METHODS, VALUE AND LIMITATIONS OF THE KNOWLEDGE OF THE GASTRIC CONTENTS
Journal of the American Medical Association (JAMA)
still has an abundance of available protein in the nutritive fluids, and this is why it only gradually and only under the pressure of an excessive supply of food protein again acquires the original maximum store of this reserve material. Based on the above interpretation of metabolism and nitrogenous equilibrium, the so-called standard diets are unnecessarily rich in proteids. It is necessary to supply protein in the food in sufficient amount to provide liberally for the endogenous or tissue
... genous or tissue metabolism and to maintain a reserve protein in solution. If the blood is in need of tissue builders, the organism can rapidly assimilate large amounts of nitrogenous food. This is clearly shown in emaciated conditions following fevers, surgical operations, etc., for during convalescence there is often a ravenous appetite and a rapid increase in weight and strength with a corresponding retention of nitrogen. The main contention of Voit and others is that it is necessary to consume 118 gm. of proteid daily in order to maintain a nitrogenous equilibrium and at the same time preserve a condition of health and mental and physical efficiency. The experiments of Chittenden are so decisive that a proteid rich diet is proved not to be necessary. He is unquestionably right in the conclusion that the standard diet may be divided by two, as far at least, as the proteids are concerned. The practical results of the experiments of Chittenden are made more rational and clear by the researches and deductions of Folin. THE DAILY DIET. Chittenden maintains that the daily requirement is not only much less of protein than that recognized in the standard diets, but that the fats and carbohydrates also may be considerably diminished. We recognize the fact that the diet must differ for individuals, dependent on the occupation, the season of the year, the climate, etc. However, the modification in the diet will consist chiefly in the variation of the amount of fats and carbohydrates rather than a change in the quantity of the proteid. Folin has shown that physical activity does not cause a material tissue waste of muscle, for kreatinin is not appreciably increased in the urine by physical labor. The growing individual and the emaciated convalescent only can utilize a large nitrogen intake and retain it. The difference in the dietary of grown normal individuals will consist mainly in the fuel foods-the fats and carbohydrates. The achievements of the Japanese on a diet chiefly carbohydrate is sufficient proof that a high efficiency, both mental and physical, may be maintained on a low proteid and full fuel diet. If a large proteid diet is unnecessary, is it also detrimental? In the light of the theory of exogenous metabolism of Folin, an excess of proteid furnished with the food is normally rapidly converted into harmless urea and is quickly eliminated by the kidneys. The excessive production of uric-acid, xanthin bases, kreatin and other so-called extractives is looked on as the cause of gouty and other so-called autointoxication diseases. The excessive production of these substances is usually ascribed to an excess of proteid consumed. These substances are the result chiefly of the endogenous metabolism, and, scientifically speaking, have no relation to an excess of protein, for that substance is converted into harmless urea. However, the meats contain considerable extractives or substances out of which they may be formed, and therefore an excess of concentrated protein food in the form of meat may result in such an autointoxication. The continued excessive use of protein may lead in time to the accumulation of a larger amount of reserve protein than the organism can retain in the fluid media. The continuous presence of such a large unnecessary supply of unorganized reserve material may weaken one or all of the living tissues. We are the creatures of habit. With palates craving for new sensations and the prevalent belief that hearty eating promotes health and strength, it is no wonder that we eat too much. It is proper, too, that the pleasures of the palate should be gratified. The pleasure which eating affords promotes digestion. Bolting does not permit proper enjoyment of food. Thorough mastication undoubtedly makes the palate more discriminating and serves as a check to overindulgence. Chittenden says: "Physiologic economy in nutrition means temperance and not prohibition. It means full freedom of choice in the selection of food. It is not a cereal diet nor vegetarianism." Practical application of the newer ideas of metabolism and nutrition to diets in disease could be readily made, but are outside of the limits of this paper.