Nutrition

NUTRITION

WITH the passage of the liquefied alimentary substances through
the mucous membrane lining the tube, digestion, strictly so-called,
ends. Anything which afterwards occurs to the incoming matter
may more properly be classed w r ith nutrition.

Prominent among the needful changes in the material for build-
ing up the tissues, stands that which takes place in the liver.
The biliary secretion from this organ has been spoken of in the
previous chapter as taking a part, though not a leading part, in
the solution of fat in water, as staying the too rapid decomposition
of albuminous food and excretory matter, and as supplying some
of the liquid vehicle in which the aliment is conveyed through
the walls of the digestive tube. In all these the liver is subordi-
nate, and its place may be readily supplied. But the anaemic de-
generation of the blood, the gradual pining emaciation, and ulcer-
ation of the tissues, and finally death, which follow its suppression
all of w r hich point to some deficiency of assimilative capacity
and not merely to the stoppage of an excretion show that it per-
forms in the circle of life some special duty which cannot be spared
or replaced by another gland. The blood going into the liver is
altered before it comes out of the liver much further than is in-
volved in the mere formation of bile.

During the last thirty years, the changes, necessary to life,
wrought on the blood by the liver have engaged a large share of
the attention of physiologists. I have been comparing the account
which I printed in 1856 1 of what had been done up to that time
with those of the present day, and I find a progressive advance
tow r ards the light, which seems to promise our sons not only in-
teresting, but practical knowledge. It was then established that
" a copious amount of sugar is formed in the cells, and is forwarded
into the hepatic vein, but not into the bile-ducts," and " that the
sugar is formed in consequence of taking food." 2 It has been

1 Digestion and its Derangements, chapter vii. 2 Ib., p. 160.

NUTRITION. 123

now ascertained that it is not only an immediate consequence,
that the sugar does not pass from the food into the liver, but that
the sugar-making in the cells of the gland continues for a long
time after the alimentary canal is emptied. It appears, moreover,
that the sugar, though more copious even than had been supposed, is
a very transitory stage in the circle of chemical changes. It is so
momentary that it can be made evident only by an artificial arrest,
just as electrical action in the earth, though so vast in its results,
touches our senses only through the partial derangement which
shows itself in the lightning's flash.

But let it not be reckoned as of small moment because of its
latency. It is an observation as old as Thucydides, that the in-
fluential forces in the world are the most active when most un-
noticed ; for, indeed, perturbed crises are usually the results of
their disturbance. We may see in diabetes the serious evil of the
further conversion of the sugar being interfered with, and of its
remaining in the blood only to run off by the urine, and we can
hardly doubt that the breach of a previous link in the chain, the
formation of sugar, may cause equal discomfort and explain at a
future time some obscure morbid states.

Those who take delight in the glimmering through the mist of
future light, will find much to interest them in Dr. Dalton's sketch
of this subject, and the details of the experiments repeated by him-
self, with ingenious precautions to avoid error, in the ninth chap-
ter of his " Human Physiology."

That the spleen and lymphatic glands take also a part in nutri-
tion, or blood-making, is pretty clear, but which part is entirely
unknown.

The defectiveness of our information about the stages and
machinery of nutrition does not, however, prevent us from having
a clue to a good deal of practical knowledge of the comparative
NUTRITIOUSNESS, for different purposes, of different kinds of diet.

By nutrition, two ends have to be accomplished, the growth or
repair of the body, and the production of motion or force. The
first indication is more or less fulfilled in proportion to the quan-
tity of digestible nitrogenous material, the latter in proportion to
the quantity of digestible carbohydrates which the aliments con-
tain. It is very clear that the digestibility must be insisted upon,
otherwise we should make serious mistakes in our valuations of

124 GENERAL DIETETICS.

food. For instance, according to the well-known table of M.
Payen, a pound of chestnuts and a pound of milk contain very
nearly the same quantity of nitrogen ; yet, to expect that a baby
would grow as well upon one as the other would be criminal folly.
When, then, circumstances require us to foster growth, to increase
the vigor of the muscles and nerves for short temporary exertions,
to replace preternatural wear and tear, meat is valuable in the
direct ratio of its solubility in the stomach. When the regular
performance of a daily round of moderate exertion alone has to be
provided for, carbohydrates in the form of farinaceous and oleag-
inous food may with advantage constitute the chief of the diet.
So that before giving any general rules for the selection of a diet-
ary which will best perform its duties, it will be needful to review
the special circumstances for which it is required, which I propose
to do in respect of normal conditions in the second part, and in
respect of morbid conditions in the third part of this volume.

SPECIAL DIETETICS OF HEALTH.

CHAPTER I.

REGIMEN OF INFANCY AND MOTHERHOOD.

IT may be presumed no Englishman doubts that the best food
for a new-born infant is a mother's milk. 1 Even deviations from
the normal condition of the general system, or of the breast, should
not be allowed too readily to deter a mother from suckling, till
there is evidence that the secretion is disagreeing with the child.
Unless diarrhaaa or thrush occur, it may be taken for granted that
proper nutriment is afforded, and if proper nutriment is afforded,
we may be sure a woman's health is not affected by the inconve-
niences which she may be enduring.

I have known a woman, unable to feed herself from severe
rheumatic fever, have her child held to her breast and be nour-
ished only from thence, without any harm following. And in
several instances slight inflammation of the breast has seemed to
be benefited by the flow of milk induced by suckling. Indeed, I
have once seen a breast with an abscess in it supply healthy nutri-

1 Strange to say the opinion is not universal. Dr. Brouzet (Sur I'^duca-
tion Me'dicinale des Enfants, i, p. 165) expresses a wish that the state should
interfere and prevent mothers from suckling their children, lest they should
communicate disease and vice ! A still more determined pessimist was the
famous chemist Van Helmont, who thought life is reduced to its present
shortness by our instinctive infantile propensity, and proposed to substitute
bread boiled in beer and honey for milk, which he calls " brute's food " (in
the chapter " Infantis nutritio ad vitam longam)."

126 SPECIAL DIETETICS OF HEALTH.

ment to a child, the mother feeling sure that the abscess did not
communicate with the lacteal tubes. I fancy no medical man
would sanction a persistence in the latter risk, but still it were to
be wished that our accoucheurs would be somewhat less hasty than
they generally are in debarring mothers from suckling on slight
grounds. A certain injustice is inflicted on the child, and prob-
lematical benefit conferred on the parent.

During the months of suckling it should be the object of the
mother first to provide herself with an appetite, and secondly, to
provide herself with proper food. The appetite often fails simply
from want of fresh air, especially in those who are used to enjoy
it, the remedy for which state of things is sufficiently obvious.
Sometimes the disrelish for food is a symptom of the exhaustion
induced by the labor, and then small doses of sal volatile or a
light bitter, such as gentian, will remove it. Sometimes it is a
direct gastric anaemia, arising from going too long without food.
The patient should eat directly she begins to feel hungry, and not
wait to feel very hungry. But at the same time she should be
careful not to overload the stomach ; in fact, though she eats often,
she should not eat more than when in ordinary healthy exercise.
A great mistake is often made by endeavoring to supply the wants
of strength and appetite by an extra supply of wine or malt liquor.
The nurse should never take more than she is accustomed to ; if
she does, it makes her eat less and digest less, though she does not
feel the debility which is the consequence of the innutrition. Beer
increases the quantity of the milk, just as it increases the quantity
of the urine, but it also renders it thin and watery in the one case
as in the other. Indeed less than she is accustomed to is the more
rational rule of diet, for the happy peaceful circumstances of her
situation usually exempt her from the mental wear and tear, and
the exhaustions of the nervous system incidental to social life,
which it is the special purpose of alcohol to compensate.

The most proper food is cow's milk, fresh and unskimmed. It
can be taken at all times, in a great variety of forms, and nobody
has ever been known to take too much. If it turns sour, lime-
water mixed with it not only corrects its acescence, but also supplies
a valuable aid to the growing bones of the infant. In the solid
dietary again, milk may fairly be taken as the type of the due

INFANCY AND MOTHERHOOD. 127

admixture of alimentary principles, because not individual growth,
not the production of force, but the secretion of that very sub-
stance is the object of the selection of diet. So that we cannot do
better than take the proportions of nitrogenous, carbonaceous, and
aqueous constituents of the lacteal secretion as a guide to the pro-
portions of these principles in the diet of nursing mothers. Anal-
yses of milk are to be found in all physiological works, and if it
be reckoned roughly that in food as presented for our consump-
tion, there is 50 per cent, of combined water, I think it will be
found that the following scale of diet corresponds pretty closely to
the proportion of the several constituents there enumerated.

Supposing the full diet to consist of three pounds of solid food,
that will require six pints extra of uncombined aqueous fluid to
make it as fluid as milk. And the three pounds of solid food
should consist of

14J oz. of meat,

13 oz. of fat, butter, sugar,

20 oz. of farinaceous food and vegetables,

^ an oz. of salt, lime, etc.

Small women and small eaters, especially if they have small
children to bring up, will require less; but let the reduction be
proportionate in each of the several classes of alimentary sub-
stances. And at first from the exhaustion of parturition, from the
want of exercise and of fresh air, the appetite turns against meat.
Let then milk, especially boiled milk with arrowroot or the like,
chicken broth, egg-custards, fill up the deficiency. Only insist
that enough is taken.

The observations by Dr. Barker, of New York, on this subject
are so much to the point that I cannot forbear quoting them. He
says, "Give the puerperal woman as good nutritious food as she
has an appetite for, and can easily digest and assimilate. You
will at first find many nurses who will not accept these views, and
they may fail to carry out your directions in this particular; but my
experience has been that after a time the intelligent ones become
enthusiastic converts to this course. . . . Your patients rest
and sleep better, and their functions are established with less dis-
turbance than they would be with a spare or insufficient diet.

128 SPECIAL DIETETICS OF HEALTH.

Since I have adopted this measure with my puerperal women,
am very sure I have much less frequently met with those annoj
ing and troublesome nervous phenomena that so commonly folio 1
parturition, as the nervous system is then apt to be in a conditio
of exalted susceptibility. The function of lactation is thus ger
erally established without that disturbance of the system calle
milk fever, formerly so common." 1

It may be noticed that the Professor says nothing about wir
and malt liquors. They are conspicuous by their absence in h
dietary. And in truth the less a nursing mother takes of thei
the better, so that her temper and digestion do not obviously suffi
from the restriction.

The child should be put to the mother's breast as soon as si
wakes from her first sound sleep after its birth. The waiting fc
three or four days is an old-fashioned relic of the days of dru
ging, when it was considered wrong that the young bowels shoul
be relaxed by the colostrum of the first milk, but right that the
should be griped with castor-oil. Not to use the first milk
wasteful and injurious. The best substitute for it is cow's mil
diluted and sweetened as hereinafter described.

The education of the infant must begin immediately after birtl
In the first place it has to be taught to suck, for which ever
monthly nurse has her own device, and will only laugh at an
male who should presume to interfere. Next it has to be taugl
not to be always sucking, whenever the whim takes it or th
mother comes in sight. Regular definite times, the intervals b<
tween which are gradually lengthened as the child's strength an
growth allow, give a rest both to the stomach of the receiver an
the breast of the giver, which conduces to the due digestion of th
nourishment. As a general rule the daily allowance of milk r<
quired by a healthy infant is on the first day very small indeed
on the second day it takes about a quarter of a pint ; on the thir
day two-thirds of a pint ; on the fourth or fifth day it will cOr
sume a full pint. And this quantity augments gradually till b
the sixth month you must not calculate on less than two pinl

1 "The Puerperal Diseases," Clinical Lectures delivered at Bellevue Ho:
pital, by Fordyce Barker, M.D., p. 27.

INFANCY AND MOTHERHOOD. 129

being wanted. The distribution should be in an inverse ratio to
the quantity. During the first two months the child should have
the breast eight or nine times daily, if the quantity yielded is
small, and six or seven times if it is large. After that a gradual
reduction may be begun, which before weaning should have ar-
rived at the number of four meals daily, which is the most proper
for the digestion of mixed diet.

If a mother, with or without reasonable cause, deputes her
duties to a wet nurse, she ought thoroughly to understand that
the expedient is not without drawbacks. All the best accoucheurs
agree that in choosing a woman for the office, observation of the
figure, the complexion, the color, the teeth, or even the shape and
development of the breasts, and the analysis of their secretion, are
all unimportant compared with a knowledge of the regularity of
the catamcnia. In this respect, it stands to reason we must take
the applicant's own character of herself, a serious temptation to
dishonesty. An unmarried woman may not improbably have a
concealed constitutional taint which is communicable through the
milk, and at the best is an unpleasant inmate in the family. A
poor married woman, however respectable, is removed from a starv-
ing home to sudden abundance, and invariably overeats herself,
and it is fortunate if she does not overdrink herself too. She
pines and grows anxious about her own child if it is alive, and
insists upon having her troublesome husband to see her openly or
secretly, on the pretence (a fallacious one) that his visit increases
the flow of milk. Moreover, a rich mother cannot but feel some
compunction in purchasing for her own offspring what is stolen
from another, who is sometimes seriously affected by the fraud,
and retires disgusted from this false world.

At all events, a trial ought to be first made, under the snperin^
tendence of a medical man, of fresh cow's milk or goat's milk, and
of Swiss condensed milk.

Cow's milk should at first be mixed with half its bulk of soft,
pure, tepid water, in each pint of which has been suspended a
drachm of " sugar of milk " (which is procurable at any chemist's,
being used for grinding up powders), and two grains of phosphate
of lime finely powdered. If the milk has been partially skimmed,
as is often the case in cities, then a good tablespoonful of cream.

9

130 SPECIAL DIETETICS OF HEALTH.

should be added to each pint, to make the mixture equal to human.
If it has not been skimmed, a couple of teaspoonfuls of cream is
sufficient. 1

The advantage of using goat's milk, is that the animal can be
brought up to the very nursery, even in cities, and will supply
nourishment directly to its little master's lips if called upon.
Children do not seem to dislike the peculiar taste.

Swiss milk has been already alluded to in the second chapter of
the first part (p. 65). No inconvenience has as yet been proved
to arise from its use, but, at the same time, no superiority to fresh
cow's milk has been confirmed. As it is already sweetened in the
preparation, no additional sugar is required, but care must be
taken to dilute it sufficiently to make it resemble not ordinary
milk, but milk and water.

Laputa never devised anything more preposterous than " Lie-
big's food for infants." It is composed of malt flour, wheaten
flour, bicarbonate of potass, water, and cow's milk, and the fol-
lowing is recommended as the simplest mode of cooking it :

Take of wheaten flour, oz.

Malt flour, oz.

Bicarbonate of potass, 1\ grs.

"Water, oz.

Mix well, and add of cow's milk, 5 oz.

Warm the mixture, constantly stirred, over a very slow fire till it gets thick.
Then remove the vessel from the fire, stir again for five minutes, put it back
on the fire, take it off as soon as it gets thick, and finally let it boil well. Be-
fore use, strain through a muslin sieve.

The object of all this is to convert the starch of the flour into
dextrin and sugar, and to elaborate a product which after all is

1 In the above recipe household measurements are used as the nearest pos-
sible approximation to the following formula :

Whole cow's milk, 600 parts.

Cream, 13 "

Sugar of milk, 15 "

Phosphate of lime, ....... 1 "

Water, 339 "

1000
:(Dict. Encycl. des Sciences Med., art. " Lait," 1868.)

INFANCY AND MOTHERHOOD. 131

not nearly so like the natural sustenance as may be made with
cow's milk, water, and a little additional sugar of milk. It is
needless to say what a number of unnecessary risks are incurred
of some one of the numerous articles employed being adulterated,
of inaccurate measurement, of dirt, and of careless preparation by
tired servants, who, it will be observed, have to keep the fire low
for the first part of the process, and then to coal it up, making no
small smoke, for the final boil. Sensible parents will be content
to leave the recipe for some coming race who may prefer art to
nature.

It is advisable to nourish the infant directly from the breast;
and where this cannot be done, as soon as possible after the milk
is drawn. Our senses tell us of a peculiar aroma given off by
fresh milk which quickly exhales, and appearances seem to war-
rant the conclusion that this contributes to soothe the sensitive
nervous system of the suckling, and so assists digestion.

The best diet for an infant during the first six months, is milk
alone. It is true, man is a tough animal, and can stand with im-
punity much rough usage, and therefore a vigorous baby often
seems none the worse for a certain quantity of farinaceous food ;
but the first appearance of flatulence, gripes, screaming, ill temper,
or other ways infants have of complaining of dyspepsia, should
make the nurse desist from these attempts to hurry on natural de-
velopment.

It is only when the coming teeth are on their road to the front J
that the parotid glands secrete sufficient saliva to digest farinace-
Lous food. When dribbling begins, then is the time to begin with
the various preparations of these substances bountifully supplied
by nature and art. Till then, anything but milk given to a
healthy baby must be tentative, and considered in the light of a
means of education to its future dietary, and must not take the
place of milk.

Among the various means of education, I would select as most
generally applicable broth or beef tea, at first pure and then thick-
ened with a little tapioca or arrowroot. Chicken soup, made
with a little cream and sugar, serves as a change. Baked flour,
biscuit powder, and tops and bottoms should all have their turn ;
in fact, change is necessary, or the child is apt to get too fond of

132 SPECIAL DIETETICS OF HEALTH.

its soup, and to neglect the really essential nutriment of milk, and
to wean itself prematurely.

The consequences of premature weaning are most disastrous, but
insidious. The child continues to present the external aspect of
health, its muscles are strong and elastic, but the bones do not
grow in equal proportion. It is active and anxious to walk, but
the limbs give way and become distorted. If it is ill enough to
be taken to a medical man, he calls the condition "rickets," but
there are crowds of poor creatures affected in this way whose pa-
rents refuse to see that anything is wrong till the malady has gone
too far for cure. The suspicion that rickets was due to this cause
has long been prevalent in the profession, but it is to M. Jules
Guerin that we owe the proof derived from direct experiment.
This pathologist found not only that rickety children had almost
invariably been prematurely weaned, but that the disease was capa-
ble of artificial and intentional induction. He took young puppies
and young pigs, specimens respectively of carnivorous and herbiv-
orous animals, and he produced a rickety softening of the bones
of each by removing them early from the mother, and giving the
one set meat and the other set vegetables before the natural period.
Professor Trousseau has backed the deductions of M. Guerin with
his valuable imprimatur.

The time for weaning should be fixed, partly by the almanac,
partly by the growth of the teeth. The troubles to which chil-
dren are liable at this crisis are usually gastric, such as are induced
by hot weather ; so that in summer it should be postponed, and
in winter hurried forward. The first group of teeth nine times
out often consist of the lower central front teeth, which excite no
wonder in any but very young parents by appearing any time
during the sixth and seventh month. The mother may then
begin to diminish the number of suckling times ; and by a month
she can have reduced them to twice a day, so as to be ready when
the second group makes its way through the upper front gums to
cut off the supply altogether. The third group, the lateral incis-
ives and first grinders, usually after the first anniversary of birth,
give notice that solid food can be chewed. But I think it is pru-
dent to let milk, though not mother's milk, form a considerable
portion of the diet till the eye-teeth are cut, which seldom occurs

INFANCY AND MOTHERHOOD. . 133

till the eighteenth or twentieth mouth. At this period even very
strong children are liable to diarrhoea, convulsions, irritation of
the brain, rashes, and febrile catarrhs. In these cases the resump-
tion of complete milk diet is advisable, and sometimes a child's
life has been saved by its reapplication to the breast. Now these
means are the most readily feasible when the patient is accustomed
to milk ; indeed, if he be not so, the latter expedient is hardly
possible.

134 SPECIAL DIETETICS OF HEALTH.

CHAPTER IT.

REGIMEN OF CHILDHOOD AND YOUTH.

THE diet of childhood requires from its rational guardians as
much attention as that of infancy. The passions at this age over-
power the instinct, and reason has not yet asserted its throne.
Children should have four meals a day, but meat only at one, or
at most two ; the latter when only a small portion at once is al-
lowed. When in health they should have no wine or beer except
as a festive treat, no coffee, strong tea, or other exciting drink.
Once-cooked succulent meat without sauces or condiments, eggs,
plenty of farinaceous pudding, mealy potatoes, carrots, spinach,
French beans, rice, bread, fresh butter, porridge, roast apples,
oranges, should form the staple of the nursery commissariat.

As to quantity, we may take the full diets of hospitals as fairly
representing what should be the minimum proper for those who
are not restricted by fortune in the matter of food, and the mean
amount upon which a growing child can continue to flourish. For
it may be observed that while all extravagance is herein avoided,
the food is intended mainly for those who are convalescent from
acute disease, and have not only to remain well, but to recover
flesh.

The following estimates are taken from the published tables of
diet. The quantities named are those which may be fairly put
before each child of each article, and by selecting the larger quan-
tities we may give a very full allowance. If the smaller amounts
of one are eaten, then care should be taken that the fuller weights
of others are chosen.

And let it always be understood that food is not to be dispensed
with pedantic accuracy as if it were a pharmaceutical prescription.
Even in hospitals considerable latitude is allowed, and still more
in private nurseries should we avoid making life a toil by too
much interference. It is only in cases of prominent and persist-

CHILDHOOD AND YOUTH.

135

ent excess in one direction or the other, that we should bring our
adult reason to bear on infantile instinct.

Full Dietaries for Children at various Hospitals.

Age.

Bread.

Butter.

Milk.

Meat.

Vegetables.

Pudding.

Hospital.

Under 7

Unlimited.

1 oz.

% pint.

2oz.

4 oz.

Unlimited.

St. George's.

Under 7

12 oz.

7

}/ 2 pint.

2oz.

8 oz.

(Twice a
\ week.

London.

Under 8

5%oz.

f about
1 %oz.

y> pint.

2 oz.

4 oz.

^ pint.

Children's Hospi-
tal, Great Orm-
ond Street, and
Evelina Hospi-
tal.

Under 8

8 oz.

{about
1 oz.

?

2oz.

4 oz.

Leeds Infirmary.

Above 8

8 oz.

/about
t loz.

%pint.'

(3oz.
\ broth
l^pnt

6 oz.

S Gruel, y 3
I pint.

1 Children's; Great
Ormond Street,
and Evelina
Hospital.

Under 9

6 oz.

?

1 pint.

2oz.

6 oz.

f 14 pint
-< gruel or
(. broth.

f Birmingham Gen-
\ eral Hospital.

Under 9

7 oz.

KOZ.

1 pint.

4oz.

4 oz.

To order.

St. Bartholomew's.

Under 10

12 oz.

%oz.

1 pint.

2oz.

4 oz.

6 oz.

St. Thomas's.

Under 10

6 oz.

f

114 pint.

2 eggs.

?

8 oz.

King's College.

Extreme monotony should be avoided. It is a great inconve-
nience to young persons in after-life to have been brought up in
such a narrow round of indubitably wholesome victuals that they
cannot eat this or that. They should especially be guarded against
family whims; and if the parents are conscious of prejudices
against any of the ordinary foods of mankind, they should edu-
cate their descendants to take these as a matter of course. For it
is astonishing how ingrained some of these acquired idiosyncrasies
become, and indeed after full manhood they may be concealed but
are never quite overcome. Yet few of the minor thorns in the
rose-bed are so vexatious to oneself and others. I shall not soon
forget the annoyance of taking a young man to a Greenwich din-
ner, and finding that he never ate anything which swam in the
waters. Thus occasional abstinence, in the shape of no meat or
the substitution of fish, and occasional festivities, consisting of food
given deliberately because it is nice, are not out of place in the

1 Including what is put in mashed potatoes.

136 SPECIAL DIETETICS OP HEALTH.

nursery. Most kind fathers and mothers act on this principle,
but they sometimes needlessly let the indulgence trouble their
conscience.

The articles of diet should be as good and as clean as can be
obtained, but no criticism should be permitted to those who sit at
table. A boy or girl should be ready to eat anything which is set
before them, and not refuse even badly cooked or strange meats ;
for in roughing it through the world, whatever position they are
in, the choice often lies between that and going without.

The plan adopted at many schools of working before breakfast
is not conducive to health. If it is inconvenient for the house-
hold to prepare the meal immediately the pupils are dressed, the
most that should be exacted is the repetition of some light task
prepared overnight ; but better than that is to let them have half
an hour's run in the play -ground. Violent exertion also of mind
or body before and after other meals should be discouraged by a
suitable arrangement of the hours of work and play. ^Esthetic
pursuits, drawing, dancing, singing, may be made so to combine
relaxation and amusement as to leave the powers of digestion un-
exhausted, and may be practiced up to the time of meals.

To the full development of the digestive organs, muscular ex-
ertion in the open air is essential, and it is doubly valuable when
it is of a pleasurable character. Proper exercise always involves
a rational style of dress ; for ill fitted and uncomfortable clothing
is soon rejected by those who rejoice in the natural movement of
the limbs.

It is even more necessary for girls than for boys that a sufficient
playground should be attached to places of education, for they
cannot be allowed to wander about the country like their brothers,
and the funeral processions falsely called exercise are almost use-
less. In town, gymnastics or riding on horseback may be. made
substitutes for games ; but the money required for these would be
much more profitable if expended in the rent of a field or lawn.

For families who are so fortunate as to be near a river or lake
there is no exercise for girls so good as rowing a light oar or scull-
ing. It opens the chest, throws back the shoulders, straightens
the back, and insures the shoulder straps of the dress not imped-
ing movement, so that the liver and stomach gain space to act.

Many a sculpturesque figure will acknowledge her debt to her

CHILDHOOD AND YOUTH. 137

boat for her beauty ; and a few weeks' instruction in swimming
at Dieppe or Trouville takes away all sense of clanger from the
amusement.

Up to the period of puberty the daily use of wine should be
allowed only during illness and by the express advice of a medi-
cal man. Its habitual, consumption by healthy children hastens
forward that crisis in their lives, checks growth, and so habituates
them to the artificial sensation induced by alcohol that they can
scarcely ever leave it off when they wish. This restriction does
not exclude occasional festivities, and boys in active exercise seem
to digest well a glass of well-brewed beer at dinner.

Between puberty and full growth the principal thing we have
to guard young people against is overloading the stomach. Their
meals should be sufficiently frequent to avoid this, otherwise the
stomach from habitual distension becomes larger than is appro-
priate for the size of the trunk, and there is in after-life a tendency
to gastric flatulence. Lads sent to learn a business in the city are
often much neglected in the matter of a midday meal, and have
to make up for it by gorging themselves in the evening. This
spoils their breakfast next morning, and they really get starved
from over-repletion. The best luncheon a growing young man
can have is a dish of roast potatoes, well buttered and peppered,
and a draught of milk. Or the same vegetable with a little bacon
or fish may be made into a Cornish pastry, which if wrapped up
in flannel will keep hot for several hours. In the summer boiled
beans and bacon, or bread and cheese and lettuce, with a glass of
claret or a draught of bitter beer, may take its place. But let the
repast be confined to one dish, and then they will not eat too
much. Red meat in the middle of the day is too heating during
active life, so that if the conventional form of a sandwich is the
only convenient lunch found practicable, let it be made of eggs,
or fowl, or cold fish, flavored with a little salad dressing, or the
like.

Youth is the time when gluttonous habits are acquired. The
commencement of them is easily detected, and they should un-
sparingly be made as disgraceful as they really are. Ridicule is
not always a wise engine to employ in education it is too power-
ful but against gluttony it may fairly be used. Let it not,
however, be supposed that excess in gratifying the palate is at all

138 SPECIAL DIETETICS OF HEALTH.

a laughing matter. It is a vice just as truly as sexual excess is a
vice ; and there is the less excuse for its becoming an habitual
vice, in the fact that the temptation to acquire it is strongest in
youth, and becomes weaker as full growth is attained. That it is
regarded as a serious vice by the highest authority is shown to all
time by that Avonderful history of the civilization of a specially
favored race preserved in the commonest of books. Kibroth-
Hataavah " The Graves of the Greedy " remained for future
generations as a standing memorial of Heaven's wrath, and of the
natural punishment of sins against natural law. The worldly
Lord Chesterfield is equally explicit in denouncing the vice, when
writing to his son at school, and though his outspoken sentences
are couched in language too old-fashioned for quotation, they are
well worthy of the attention of both parents and children.

The gorging themselves with pastry and sweetstuff at the con-
fectioner's, as practiced habitually by school-boys, and often by
girls when they get a chance, lays the foundation not only for in-
digestion in after years, which is its least evil, but also for a habit
of indulgence which is a curse through life. A schoolmaster who
should effectually check this without needless restriction of liberty,
and make greediness unfashionable among his pupils, I would
rank far above the most finished scholar in Europe. An impor-
tant step towards it is to give the boys enough to eat at regular
mealtimes.

Yet are asceticism and hypocrisy to be equally eschewed with
gluttony. The hearty enjoyment of what is pleasant to the taste
at proper times is quite consistent with, indeed usually goes along
with, habitual temperance ; and one of the most practical lessons
knowledge of the world can teach is that all pleasure is enhanced
by self-restraint.

Young people should not be brought up to the habit of taking
physic. As a rule, the British mother is very fond of dabbling in
doctoring, and apt to try her first experiments on her own family.
If there is any definite disease discoverable, a professional man is
called iu, but if a child is only weakly, or troubled now and then
with unimportant ailments, she tries this and that which has been
recommended by her friends, without suspecting the probable
truth that the cause of the imperfect condition lies in some irra-
tional regimen pursued. She cannot make out what is the matter;

CHILDHOOD AND YOUTH. 139

surely it would be wiser to consult some one who can, or at all
events, who knows that he cannot, and will not act till he does.
The consequence of frequent drugging is sometimes real illness,
generally a debilitated state of the digestion, and almost always a
disposition to fly to drugs for the immediate relief of petty incon-
veniences, which in reality impedes their cure by more far-sighted
means. Boys get laughed out of this at school, but girls are
seldom so fortunate, and grow up with the idea that something
which calls itself physic is a necessity of human life. Now, in
all the pharmacopoeias there is not a single active article which,
joined to its virtues, has not the vice of deranging more or less
gastric digestion. It is that which makes it a medicine and not a
food. Assuredly, its secondary or final effect in suitable cases, is
to restore digestion, but when taken needlessly, it cannot but be
injurious even to such a tough animal as a boy. The proper place
for the family medicine chest is, not the bed-room or the boudoir,
but the store-room, where there is some little trouble in getting at
it, and where it should be locked up along with a stomach-pump,
and other provisions for emergencies to be applied by skilful
hands.

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