Popular Science Monthly/Volume 66/March 1905/Stamina

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STAMINA.[1]
By Dr. A. N. BELL, A.M.,

BROOKLYN, N. Y.

ANALYSIS of vital statistics for the last three-quarters of a century shows an average increase in the duration of human life among civilized peoples from 42.2 years to 48.5 years. The chief increase has been during the latter half of that period, and, for the most part, by the reduced mortality from zymotic diseases, but, above all, from pulmonary tuberculosis, from which the reduction of mortality has been nearly fifty per cent.

Inquiry with regard to the means by which this reduction has been effected, shows it to have been almost wholly by sanitary efforts; by dealing with and destroying unsanitary surroundings, soil-drainage, purifying water supplies, reporting and restricting communicable diseases, sanitary supervision of schools, the destruction of sputum—the now everywhere recognized fountain-head from which the army of bacilli is perpetually reinforced—abolishment of cellar-dwellings, diminished overcrowding, cleanliness, disinfection, isolation and aeration; improved tenements, opened-up and wider streets, public parks and recreation grounds and establishment of sanitaria. This catalogue of sanitary efforts might be still further extended, though altogether without record of special effort for improved nutrition except for nursing infants.

Communicable as all competent observers know tuberculosis to be, while they equally well know that it is not so under all circumstances, it is indeed questionable whether any one of sound constitution and well nourished has ever contracted the disease from nursing consumptives, or from living with them otherwise, under good hygienic surroundings.

On the contrary, no matter how healthful the surroundings or the salubrity of the atmosphere, for poorly nourished and feeble persons, from whatever cause, there is no immunity from tuberculosis. For no one who even approximately comprehends the universality of microbic life—and of none more than tubercle bacilli—can fail to perceive that, however much we may be able to modify the external relations bearing upon liability to tuberculosis, nevertheless every individual, no matter where his dwelling place, is more or less subject to tubercle bacilli; for, besides the utmost restriction of their prevalence by sanitary effort, unless the individual is possessed by an organism sufficiently fortified to resist and overcome conflict with them—for the conflict is certain everywhere—he is liable to contract tuberculosis. Hence it is that about one quarter of all the deaths recorded of mankind during adult life, is caused by tuberculosis, and nearly one half of the entire population, at some time in life, acquires the disease.

Tubercle bacilli are, indeed, abroad everywhere, a constant menace and challenge to one's power of resistance. Every intelligent person knows that the power of resisting the ordinary exciting causes of illness, such as sudden changes of temperature, exposure to damp soil, room or sheets, or night air with the windows closed, depends upon one's state of health. The power of resisting tubercle bacilli is no exception.

Health fortified by such conditions as the organism depends upon for its fabrication and maintenance opposes itself to all exciting causes of disease by the relative integrity, strength and vigor of all the organs and functions of the body. A person thus equipped, if beset by tubercle bacilli or other microbes, effectually resists them, devours them by oxidation and casts them off.

Feebleness, on the contrary, though not always appreciated, and sometimes cultivated, indeed, by the practise of that altogether too popular fad, abstemiousness, is always and everywhere a prevailing 'predisposition' to disease; and, associated as it commonly is with inadequate nourishment, it is the most frequent of all incitants to tuberculosis. Abstemiousness, however, is variable in its practise, and uncertain; one may over-eat and yet abstain from some essential food necessary for the maintenance of health. Adequate nourishment and stamina depend upon the supply of nutriment in the kinds and proportions required by our bodies. Food is required for a two-fold purpose; (1) to supply material for the construction and repair of tissue, and (2) to supply fuel for its maintenance, the production of heat and energy.

It is not necessary to our present purpose to pursue the subject of the origin and nature of food in its general sense, but to emphasize the importance of the essential elements of food comprehended in the various organic and inorganic compounds of which food consists, as follows: Carbon, hydrogen, oxygen, nitrogen, sulphur, phosphorus, chlorin, iodin, potassium, calcium, magnesium, sodium and iron.

It is not by any means necessary that a food should yield all these elements, indeed there is but one such food—milk—that is complete in this respect, and perfect, upon which the young of all mammalian animals are, or should be, for a time exclusively nourished. Neither is it essential next following the period of nursing, that every food should be broken up, or 'refined' to facilitate its assimmilation and combinations in the structures of the body, since the functions of the organism are adapted to these processes.

Unfortunately for the infant, however, it frequently happens that after weaning, and if it has been nursed by a healthy mother, or other wet nurse, being well fed on two or three pints of wholesome milk, daily, its food supply is reduced by substitution of one kind or another, more or less devoid of essential elements, with the common result of emaciation and tenderness, and increased liability to sickness. Moreover, as said by Dr. William H. Maxwell, Superintendent of Public Schools of New York City and president of the National Educational Association, in his address at the International Congress of Arts and Science, September 23, 190-1:

Education, whether physical or mental, is seriously retarded, if not practically impossible, when the body is improperly or imperfectly nourished. The child of poverty, with body emaciated, blood thin and nerves on edge, because he has not enough to eat, grows up stunted in body and in mind.

What a farce it is to talk of schools providing equal opportunities for all when there are hundreds of thousands of children in our city schools who can not learn because they are always hungry!

The schools of Paris provide a simple, wholesome midday meal for their hungry children. In many places in the British Islands the same thing is being done. Should we do less in the cities of democratic America? In no other way can we be sure that the schools will, as far as education may, provide equal opportunities for all.

With regard to certain infectious diseases to which children are especially liable, in part, doubtless, because of their greater functional activity, but chiefly because their power of resistance has not yet become sufficiently fortified—for it is well known that adults generally who have not encountered those diseases in childhood rarely contract them subsequently—the same relative immunity exists; the strong and vigorous child is much less likely to contract them than the feeble; and the convalescent, those who are particularly feeble from any one of such diseases, are well known to be the most of all liable to attack and to succumb from another. And of pulmonary consumption, the most prevalent and the most fatal of all diseases, who does not know that enfeeblement invites it? That individuals are less and less liable to it—whether traceable to hereditary taint or otherwise—in proportion as coddling has been avoided, appetite for wholesome fat food cultivated, cold bathing habitual, protective but loose clothing worn, and exercise in the open air unrestrained? By the maintenance of these conditions all the processes of healthy organization are promoted and the constitution fortified against tubercle bacilli, as, in like manner, against other disease germs, no matter whence the quarter or at whatever the age of the individual exposed; and no less against diseases not attributable to germs—and the more if we accept Metschnikoff's theory of the office of the leucocytes or white blood corpuscles, for these in both number and strength depend upon proper nourishment. 'In health' says Kirke, 'the proportion of white to red corpuscles, which, taking an average, is about 1 to 500 or 600, varies considerably, even in the course of the same day. The variations appear to depend chiefly on the amount and probably also on the kind of food taken, the number of leucocytes being very considerably increased by a meal, and diminished again on fasting. Also in young persons, during pregnancy, and after great loss of blood, there is a large proportion of colorless blood corpuscles, which probably shows that they are more rapidly formed under these circumstances. In old age, on the other hand, their proportion is diminished.'[2]

No good observer will fail to recognize the coincidence of the condition which diminishes the proportion of leucocytes and the increased liability to disease—that of fasting; or note the no less remarkable coincidence, the diminution in the number of leucocytes and increasing infirmity of old age.

Foods are ordinarily divided into four classes: (1) Nitrogenous or albuminous substances; (2) fats or hydrocarbons; (3) carbohydrates, chiefly starchy substances and sugar; (4) mineral substances—water and salts.

The average daily amount of food required and of the different kinds, as comprehended in this classification, severally, varies considerably with individual conditions of age, size, exercise, circulation, activity of the eliminating organs, etc. The range in different male adults is from 34 to 46 ounces of so-called solid food, and from 70 to 90 ounces of water in some form, taken with and without solid food. For adult females, the average is from 3 to 5 ounces less. For children and youths, proportionally, more in the inverse ratio to age, 0.8 to 0.6 ounces for each pound weight of the body.

If individuals are undergoing great exertion they require more food, and, if they can obtain it, the needful increase is especially in the nitrogenous and fat foods.

Every structure in the body in which any form of energy is manifested (heat, mechanical motion, chemical or electric action, etc.) is nitrogenous. The nerves, the muscles, the gland-cells, the floating cells in the various liquids, the semen, and the ovarian cells, are all nitrogenous. Even the non-cellular liquids passing out into the alimentary canal at various points, which have so great an action in preparing the food in different ways, are not only nitrogenous, but the constancy of this implies the necessity of the nitrogen in order that these actions shall be performed; and the same constancy of the presence of nitrogen, where function is performed, is apparently traceable through the whole world. Surely such constancy proves necessity. (Parkes.)

The average daily quantity of fat required by an adult to keep up healthy nutrition, according to various estimates, is two ounces, and proportionally more during the period of growth, after weaning—from half an ounce to two ounces.

1. A supply of fat, per se, to the blood is essential for histogenesis and for the protection of the tissues, and is also of importance for general use as a source of heat and mechanical force.

2. The carbo-hydrates and albuminoids may supply heat and mechanical force, but they can not take the place of fat in histogenesis and protection of tissue.

3. Fats may be supplied by absorption into the portal system, by absorption into the general lymphatic system, and by absorption into the lacteal system. But the latter is the means by which the principal supply of solid fat is carried into the blood, and is the most important.

4. The mean consumption of oxygen by an adult man of average stature (weight, 150 lbs.), taking ordinary exercise, is about thirty ounces in the twenty-four hours, and the heat evolved by each ounce of oxygen in combining with carbon, hydrogen, etc., is about 350 British units. Hence, 10,000 British units of heat will be evolved every twenty-four hours by the combination of thirty ounces of oxygen with carbon, hydrogen, etc.; therefore, the food of an ordinary adult man under ordinary circumstances, should be such as may, in addition to other purposes, evolve at least 10,000 British units of heat.

5. Practical experience in the dieting of large numbers of men, and other means, have enabled us to establish the fact that such an average man as I have spoken of requires for the maintenance of health, a diet which shall contain about four ounces of plastic material, three ounces of fat and ten ounces of carbohydrates; and, on careful analysis of this diet, we find that it can supply the required 10,000 British units of heat, viz., 2,516 from the plastic, 3,357 from the fat and 4,150 from the carbohydrates, total, 10,023.[3]

Fat, as an article of diet, furnishes the potential force necessary for the conversion of other food material into organic tissue and to maintain the bodily functions.

Professor W. O. Atwater, in one of his most important contributions to the Department of Agriculture,[4] on the nutritive value of foods, in comparing nutrients in respect to their fuel values, their capacities for yielding heat and mechanical power, states that 'a pound of protein lean meat or albumen of egg is just about equivalent to a pound of sugar or starch, and a little over two pounds of either would be required to equal one pound of the fat of meat or butter.'

The mistake commonly made with reference to the use of fat food is, that it is only, or especially, applicable to cold climates—an erroneous inference, the same as that cold is preventive of tuberculosis. That fat is the almost exclusive food in Arctic regions is because other food is not obtainable, not because of the frigid climate. It is necessary food, though not in such excess, at all times and everywhere, to supply the potential energy required by the organism to construct the tissues and maintain the body, the temperature of the body being about the same in all climates. Fat does not stand alone in this regard, except under such extraordinary circumstances as those referred to. Carbohydrates of various kinds contribute to the same functions as fat, under ordinary conditions, but they do not suffice to maintain the stamina of the organism to the highest degree anywhere without the assistance of, or being supplemented by, some kind of fat.

A correct appreciation of the benefit of fat food in the Arctic regions serves as an index to its advantages under other conditions. It is not limited to blubber, 'toodnoo' or oil, even among the Laplanders. It includes the solid portions of reindeer, seal and other meat. And this in its composition doubtless compares favorably with the choicest cuts of beef and mutton, which consist of 20 to 30 per cent, of fat; or possibly with good bacon or ham, 35 to 50 per cent. Good butter, it need hardly be said, is almost wholly fat—85 to 90 per cent.

Of approximate stamina and exemption from tuberculosis, it is not far fetched to refer to the history of most of the North American Indians, before the cultivation of cereals was introduced by the white settlers. Their food was almost exclusively the fat game which they hunted and killed in such a manner as to retain the blood. Of the wonderful physical strength and endurance of those savages, their history of them furnishes many examples. And the earliest records of consumption among them are contemporary with the attempted methods of civilizing them—inducing them to leave their tents and live in houses; restricting their game supply and supplying them with an excess of farinaceous food. They have ceased to be a hardy race and tuberculosis is common among them. The Gauchos of the South American pampas, who live almost exclusively upon fat animal food, are alike remarkable for their extraordinary stamina. The flesh-eating Mahometans of India are described by historians as being the most powerful, active-minded and hardy race of human beings in the world, presenting the widest possible contrast in physical development to the rice-eating and feeble Hindoos, of whom but few reach the age of forty years.

A striking example of what appears to be the result of a change from an almost exclusive fat meat diet to one largely farinaceous, in relation with tuberculosis, is afforded by the history of the New Zealanders, who, until about fifty years ago, were cannibals, eating their captives in war, but who besides consumed an enormous amount of fat pork. Dogs also composed a part of their dietary, and fish to some extent. They were remarkable for their physical development and exemption from tubercular diseases. But soon after the introduction of the potato as a staple food, at about the time mentioned, scrofula and other forms of tuberculosis began to prevail among them, and have attained a degree of prevalence even greater than among the poorest people in Ireland, where the staple food is of the same kind, but beneficially supplemented to a considerable extent by the use of buttermilk.

Moreover, I have observed among people in the tropics, as well as in temperate latitudes, that there is a marked difference in the health of persons whose chief food is farinaceous, between those who but rarely eat anything else and are particularly feeble, lymphatic and scrofulous, and those who eat butter or oil with their rice and similar food, or supplement it with sardines in oil, or oil-dressed salads.

Recurring to what I have remarked on the superiority of meat that retain the blood as well as the fat, every epicure knows, and every physician ought to know, that the meat of animals of every kind so killed as to retain the blood is more delicious than that of animals otherwise killed. It is also more digestible and more nutritious. All fresh meat is more or less acid, and that from which the blood has been drained requires to be kept until alkalinity is induced by incipient decomposition before it becomes tender and digestible. On the contrary, that which retains the blood only requires thorough cooling before it is ready for cooking and is tender and digestible from the outset, because the alkalinity of the blood speedily acts upon and neutralizes the acid. Hence, the meat of the buffalo, as it used to be killed and prepared by the North American Indians; the jerked beef of the Gauchos; the beef of cattle that have been knocked in the head, or preferably, by dividing the spinal marrow in the neck, as now practised in the abattoirs of Chicago (if it is not afterward drained of its blood), is greatly superior to that which is prepared after the method of the Jews. Besides, the draining or soaking away of the blood from meat impairs its nutritive value. The blood is essentially of the same composition as the flesh, but besides, it holds in solution phosphates of soda, salts of potash, iron and sulphates; all nutritives of vital importance to the human economy. But there is no method of slaughtering animals that entirely divests the flesh of blood, hence to attempt to prohibit eating it, to be effective, should prohibit the eating of meat altogether.

Relative exemption from tuberculosis, under all circumstances, is, according to my observation, due to the generous use and potentiality of fat food. My conclusion in this regard is fortified by many years' observation and study of the liability to consumption of people collectively, families and individuals, more or less proportional to their abstinence from fat foods. The most prominent example, of which I have never lost sight from youth up, is the negro race in America. I began my professional life among them when they were slaves and were always supplied with an abundance of 'hog and hominy' not by any means restricted to these articles, but pork or bacon was a standing portion of at least one daily meal. Consumption among them was relatively rare. My observation in this respect was not singular, but accords with all other medical observers of the time, of whom I have knowledge. Conversely, it seems hardly necessary to invite attention to the prevalence of consumption among the same people now, under their changed conditions with regard to diet. 'Hog' at least is notable by its absence from the daily fare of most of them and no other fat meat has taken its place; and consumption among them is more than twice as great as it was formerly.

The same observation extends to smaller communities, families and individuals. Consumption is most prevalent among those who are stinted or who stint themselves of 'bacon' and 'butter.' I mention these as ideal and because they are among the most digestible of fat foods; other fat foods are commendable. Everybody has learned, when it is unfortunately, in most cases, too late, that cod-liver oil is good for consumptives, but few seem to have learned that food of the same character as cod-liver oil, suitable for the table, is preventive of consumption.

In the whole course of my professional observation, now covering a period of more than sixty years, I have never known a family or an individual that was brought up on a liberal supply of butter and bacon who became tuberculous. Moreover, such food fortifies the system against other diseases as well as consumption; it establishes stamina.

  1. Read at the International Congress on Tuberculosis, St. Louis, Mo., October 3, 1904.
  2. Kirke's ' Hand-Book of Physiology,' Vol. I., p. 79.
  3. 'Loss of Weight, Blood-spitting and Lung Diseases,' Horace Dobell, M.D.
  4. Farmer's Bulletin, No. 23, 1894.