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.)