Meatritionist

Dr Edoardo Ughi – Italy -1886

THE CARNIVOROUS DIET IN GENERAL AND PARTIAL OBESITY

COMMUNICATION BY DR. EDOARDO UGHI Prof. of Propaedeutic Medical Clinic at the University of Parma

The method to be followed in the treatment of obesity is now the subject of lively discussion in Germany, where it appears that such an affliction is frequent due to abundant nutrition, and perhaps most of all due to the exaggerated consumption of beer. Three systems are now followed in the cure of corpulence, and each of them has valid supporters.

The first, and oldest, used without contest for many years, is that of Banting. It is based on the fact that one must eat much albumin, without starch and without fat. The exact prescription is as follows: in the morning 150 gr. of lean meat with bitter tea and 30-40 gr. of bread; at midday 150-180 gr. of lean meat with a small quantity of legumes, little wine, no beer, no farinaceous foods; in the evening 60-100 gr. of meat and later another 120 gr. In total about 170 gr. of albumin, 10 of fat and 80 of carbohydrates are administered.

The cure of Ebstein consists in giving fewer fats and carbohydrates than the body consumes, with the prescription of eating slowly and stopping at the first sense of fullness.

Oertel subtracts liquids as much as possible, with the aim of producing a desiccation of the body. He permits all foods, but in small quantity, so that the pre-existing substances must be consumed in part. He also recommends muscular exercises, both because much water is subtracted from the body through sweat, and because more fats are consumed and the respiratory muscles and heart are strengthened.

The cure of Schweninger, with which Prince Bismarck was cured, is identical to that of Oertel. He too permits all foods in small quantity, prohibits drinking during meals and prescribes muscular exercises. It cannot be denied that each of these methods is founded on good physiological arguments, and is not in disagreement with the laws that regulate material exchange. Therefore, it is no wonder that each of them is effective in achieving the goal, and is thus preferred by various authors. But objections have been raised against all of them.

It has been said that Banting’s cure should not be adopted, because it is poorly tolerated, and gives rise to gastro-enteric disturbances due to the large quantity of meat that must be introduced. Oertel’s cure is burdensome due to the thirst that must be suffered, and Ebstein’s is long and uncertain. It suffices, moreover, to read the debate that took place between these two authors and the various opinions expressed within the Medical Society of Leipzig, last year, by Wagner, Hoffmann, Heubner, Taube and others, to recognize how results and assessments vary. I therefore gladly take this occasion to bring to the attention of the medical public my not insignificant experience on the subject, having treated many sufferers of obesity over various years. I will thus be able to demonstrate the advantages of the exclusive carnivorous diet in obesity, and in general the tolerance that the organism presents for such a diet, which should therefore be more easily utilized even in other cases. It should be noted that I consider here, with many German authors, not only the general increase of fat in the organism as obesity, but also more specifically that limited to certain organs (heart), in such a way as to disturb their function and give the same phenomena as general obesity. I therefore distinguish between absolute and relative obesity.

1st Case. -- B.L. 30 yo, weighs 126 kg

1st Case. — B. L. aged 30, whose father died of apoplectic stroke and was very obese, is 1.88 m tall, weighs 126 kg, and suffers heart disturbances, without having any valvular defect: when climbing stairs, and walking at only a moderate pace, he is seized by strong shortness of breath; moreover this gentleman is affected by dyspepsia due to chronic catarrh of the ventricle. He habitually took two meals a day, a soup and a meat dish for breakfast, a soup and two dishes for dinner, plus 300 gr. of bread, and usually drank a liter and a quarter of wine and almost no water. I suspected that the aforementioned disturbances were caused by obesity and fatty infiltration of the myocardium. The weak and sometimes irregular pulse, the cardiac tones also weak and not very clear, and the arrhythmia that was observed, confirmed me more in my suspicion, so I subjected him to the following dietetic cure: For each day: lean meat from 700 to 900 gr., broth 300 gr., a bottle of wine, and when he ate a smaller quantity of meat, I allowed two or three eggs. I also prescribed that the individual maintain his habits strictly, that is, to always do that exercise to which he was accustomed, not to exert himself more than usual and to drink the usual quantity of water, etc. In five months of practicing these dietetic and hygienic prescriptions, his body weight decreased by 22 kg, that is, it went to 104 kg; the shortness of breath and heart disturbances disappeared, the conditions of digestion improved. For two years now he has returned to his habitual regimen, and his weight oscillates between 106 to 108 kg.

2nd Case. – G.L. 96.5 kg to 88 kg and maintained two years

2nd Case. — G. L. complains of dyspepsia, shortness of breath and inability to resist in the work of grocer; he is 1.73 m tall, weighs 96.500 kg; apart from obesity, I found no sick organ, except for a slight gastric catarrh due to excessive use of wine. The individual is accustomed to taking two meals a day, and in total took a soup, two dishes (sometimes meat, sometimes vegetables), 300 gr. of bread, and drank 2 or 2½ liters of wine, very little water and often made no use of it. I subjected him to the identical cure of the previous case, because in this case too I believed that obesity was the principal cause of the shortness of breath and inability to resist at work. The individual maintained his habits in work, walking, etc. After three months of said cure the weight descended to 87 kg, the shortness of breath and dyspepsia disappeared, and the individual could frankly resist, without need of tiring himself, his occupations. Two years have already passed since the cure, and the weight has oscillated between 87 to 88½ kg.

3rd Case. – Mr. U. O. 87.5 kg to 73 kg over 5 months

3rd Case. — Mr. U. O., 1.69 m tall, weighs 87½ kg, suffers no ailment, except for slight dyspnea when climbing stairs. The individual takes three meals a day: in total he eats a soup, 450 gr. of bread, 300 gr. of meat, and drinks a liter of wine, a black coffee and little or no water. For 5 months he takes 200 gr. of broth, 700 gr. of meat, two or three eggs, and drinks a liter of wine, as usual, nothing or almost no water, does not modify his occupations and habits at all. At the beginning of this cure he felt weakened, afterwards he noticed no ailment. In these five months the weight descended to 73 kg; a year has passed since the end of the cure, and now he weighs 78 kg. Currently he has no longer the slightest trace of shortness of breath.

4th Case. – C. D. 45 yo, 102 kg to 89 kg over 4 months

4th Case. — C. D. aged 45, 1.66 m tall, weighs 102 kg, and suffers from shortness of breath, frequently also from dizziness. The cardiac impulse is weak, as are the cardiac tones; after prolonged efforts the individual remains very exhausted, and then a slight degree of cyanotic color is seen on the lips, face and also hands: it is in these moments that he complains of strong dizziness, to free himself from which the individual resorts to bloodletting. I believed that following fatty infiltration of the myocardium, systolic insufficiency had arisen, hence the cyanosis, shortness of breath, dizziness due to venous stasis. This man eats moderately: a soup, 300 gr. of meat, 350 gr. of bread, drinks two liters of wine. For 4 months he abandoned the soup and bread, and reduced the wine by one liter. In this time, he took a broth of 300 gr., meat 750 to 800 gr., some eggs and one liter of wine. During the cure he did not modify his habits in working, walking, etc. at all. When the cure was finished, the weight went to 89 kg, the shortness of breath diminished, the cyanosis only occurs at some moments and in slight degree, the dizziness is much less frequent and lighter.

5th Case. – B. Appio, 35 yo, 98 kg to 88 kg

5th Case. — B. Appio aged 35, 1.60 m tall, weighs 98 kg, suffers very much from shortness of breath, somnolence, cyanosis, dizziness, sleeps a very agitated and interrupted sleep, has an irritating cough with frothy serous expectoration, and has strong edema in the lower limbs: this man finds himself almost unable to discharge his duties as a tobacco seller. In this man are found in the maximum degree all the phenomena of the previous case, and certainly they arose through the same modality, except that in B. there is severe edema in the lung, legs and perhaps also in the brain, given the disturbances already mentioned and the cries he emits at night. The examination of the heart does not permit admitting any valvular defect, only the 2nd tone of the pulmonary is found anomalous, which is much reinforced relative to the first; a fact that is explained taking into account that there is strong congestion and edema in the lung. B. eats much soup (two or three portions), 300 gr. of bread, little meat, drinks a very large quantity of water and only half a liter of wine per day. I had the individual continue for three months to take from 700 to 800 gr. of meat, some eggs, a broth of 200 gr. and his usual quantity of wine (½ liter) and water. Weighed after this time, he is no more than 88¼ kg. Now he is well; the edema in the legs and lung has disappeared, moreover all the other facts have almost dissipated, except for a slight degree of shortness of breath. The cure ended at the end of November last, and until today the patient has remained in the conditions just described. I note that this man led a sedentary life before the cure, and during the same.

6th Case. – B. G. 42 yo, 110 kg to 99 kg

6th Case. — B. G. aged 42, 1.85 m tall, weighs 110 kg, suffers from dyspepsia and has impeded movements; has dilatation of the ventricle. This subject eats a kg. of bread per day, in addition to a very abundant soup and a dish; drinks 2 or 2½ liters and little water. For three months I arranged so that the individual did not change habits, did not walk more than usual, did no work more than usual, and always drank the same quantity of water, which he was accustomed to in the past. In these three months he ate a kg. of meat and two eggs per day, and drank a liter and ¼ of wine, 300 gr. of broth per day; after this term he weighed 99 kg. During the cure he improved in digestion, and movements became easier. Having returned to the habitual diet for a year, he now weighs 102.500 kg. The phenomena of altered digestion have renewed.

7th Case. – B. Lawyer, enormously obese loses at least 15 kg

7th Case. — B. Lawyer, 1.68 m tall, is enormously obese, orthopneic, edematous (in the lower limbs); had several attacks of asystole, and due to these serious facts had to abandon his profession and go to the city. Due to the gravity of the aforementioned symptoms, it was not possible for me to establish a physical examination of the circulatory center and therefore a certain diagnosis. This gentleman was always a good eater and a discrete drinker, but I could not say the quantity of food and drink he introduced daily. I saw this gentleman only once, not being his doctor, and I advised him to the identical cure of the first two cases. After about three months of such cure, I learned that all the imposing symptoms had disappeared, but that some shortness of breath remained. A short time ago I met the aforementioned gentleman and saw that he must have decreased in weight by at least 14 or 15 kg. I hope to be able to know where he currently resides and thus specify many of the aforementioned facts.

8th Case. – B. M., 65 yo, 90 kg to 83 kg

8th Case. — B. M. aged 65, 1.55 m tall, weighs 90 kg, and is almost unable to walk due to strong dyspnea. This lady leads a sedentary life; takes daily a coffee and milk with bread, a soup, two dishes (more often meat), 200 gr. of bread and drinks a bottle of wine and very little water. I did not want her to change her habits, except in food; during the cure she therefore led an extremely sedentary life. For two months she continued to take daily 700 to 800 gr. of meat, some eggs, two broths (400 gr. in total), and her habitual bottle of wine. After this time the lady weighed only 83 kg, and walked, moderately, without shortness of breath.

9th Case. – Mrs. Z. G., 32 yo, 92 kg to 84 kg

9th Case. — Mrs. Z. G. aged 32, daughter of an extremely fat mother, weighs 92 kg, has no serious disturbance, only feels heavy, and cannot therefore attend to her affairs with that agility to which she was accustomed in past years. At night she is almost always seized by tingling in the limbs on which she lies. She uses mixed food, but prefers vegetables, and drinks a bottle of wine per day and little water. For two months I had her completely abandon vegetable foods, and allowed her a broth of about 200 gr., 700 to 800 gr. of meat, two eggs and her usual wine. This lady was always very active, and during the cure did not modify her habits at all. Weighed after the cure was finished, she was only 84 kg; she acquired complete freedom of movement, and the tingling completely disappeared.

10th Case. – G. Adele, 39 yo, 95 kg from much use of vegetable food, down to 86 kg

10th Case. — G. Adele aged 39; her father is very obese, and she weighs 95 kg, and for a long time has had shortness of breath, cough, edema in the lower limbs. This lady makes much use of vegetable food, and hardly eats meat except in winter, drinks almost a bottle of wine every day. Having made a delicate examination of the heart, I could find nothing morbid, only the tones were weak, and the radial pulse also weak and small. To explain the phenomenological syndrome, in addition to taking into account the general adiposity, I also had to resort to fatty infiltration of the myocardium and the diminished strength of the same due to this fact. For 70 days continuously she took 700 to 800 gr. of lean meat (for the previous cases too I always gave lean meat), a pair of eggs, a broth of 200 gr., and the usual quantity of wine. During this cure she did not change her habits in any way. Weighed after the cure, she was no more than 86 kg, and her sufferings had almost totally disappeared.

I add to my cases the following treated by my esteemed friend Dr. Guido Musiari.

11th Case. – Mr. Cotti Giuseppe of Noceto, 40 yo, 137 kg to 97 kg

11th Case. — Mr. Cotti Giuseppe of Noceto, aged 40, 1.88 m tall, weighs 137 kg; is not dyspneic, and it is surprising to see much agility preserved in his movements. This gentleman eats and drinks much, following which a strong dilatation of the ventricle was established. Three years ago, Mr. Cotti ingested a very strong quantity of ice-cold water, and immediately afterwards was seized by an epileptiform attack. The doctor thinking that the attack had arisen from a reflex fact (dependent on the ventricle), advised this man to follow a predominantly carnivorous diet, allowing only a very small quantity of bread, a small soup, meat at will, some eggs and a moderate quantity of wine; the patient has continued for almost three years to put into execution the prescribed diet, and in this time his body weight has diminished by 40 kg, that is, he weighs 97 kg. I note that this man used potassium bromide for a long time, the epileptiform attack still repeating from time to time, but Cottis mental faculties are not altered at all.

SUMMARY TABLE [Table showing 11 cases with columns for: Case number, Initial body weight, Diet used, Duration of cure, Final body weight, and Observations. The table details the results of the carnivorous diet treatment for each patient, showing significant weight loss and improvement in symptoms across all cases.]

From this exposition results:

1) 1st That the exclusive, or almost exclusive, carnivorous diet was well tolerated in all cases, and never gave rise to disturbances; indeed, the dyspeptics improved greatly in their sufferings, and the individuals, after becoming accustomed to it, suffered from flatulence when they returned to the ordinary diet.

2) 2nd That the carnivorous diet always produced a notable diminution of body weight, with improvement of the general state.It especially served to dissipate shortness of breath and all phenomena related to obesity of the heart and weakness of the respiratory muscles, for which Oertel so much vaunts his own method. Finally, I must add the singular observation, that in many of my patients the skin acquired through the use of meat a more intense color than it had before. Some of the men confessed to me that before the cure they also had impotence or almost impotence in coitus; after they became thin, they regained their virile potency.

Physiology gives us reason for these results, and supports them with its laws.

It is true that man can make use of all aliments, but it must be recognized however that the gastro-enteric tube is more conveniently conformed for animal foods, as in carnivores. Therefore, the carnivorous diet must be suitable for him. This moreover satisfies very well the norms to which any system of cure for corpulence must correspond, that is:

1st That the individual does not consume fats, or bodies capable of forming them, in quantity greater than that necessary for the maintenance of the body.

2nd That the individual consumes a part of the fat accumulated in the organism.

In the cases we have reported, the individuals consumed 700 gr. of lean meat per day, with slight addition of wine and other substances.

If we calculate with Voit that an adult man must, on average, introduce with food 18.3 gr. of nitrogen, in the form of albumin, and in total 328 gr. of carbon, the 700 gr. of meat are truly more than sufficient to cover the loss of nitrogen; indeed they give 23.81 gr. of nitrogen, instead of 18.3, but are totally insufficient to supply the 328 gr. of carbon. In fact, according to Voits calculations (Hermanns Handbuch der Physiologie, Bd. VI, pag. 407), it would be necessary for this purpose to eat 2620 gr. of lean meat. Let us also put in the calculation about 70-150 gr. of alcohol, contained in the wine consumed by these individuals, which, as was demonstrated by Albertoni and Lussana (On alcohol, on aldehyde and on wine ethers. Lo Sperimentale 1874), and recently repeated ad litteram by Bohland, copying the work of our compatriots without remembering it, burns almost entirely in the organism, and gives CO₂ and H₂O; nevertheless there always remains a notable deficit in the combustible carbon introduced, that is about half of the necessary, which must be covered by the fat previously accumulated in the organism, which is consumed, thus producing a notable diminution of body weight. Some of my patients did not truly show an increase beyond the ordinary in body weight and a large general deposit of fat, but instead showed well manifest the phenomena dependent on abnormal deposit of fat within the heart and respiratory muscles, whence shortness of breath and other related symptoms. Oertel justly calls attention to such a condition, and insists on the fact that his cure serves to dissipate it. I am pleased to note here that also in the cases reported by me a happy outcome was always obtained with the carnivorous diet. Regarding etiological conditions, heredity often plays a role in my patients. Few of them made use of truly superabundant food, although they belonged to the well-to-do class and had a certain alimentary budget of luxury. But in face of daily observation, that many persons with a luxury budget much greater than that of my patients, and not all of them, do not become obese, one is forced to admit for the development of such an affliction a particular disposition to the formation of fat from albuminoids and carbohydrates. It results finally that meat alone, when there is fat to burn, suffices very well to maintain life for months.

"Sir, - On Friday, January 8th, I read the account of Dr. Salisbury's treatment in the Pall Mall Gazette, and determined to try the effect of it in my own case. Seven years ago, I weighed 11 st. 12 lbs. (height, 5 ft. 9 in.), and when I trained for my college-boat I always lost five pounds. A month ago, I weighed 14 st., so I was at least two stone above my weight. If any of my lean brethren wish to know how I felt, let them put on a top coat with two stone of shot stowed away in the pockets, and wear it for a single day. When my friends congratulated me on my aldermanic appearance, their compliments were as gall and wormwood to my soul. If they had felt as I did, that the hills of life were growing steeper, and that the pleasure of living was contracting in a daily narrowing circle, they would have condoled with instead of congratulated me.

For the last six weeks, I have lived on lean meat and hot water, or its equivalent, and yesterday I weighed 13 stone. I have taken a pint of hot water (130° Fahr.) at 7 A.M.; a pint of "schoolroom-tea" with a squeeze of lemon in it at 11.30 A.M.; the same at 3.30 or 4 P.M.; and a pint of hot water (130° Fahr.) at 10 P.M.; a pound of beefsteak at 8.30 A.M.; a pound and a quarter at 1.30 P.M.; and a pound at 6.30 A.M. This has been hot, but preferably cold, and has been varied with hare, chicken, etc.

The result is this. I am a stone less in weight; I am six inches less in girth; my gouty "heirlooms," in the shape of "hereditary deposits," have disappeared; my flatulent indigestion has vanished; my mental and bodily activity have doubled; I spoke on Thursday for an hour with less effort than I did in December for ten minutes; I sleep for seven hours without moving; I can wear gloves and shoes a size smaller; I have lost my tendency to catch cold; my muscles are daily hardening; my kidneys are doing their duty nobly; my figure is altering so rapidly that my tailor is in despair, but I am triumphant.

When I have completed the course, if you will spare me room, I will finish my tale, and relate the lessons I have learnt in dietetics and therapeutics during the experiment. - Yours faithfully, Ben Rhydding, Leeds. JOHN FLETCHER LITTLE."

"It may safely be affirmed that all chronic diseases which afflict the human organism, aside from those arising from injuries, poisons, and infections, have their genesis and development in something we are doing every day; or at least, in something to which we expose ourselves at regulary and frequently repeated intervals. These various occurrences include drinks and food; the kind, condition and proportions of each used ; the state and rapidity with which they are taken in ; the intervals at which they are drunk and eaten, and the quantities of each consumed."

XXXII. DRINKS, FOOD, BATHS, EXERCISE AND CLOTHING ADVISABLE IN CONSUMPTION, 

Drinks. — Drink from half a pint to a pint of hot water, from one to two hours before each meal and on retiring, for the purpose of washing out the slimy, yeasty and biUous stomach before eating and sleeping. Drink a cup of clear tea, coffee or beef tea (the latter free from fat), towards the close of each meal, sipping slowly. During the interval, between two hours after, and one hour before each meal, drink hot water or beef tea if thirsty. 

Food Meats. —Eat the muscle pulp of lean beef made into cakes and broiled. This pulp should be as free as possible from connective or glue tissue, fat and cartilage. The " American Chopper " answers very well for separating the connective tissue, this being driven down in front of the knife to the bottom of the board. In chopping, the beef should not be stirred up in the chopper, but the muscle pulp should be scraped off with a spoon at intervals during the chopping. At the end of the chopping, the fibrous tissue of the meat (the portion which makes up fibrous growths) all lies on the bottom board of the chopper. This may be utilized as soup meat for well people. Previous to chopping, the fat, bones, tendons and fascife should all be cut away, and the lean muscle cut up in pieces an inch or two square. Steaks cut through the centre of the round are the richest and best for this purpose. Beef should be procured from well fatted animals that are from four to six vears old. The pulp should not be pressed too firmly together before broiling, or it will taste livery. Simply press it sufficiently to hold it together. Make the cakes from half an inch to an inch thick. Broil slowly and moderately well over a fire free from blaze and smoke. When cooked, put it on a hot plate and sea- son to taste with butter, pepper and salt ; also use either Worcestershire or Halford sauce, mustard, horseradish or lemon juice on the meat if desired. Celery may be moderately used as a relish. No other meats should be allowed till the stomach becomes clean, the urine uniformly clear and free, standing at a density of from 1.015-1.020, and the cough and expectoration so improved that they cease to be troublesome. When this time arrives, bring in for variety as side dishes, broiled lamb, broiled mutton, broiled game, broiled chicken, oysters broiled or roasted in the shell, boiled codfish (fresh or salt), broiled and baked fish free from fat, and broiled dried beef, chipped thin and sprinkled over broiled beefsteak to give it a relish. A soft boiled egg may be taken at breakfast occasionally with the meat if it does not heighten the color of the urine. 

Bread. — Bread, toast, boiled rice or cracked wheat may be eaten in the proportion of one part (by bulk) to from four to six parts of the meat. The bread should be free from sugar and raised with yeast. It may be made from gluten flour, white flour or Graham flour ; corn meal preparations should be avoided. All things not previously enumerated and the following articles of food in especial should not be eaten, viz. : beans, soups, sweets, pies, cakes, pickles, sauce, preserves, fruits, vegetables, greens, pancakes, fritters, crullers, griddle - cakes and mush. Vinegar should be carefully avoided.

Meals. —Meals should be taken at regular intervals, and it is better not to sit down at a table where others are indulging in all kinds of food. Eat alone, or with others who are on the same diet. After the system gets in good running order, which is indicated by the urine flowing at the rate of from three pints to two quarts in twenty-four hours, and standing constantly at 1.020 density, the appetite becomes good, and usually more than three meals a day are desired. This desire for food shoidd be gratified by allowing the patient a nice piece of broiled steak, with a cup of clear tea, coffee, hot water or beef tea, midway between the breakfast and dinner, and dinner and supper. If the directions here given are faithfully followed out and persisted in, consumption in all its stages becomes a curable disease.

All anodynes that disorder the stomach are to be rigidly avoided. No medicines of any kind should be taken, except such as are prescribed by a physician. The cure is accomplished by getting the system in splendid basic condition, Avhen the urine becomes clear and flows at the rate of three pints or more per diem, standing at 1.020 density, the appetite becomes enormous, and from two to four pounds of lean beef are eaten daily. The chills, fevers and sweats, growing- lighter, soon cease entirely. Blood-making processes go on rapidly ; the blood-vessels fill out; repair of tissues begins and steadily continues; the eyes brighten; the cough lessens by degrees; interstitial death, decay and disintegration of lung tissue cease ; the entire organism is pervaded by the glow of health, and step by step the patient (if he perseveres) advances safely and surely towards the goal of cure, to reach which, only patience and the strict observance of the rules here laid down are required. To accomplish this end, both diet and treatment are to be minutely and conscientiously carried out in all their details, with the soul and body of the patient firmly enlisted in the good cause. All this of course takes time, for it is Nature, after all, that does the work. Consequently all the changes must be physiological, and as such can only ensue as rapidly as the human machine — when well run — can organize and repair. 

The physician must know precisely what to do, and do it. He must watch his patient daily, scrutinize excretions, secretions and blood alike carefully, and see that every part of the programme is faithfully and honestly carried out. Any deviation from the right course can be at once detected by increased fermentation ; the consequent biliousness ; heightened color of urine ; aggravation of cough, and all the other pathological symptoms. Patients cannot deceive the physician sldlled in this field of positive work. If the directions are all rigidly followed, the machine will soon get to running nicely and continue to do so unless thrown off the track by deviations. Such departures should be at once detected and corrected, or the patient begins to lose ground. 

No one need hope to handle consumption successfully by change of climate or by medicinal remedies. It is a disease arising from long-continued, unhealthy alimentation, and can only be cured by the removal of its cause. This cause is fermenting food, and the products of this fermentation (carbonic acid gas, alcohoKc and vinegar yeast and vinegar) are the more miportant factors in developing the pecuHar pathological symptoms, conditions and states in this complaint, Avhich is generally and erroneously believed to be incurable. 

Consumption of the bowels can be produced at any time in the human subject, in from fifteen to thirty days, and consumption of the lungs within three months, by special, exclusive and continued feeding upon the diet that produces them.

XLV. SOME OF THE DISEASES PRODUCED BY TOO EXCLUSIVE FEEDING UPON AMYLACEOUS AND SACCHARINE FOODS AND FRUITS, WITH THE DIET TO BE USED FOR THEIR CURE. 

Vegetable Dyspepsia, or the first Stage of Consumption. 

This arises from the too exchisive and long-continued use of vegetable or amylaceous and saccharine foods and fruits, or either of them. The stomach is the first organ to suffer. In man this organ is mainly designed for digesting lean meats. It may be called a purely carnivorous organ. It requires lean meats to excite a normal quantity of healthy secretions in its glandular follicles for digestion, and the healthy excitation of these secretions stimulates the muscular fibres to maintain those normal downward peristaltic movements which are necessary for physiological digestion and transmission. The stomach does not digest amylaceous and saccharine foods, fruits and fats. These are digested by the secretions that are poured out into the duodenum by the liver, pancreas, and glands of Lieberkuhn and Bruner. Hence the too exclusive and long-continued use of vegetable, and especially amylaceous and saccharine food, fills the stomach with materials which do not stimulate it even enough to pass them along to where they are digested, in consequence of which they lie so long in this organ that fermentative processes supervene little by little, and we have the stomach filled with carbonic acid gas, sugar, alcohol, acid and alcoholic and acid yeast plants. These products of fermentation soon begin to paralyze the follicles and muscular walls of the stomach, so that it becomes flabby and baggy, and will hold an unusual amount of trashy foods and fluids. The organ has been turned into a veritable sour " yeast pot," and we have the first stage of the disease known as vegetable dyspepsia of the stomach, or the first stage of consumption. 

In this stage of the disease, the stomach is almost constantly distended mth gas, which is only partiafly relieved by the frequent sour eructations. 

Yeast plants are rapidly developed in the organ, and every particle of vegetable food which is taken in immediately begins to ferment, —the stomach being converted into an apparatus for manufacturing beer, alcohol, vinegar and carbonic acid gas. This carbonic acid gas soon begins to paralyze the gastric nerves, and the follicles of the mucous membranes of the organ commence to pour out a stringy viscid mucus, in considerable quantities. This, together with the partial paralysis, produces a relaxed, dilated state of the blood-vessels, so that a congestion (with a low state of vitality) results. The epithelial surfaces and connective tissue layer beneath them, then begin to mcrease in thickness, and if this process and state continue long enough, we have a gastric fibroid which may terminate ni scirrhus of the organ. If, however, the person is fairly active, so as to shake the food out of the stomach into the duodenum and small bowels, or if the pyloric valve becomes sufadently paralyzed to remain open, so that the food and hquids flow into the small bowels soon after being swallowed, then danger of gastric thickening is lessened : the patient feels much more comfortable and thinks he is greatly improved. The disease, however, is no better. It has simply changed its base of action and is transferred from the stomach to the small bowels. This is the second and most dangerous stage, bemg vegetable dyspepsia of the small bowels. 

The exercise, habits of living, eating and dnnkmg may be such as to detain the disease in this stage a long whfle. There is then great danger of the passage of Mycoderma spores (and the products developed by their multipHcation) into the blood stream. Should this occur, we are in the second or transmissive stage of Consumption. In this stage of the disease, the bowels are more or less constipated. Generally speaking, the more constipated they are, the greater the danger. 

An inactive, sedentary life, and a great disturbance of the bowels with carbonic acid gas and other yeasty products, may early paralyze the ileo-csecal valve so far as to let the fermenting products pass readily and freely into the large bowels. The danger of having the yeast spores transmitted is then lessened by the free passage of the spores into the colon, where they go on exciting fermentation in the various fermenting foods used. This soon results in many copious, yeasty evacuations during the night or early every morning and forenoon. Sometimes there are twenty or more passages daily. The passages are light and bulky, and have but little weight. They are sour yeast. This is the third stage of Vegetable Dyspepsia or Chronic Diarrhoea, or more strictly speaking, Consumption of the Bowels. The disease, if left to itself, and if the foods producing it are kept up, may run on for months or even years. I have treated and cured cases that had been running on for from fifteen to twenty years. 

In all cases of this stage of the disease, the large bowel becomes greatly thickened, and often in severe cases is almost entirely closed up. This thickening goes on quite rapidly in the connective tissue layer, and in the epithelial lining of the bowel. The folds of the bowel soon become greatly enlarged and are elongated from a few inches to a foot or more extra in length. If the patient lives long enough, and is on a curative diet, these folds and the thickening gradually disappear by absorption, though sometimes the elongated folds slough away partially decayed. Occasionally, in severe cases, from three to four years are required to remove all traces of the disease and all thickenings of the bowel. As long as the thickenings are present, there will be more or less of a thick, jelly-like, ropy, viscid mucus, coming- away every day . or every few days or weeks, according to the condition and severity of the disease. In consumption of the bowels, the lungs almost invariably become involved before death. Checking the diarrhea with astringents —while the fermenting foods are kept up —only aggravates the disease in the end and endangers lung invasion.

Summer Complaint in Children. 

The summer diarrhoeas in children are of the same character as the so-called Chronic Diarrhoea, previously described. It is essentially a disease of unhealthy or defective feeding, and readily yields to the simplest treatment, by removing the cause and substituting food that will not ferment with yeast. As soon as green vegetables and fruit begin to appear in early summer, children live almost entirely upon this kind of food at the expense of more substantial aliments. The same symptoms and pathological lesions, in the same order, result as has been previously described under the head of chronic diarrhoea, and the disease yields readily to the same treatment. 

Influence of Army Diet in Producing Diseases of Soldiers. 

In the army there is in all the men a peculiar chronic condition of the "alimentary membranes, excited by frequent fermentation of amylaceous matters too long retained, and which condition does not run on to chronic diarrhoea unless some enervating cause — such as over-fatigue, dysentery, typhoid, bilious, remittent or intermittent fever, or other cause —debihtates the system, and further impairs the condition of the alimentary membranes. This is evidenced by the almost universal condition of the alimentary canal in apparently healthy soldiers who are shot dead in battle. (See Eng. Surg, and Med. Hist, of Crimean War.) The follicles of the large intestines are more or less enlarged and frequently disintegrated, leaving ulcers. The amylaceous, army biscuit diet of the common soldiers, besides its fermentative and carbonic acid poisoning effects, does not furnish to the system the proper proportion of ingredients for healthy alimentation and nutrition. Hence a scorbutic condition results, which renders the disease an obstinate one to treat, unless this state is recognized and particularly attended to. This explains the reasons why the vegetable acids, combined with potassa and iron, are so useful in treating this disease. Rochelle salts are admirably adapted for exciting intestinal epithelial activity, and secretion and absorption in the alimentary canal. 

Any one kind of food too long continued has a tendency to produce systemic derangements of a scorbutic type. Amylaceous matters, too exclusively used, tend to excite abnormal actions in the parent epithelial cells of the mucous surfaces and of the glands ; while any one kind of animal food, too long and too exclusively eaten, produces derangements which show themselves more strongly in skin and mouth. A too free use of oils and fatty food, and of alcoholic beverages, produces the red, blotched face, and swollen carbunculated nose, oily surface, and erythematous swelling and redness of the skin generally. 

Salt meats produce a dry, scaly eruption upon the surface, with spongy, swollen and discolored gums ; loosened teeth, and a watery, flabby, often bloody tongue ; pains in the limbs and back resembling those of chronic rheumatism ; leaden-hued features ; offensive breath ; patches of extravasated blood in various parts of the body ; hard, contracted condition of the muscles ; stiffness of the joints ; diarrhoea and hemorrhage from mucous surfaces generally ; mental depression and indisposition to any kind of exertion. From this scorbutic condition —produced in all the men by the want of the necessary variety in their food —arises a long train of the most fatal and most obstniate diseases of the army. Among these may be mentioned chronic diarrhoea ; the so-called muscular rheumatism ; dysentery ; hospital gangrene in wounds ; tuberculosis ; fibrinous depositions iii the heart ; the clogging up of pulmonary vessels with fibrinous clots ; paralytic conditions and tendencies, and many of the diseases of the larynx, ear and eye. This condition of the system also renders it extremely subject (when exposed to the exciting cause) to typhoid, intermittent and remittent fevers. The vital powers are so depressed that the organism on light exposure to cold, is liable to be frostbitten and is strongly inclined to attacks of pneumonia and bronchitis, with diseases of the eye and ear. In short, the long list of army diseases may be traced, in great measure, to an extreme susceptibility to them, which susceptibility is produced by a want of the proper admixture of nutrient ingredients in the food of the soldier in campaigns. All authorities agree that scorbutic states arise from this cause, and no one having any experience in army diseases can fail to detect symptoms of scorbutus in almost every one of them. If they are not plainly visible in the apparently well man, they make themselves manifest in him as soon as he is placed under treatment for any disease, in the surprising benefit his system derives from the vegetable acid salts of potassa and iron, and from the free use of those articles of food of which his system has been deprived. Without this treatment almost all army diseases become obstinate to deal with, much more so than similar ones in private practice. In old cases of chronic diarrhoea, it frequently happens that the diarrhoea somewhat abates, the appetite becomes remarkably good and the patient fattens rapidly. His abdomen becomes hard and distended, it being either dropsical, tympanitic, or distended by enlarged viscera ; the whole surface becomes bloated and presents the appearance of having been affected by an excessive use of alcoholic beverages. The eyes become prominent, red and watery ; the thyroid glands become enlarged ; the heart gives marked evidence of fibrinous depositions internally (1 It has been noticed that in certain cases of heart disease tlie thyroid glands become enlarged, and the eyes prominent, watery and red. Whether there is any analogy between the condition of tlie symptom in this form of heart disease, and that productive of heart disease, chronic diarrhea, paralytic tendencies, etc. in the army, I am unable to say. I merely mention the circumstance here to draw attention in this direction.)