Part 10

Diabetes.--There are two more or less distinct stages of this serious trouble; the first stage is generally curable, the second stage generally incurable. Yet good natural means of cure will very much alleviate even the incurable stage. The earlier as well as the later stages are marked by extreme _thirst_. This, in the case of some poor sufferers, is enormous. Gallons of water are taken, and the more is taken the more is wanted. But this thirst is not the effect of heat, as fever thirst is. It cannot be quenched by means of cold cloths often changed over the stomach, as fever thirst can. A sufferer in this disease will set a large pitcher down at the bedside to serve for the night, and drink it all before morning; but there is no extra heat anywhere to account for this. The thirst is more like that which is caused by eating very salt food. It points to the character of the juices which are affecting the stomach, and not to any heated condition of the stomach itself. The drinking is a desperate effort to dilute these juices; and, at least by cold water, that cannot be done. A wineglassful of hot water taken every ten minutes for an hour, or two hours, or three, or ten hours, as is felt to be comfortable, will do wonders in the early stages of this disease. This water, when taken at the right heat, at once mixes with the strongly concentrated juices of the stomach, and causes them to be easily managed by that and other organs. It is truly wonderful what this very simple remedy will effect by itself alone. The next thing to be noticed is the excessive hunger. The food, whatever it may be, fails to quell this hunger. Here, again, it is clearly the stomach with which we have to do. When the hunger is developed we should think the case further advanced than when thirst alone is experienced. The hot water meets this symptom as it meets the other. It is also of the very greatest moment to give right food. Oatmeal and buttermilk steeped together for a time and then moderately boiled, a very little salt or sugar being added, produces a food which we do not expect to see excelled by the most costly that can be got anywhere. Wheaten meal, or barley meal, will do as well as, and perhaps in some cases better than, oatmeal, but these may be chosen according to taste. The chief thing is the ease with which this food is converted into a large supply of the best of blood for all purposes of nourishment. Food containing much starchy matter, as white bread, rice, and all sugar, must be forbidden. To make up for this, an abundance of fat should be consumed. The bowels should be kept open by a suitable diet and exercise.

Now we come to the excessive urinary discharge which is so strong a feature of this disease. The body seems as if it were melting away in this.

We can benefit the kidneys vastly through acting on the liver, as well as on themselves. By a large hot bran poultice over the liver we can add new life to that, and whatever does so tends to benefit the kidneys. After using this large poultice, with plenty of oil rubbed on before and after, say three or four times, place it over the kidneys and use it as often there. If the heat is well kept up for an hour at a time, one poultice a day would do, but, if the patient desires it, twice a day will be all the better. It is good to do the best that can be done with the skin. By means of soap and oil rubbing, and the cleansing effects of diluted acetic acid, very considerable help may be gained. Good can be done by a hot fomentation of the feet and legs to the knees, with oiling after, so as to have these extremities in a comfortable state. Tea, coffee, and sugar _must be avoided_.

Diarrhoea.--Sudden attacks of this, though in a mild form, are very troublesome. An enema of _cold_ water is in such cases often an immediate cure. The first injection may be followed by even an excessive motion, but if a second cold injection be given this will cease. But in more troublesome cases, where the patient is an infant, or very weak, this is not applicable. For such cases, mix equal quantities of honey and lemon juice (one or two teaspoonfuls of each), and add enough boiling water to dilute it for taking. Give this three or even four times a day. It will usually and speedily cure, and is relished by infants.

Often the cause of diarrhoea in infants is the infection of milk by flies (_see_ British Cholera), or from dirty feeding bottles. Bottles with tubes should _never_ be used. The india-rubber teat should be smelt to see that it is perfectly sweet and clean before the bottle is filled. Unsuitable or too rich food will bring this trouble on.

A tablespoonful of blackberry (or brambleberry as it is also called) jelly may be given--it is a powerful and simple remedy. In adults, a dose of castor oil, with a few drops of laudanum in it, will probably remove all trouble, if it be due to nothing more than indigestible food. Where the cold enema is dreaded, one of hot thin starch, with fifteen drops of laudanum in it, may be used for adults.

Stale vegetable or animal food, also impure water, are fruitful sources of diarrhoea.

The mind has a great effect on this trouble, anxiety and worry are frequent causes. _See_ Worry. A comfortable seat by the fire, and an interesting book, will often relieve.

When the diarrhoea is very serious, use the four-ply flannel bandage. _See_ Bandage; British Cholera; Dysentery.

Diet.--The composition of different articles of food varies. A turnip is not the same as a piece of cheese. It is more watery, and has more fibre in it, and we speak of it as less nutritious. There are, however, in almost all foods certain chemical substances present which have different duties to perform in the body, and which are present in widely different proportions in the various articles we use for food.

_Water_ is the most common of these substances. Soups, vegetables, fruits, puddings, are largely water. Some foods contain less of it than others, but on the whole a very large, if not the largest, part of all food consists of water. This large amount is needed. Water makes up two-thirds of the body, and nearly two quarts are given off daily in the various excretions and secretions. If enough be not taken the tissues get dry, and Nature indicates her want in thirst.

Another of these substances is _starch_, or its equivalent, sugar. Rice, bread, and vegetables in general, are largely made up of this starchy or sugary substance, which, as it contains a considerable quantity of carbon, we speak of as the _carbonaceous_ element in food. This is the substance which goes to feed the muscles, replacing the waste from work done, just as fuel is required for the fires of an engine.

Yet another substance in food is _fat_. It may be animal, such as beef or mutton fat, and butter, or vegetable, as the oils in nuts, in the olive, etc. Fat, like carbonaceous food, also goes to feed the muscles, but both are required in a healthy diet.

Of the first importance, however, is the _proteid_ element in food. Meat, milk, cheese, eggs, peas, etc., contain proteid in considerable quantities. Its use is to repair the exhausted tissues themselves. The muscles and nerves get worn out in their daily work, and require rebuilding. This is what proteid goes to do, and from this, its high import in animal economy, is called Proteid (protos--first). Finally, in all natural foods there are certain _salts_, which also build up, _e.g._, lime, which goes to make up bone. These salts may be seen in the ash of any common vegetable after being burnt.

These four kinds of food substance make up our daily food, and a certain amount of each substance is required to replace the daily expenditure, a proportion which varies, however, under different circumstances. _See_ Food in Health.

As the relative amount of proteid, carbonaceous matter, water, and salts, may vary considerably in different articles, we rightly have combinations of food at our meals. A pudding of corn-flour and water contains no building material, hence we add milk and eggs, which do. A meal of meat and cheese requires bread and potatoes, etc., etc.

Appetite is a good test of the amount and also of the particular kind of food required, provided the appetite is in a healthy condition. If a healthy man refrain from carbonaceous foods for a day or so, he feels a great longing for them, a sign that the body really needs them. It is of immense importance, then, that the appetite should not be accustomed to over-indulgence, for then it is no guide in our selection of foods (_see_ Appetite). If disease indicates such over-indulgence, food should be restricted till the appetite is accustomed to a smaller diet. Bilious people, for example, may have accustomed their appetite to desire more carbonaceous and fatty foods than necessary. On the contrary, badly-fed people often require a coaxing of the appetite to eat strengthening foods, such as oatmeal, cheese, and brown bread.

In order to regulate our diet, it is of importance to have some idea of the composition of common articles of food. We get our food, as everybody knows, from the vegetable and animal kingdoms. The majority of the Anglo-Saxon race live on a diet of animal and vegetable combined, but many exclude flesh from their diet. In Southern Asia, for example, the vast bulk of the people rarely, or never, touch meat. The vegetable kingdom supplies us largely with the carbonaceous or muscle-forming food, whereas the animal kingdom is rich in proteid, or tissue-forming food. Much proteid, however, can be obtained from the vegetable kingdom--peas, beans, lentils, dried fruits, and nuts being particularly rich in it. We should endeavour to cultivate an appetite for these vegetables containing proteid, as it is a great mistake to rely entirely for this element on meat, as so many of our race do. The animal products--such as cheese, milk, and eggs--will also form an efficient substitute for much flesh-food. This simple diet suits both the brain-worker and the athlete, though each will have to make a selection of those foods most required by him. Certainly much animal food is liable to produce kidney disease, gout, and kindred troubles. If we have a tendency to corpulence (and many have this in advancing years), to resort to an exclusive meat diet will produce these troubles. Far better abstain from vegetables, such as potatoes, and from sweet dishes, pastry, etc., and eat largely of the green-leaf vegetables and fruits with the articles of a simple diet which build but do not fatten the body. (_See_ Diet and Corpulence; Diet for Middle Age, and the Aged.)

Fruit is a very useful article of food. The acid helps to keep the blood alkaline (which alkalinity is necessary for the normal performance of its functions). It prevents acidity of the stomach. The dried fruits, such as dates, figs, raisins, are very rich in proteid. Nuts also are rich in proteid and in fat; they require, however, careful mastication. Mills can be purchased cheaply for grinding nuts; the ground meal, either alone or made into a cream, forms a delicious adjunct to stewed fruit.

Green vegetables are a much neglected food. The salts they contain are very useful. They require careful cooking. A cabbage boiled in the ordinary way loses in the water its valuable salts. In case of flatulence arising from indigestion, the use of vegetables may, however, require to be restricted, at least for a time. Some vegetables are palatable raw, such as salads and celery. Indeed, raw vegetables have a tonic effect on the bowels.

Bread should never be too fresh, and should be thoroughly chewed. Zwieback (twice baked) can be recommended, especially for those who suffer from indigestion. It is made by cutting bread, preferably wheaten, in thin slices, and putting these in a slow oven till thoroughly dry and lightly browned. Wholemeal bread should always be present on the table, as its use prevents constipation. Indian corn can be made into a number of palatable cakes, and is a very nutritious food. Home-made jam and honey are digestible forms of sugar, but like all sugar foods should be consumed in moderation, especially by sedentary individuals. Condiments should be avoided, the healthy appetite is better without them, and they irritate the stomach.

Regarding animal foods, they are often spoilt by over-cooking, and it should be remembered that when lightly done they are easiest to digest. White fish, tender steak, or juicy joint and cutlet are superior to the oily fish, and kidney, liver, and heart. These internal organs should be avoided, as they contain even more than the rest of the animal certain extracts liable to produce URIC ACID (_see_). Milk, cheese, eggs, and butter are not open to these objections. Cheese is a food very rich in proteid. It requires careful chewing, and may with advantage be grated before use. Buttermilk is a valuable and strengthening food. A generation or so ago the Scotch peasants lived almost exclusively on buttermilk and oatmeal, and were a magnificent type of men in every respect. Whey is a pleasant drink, and may be made a substitute for tea where the latter is prohibited. It is also beneficial for the kidneys. Jellies are a pleasant addition to the diet of convalescents, but have little nutritive value.

We would strongly urge upon our readers the advantages of simple diet. We mean by this the avoidance of all those rich and spiced dishes which are made up in so many ways to tempt the appetite, of alcohol in every form, of meat to the extent often consumed by the well-to-do, of pastry and such indigestible food as heavy cakes, of fried food in general; and, on the other hand, the adoption of a diet largely consisting of milk, cheese, eggs, butter, cereals, root and green vegetables, fruits, and nuts. It will not be found an expensive diet; on the contrary, it is remarkably cheap; it will give little trouble, for but little cooking will be needed. It may require some little effort at first, and some breakings with social customs, but far less of both than will be imagined. Seeing that a large part of disease is ultimately traceable to a rich and stimulating diet, and to too much food in general, simplicity is imperative on all who seek for the preservation of health. Eat less, eat better (or more slowly, with perfect mastication), eat simpler foods at your meals, eat at these meals only when you require it, and never between your meals. Such eating will ensure good digestion, good assimilation, good blood, and good health.

Diet and Corpulence.--A tendency to obesity should always be carefully checked by attention to diet and exercise (_see_ Exercise). The fattening foods are those which contain either fat or carbonaceous substances. Carbonaceous substances are found in bread, sugar, arrowroot, puddings in general, pastry, potatoes. The fats, such as butter, cream, and animal fat, should be much restricted in their use. As we have above indicated, however, it is not wise, as many corpulent people do in their efforts to get rid of this superabundance of fat, to make up for their restriction by an increase in the quantity of meat consumed. Cheese, peas, beans, buttermilk, and oatmeal might with advantage be drawn upon instead. At the same time, if the circulation is good it is well with such proteid diet to increase the amount of water drunk during the day, as this helps to eliminate the waste which would otherwise overtax the kidneys. Green vegetables and fruits should form a large part of the diet.

It must be remembered that it is dangerous to strike out at once all fattening foods from the diet; many have injured their health permanently by such injudicious haste, and brought on floating kidneys, etc. Remember, also, that exercise is a much safer reducer of fat than a very great reduction in diet, unless there has been a decided tendency to continually overeat. All alcoholic beverages must be strictly forbidden.

Diet for the Lean.--To a large extent the preceding article will suggest what is suitable here, remembering, however, that regular exercise will be also necessary in order to enable the muscles to increase in size. Green vegetables and fruits should be largely used in addition to the carbonaceous foods, as their FOOD SALTS (_see_) are necessary to keep the blood in a condition to allow of proper assimilation. In the case of nervous and consumptive patients, the more digestible forms of fat, such as cream and butter, are to be recommended. Some thin people do not seem able to assimilate much fat. These cases will do better on a smaller quantity. Remember always that it is not what is eaten, but what is assimilated, that goes to increase the weight, therefore if any particular food is found, after a careful trial, to constantly disagree, it must be accepted that for that one at all events, it is not a suitable article of diet.

Diet for Middle Age and the Aged.--In advancing years when less exercise is, as a rule, taken, a restriction in the amount of food consumed is highly desirable. The increasing corpulence, which often begins to show itself from 30 to 40, is far from being a healthy sign; indeed, is often the premonitory symptom of serious disease. It should be remembered that a lessening quantity of food is required from middle life on. This applies to all the elements of food. It is noticeable that a fat person seldom lives to old age, most octogenarians being thin and wiry, and almost all attribute their long life to increasing watchfulness over their health, and largely over what they eat.

When a person is young and taking active exercise, a good deal of surplus food can be worked off, and if the excess be too great, a bilious attack tends to prevent any more being taken, for a time at least.

But as we get on in life, the surplus food, if much is eaten, is deposited in various parts of the body as fatty or gouty accumulations. The liver becomes deranged, and loss of health and strength are at once apparent.

It is then, as Sir Henry Thompson has well pointed out, that the fond but foolish wife often does her husband incalculable harm by her efforts to "keep up his system." She urges and tempts him to take more food, fetching him, between meals, cups of beef-tea, soup, or cocoa, when he really would be greatly the better of total abstinence from all food for several days. What we have said about appetite being the best guide applies to the old especially, and if they could but realize what a very small quantity of food is necessary, they would not be perturbed to find that their appetite guided them to eat very much less than at a younger age.

Milk, which is the ideal food for the very young, is for that reason often undesirable for the old, and it is a great mistake for such to drink much of it with solid food.

Diet for the very aged becomes mainly a question of invalid diet, and it must be remembered that much should be granted to the individual's choice and liking. All foods for the aged should be light and easily digested, and careful attention paid to proper cooking.

A striking example of lost health recovered and life and activity prolonged to a great age, by strict temperance in food, is Cornaro, a Venetian nobleman of the sixteenth century, who lived over 100 years. He says:--"Our kind mother Nature, in order that old men may live to still greater age, has contrived matters so that they should be able to subsist on little, as I do, for large quantities of food cannot be digested by old and feeble stomachs. By always eating little, the stomach, not being much burdened, need not wait long to have an appetite. It is for this reason that dry bread relishes so well with me.... When one arrives at old age, he ought to divide that food of which he was accustomed to make but two meals into four, and as in his youth he made but two collations in a day, he should in his old age make four, provided he lessen the quantity as his years increase. And this is what I do, agreeably to my own experience; therefore my spirits, not oppressed by much food, but barely kept up, are always brisk, especially after eating, nor do I ever find myself the worse for writing immediately after meals, nor is my understanding ever clearer, or am I apt to be drowsy, the food I take being in too small a quantity to send up fumes to the brain. Oh, how advantageous it is for an old man to eat but little! Accordingly, I, who know it, eat but just enough to keep body and soul together."

Digestion.--Digestion is the process whereby the food we eat is turned into material fit to be assimilated by the blood. It begins in the mouth by the mechanical grinding and crushing of the food, and the chemical conversion of the starchy part into sugar, in which form alone it can be assimilated. This conversion is carried out by the saliva. Hence the necessity for thorough mastication, even of sloppy foods that do not seem to require it, and for attention to the teeth in order that they may thoroughly chew. Alcohol and tobacco, as they spoil the saliva, are very unfavourable to digestion, and should always be avoided. Twenty minutes longer to chew one's dinner is worth a whole box of pills, and no one need expect good digestion who neglects thorough chewing and salivation of the food. This may, with advantage, be increased to an extent which most people would think quite absurd. It has been proved that when all food is chewed until completely reduced to a liquid, its nutritive qualities are so increased that about half as much will suffice. This is of immense importance in all cases of weak digestion, or indeed whenever an absence of vigorous health renders the economy of vital energy important.

[Illustration: Digestive System.]

In the stomach the food meets with the gastric juice, which has the property of turning proteid (_see_ Diet for the various substances contained in food) into material ready for assimilation. The walls of the stomach are muscular, and their contraction churns the food with the juice. The gastric juice is secreted by glands embedded in the walls of the stomach, and is poured out when food is taken.

The whole food, now in the form of a paste, passes into a pipe about 12 inches long (the Duodenum), into which pours the secretion of the pancreas and that of the liver (bile). The pancreatic juice acts upon the starch which has escaped the action of the saliva, and also continues the work of the stomach. It furthermore emulsifies the fat or divides it into extremely fine drops.