskans — meaning none. The bishop said he had discussed this with other missionaries who knew more than he did about the Eskimos; I think he mentioned the bishops Bompas and Stringer, and that he had sent messages through Stringer to the whaling captains bolstering their seacoast results with his own from the interior.

There are many people in the Mackenzie district who have given me much valuable information about their country, the greater part of which , however, has to be omitted here, but few men perhaps know the country better than Father Giroux, formerly stationed at Arctic Red River but now in charge of Providence. He says it is true in the Mackenzie district, as it is among the Arctic Eskimo, that measles is the deadliest of all diseases. There have been several epidemics, so that it might be supposed that the most susceptible had been weeded out, and yet the last epidemic (1903) killed about one fifth of the entire population of the Mackenzie Valley . He had noticed also a distinct and universal difference in health between those who wear white men's clothing and who live in white men's houses, as opposed to those who keep the ancient customs in the matter of dress and dwellings. These same elements I have since found equally harmful among the Eskimo, although among them must be added the surely no less dangerous element, the white men's diet, which is no more suited to the people than white men's clothing or houses. 

Grains and vegetables of most kinds, and even strawberries, are successfully cultivated at Providence. North of that, the possible agricultural products get fewer and fewer, until finally the northern limit of successful potato growing is reached near Fort Good Hope, on the Arctic Circle. Potatoes are grown farther north, but they do not mature and are not of good quality. 

In certain things the Mackenzie district was more advanced the better part of a century ago than it is now; the explorers of Franklin's parties, for instance, found milk cows at every Hudson's Bay post and were able to get milk and cream as far north as the Arctic Circle and even beyond. At that time, too, every post had large stores of dried meat and pemmican, so that if you had the good-will of the Company you could always stock up with provisions anywhere. Now this is all changed. Game has become so scarce that it would be difficult for the Company, even if they tried, to keep large stores of meat on hand. The importation of foodstuffs from the outside, on the other hand, has not grown easy as yet, and it is therefore much more difficult to buy provisions now than it was in Franklin's time. The trading posts are located now exactly where Franklin found them, so that taking this into consideration, and the decrease of game all over the northern country, it is clear that exploration on such a plan as ours — that of living on the country —is more difficult now than it was a hundred years ago. Another element that makes the situation more risky is that while then you could count on finding Indians anywhere who could supply you with provisions, or at least give you information as to where game might be found, now there are so few of the Indians left alive , —and all of those left are so concentrated around the trading posts , —that you may go hundreds of miles without seeing a camp or a trail, where seventy-five or a hundred years ago you would have found the trails crossing each other and might have seen the camp smokes rising here and there. 

The food supplies of the different posts vary according to location . In general the trading stations are divided into "fish posts" and “meat posts.” Fort Smith is a typical meat post, for caribou are found in the neighborhood and moose also; and the Indians not only get meat enough for themselves and for the white men, but the fur traders even find the abundance of the meat supply a handicap in their business, - for the Indian who has plenty to eat does not trap so energetically as do others who must pay in fur for some of their food. Resolution, Hay River, and Providence, on the other hand, are fish posts, while at any of the northern trading stations potatoes nowadays play a considerable part in the food supply, even as far up as Good Hope. In certain places and in certain years rabbits are an important article of diet, but even when there is an abundance of this animal, the Indians consider themselves starving if they get nothing else, and fairly enough, as my own party can testify, for any one who is compelled in winter to live for a period of several weeks on lean-meat will actually starve, in this sense: that there are lacking from his diet certain necessary elements, notably fat, and it makes no difference how much he eats, he will be hungry at the end of each meal, and eventually he will lose strength or become actually ill. The Eskimo who have provided themselves in summer with bags of seal oil can carry them into a rabbit country and can live on rabbits satisfactorily for months. The Indian, unfortunately for him, has no animal in his country so richly supplied with fat as is the seal, and nowadays he will make an effort to buy a small quantity of bacon to eat with his rabbits, unless he has a little caribou or moose fat stored up from the previous autumn.