Digestion

Arguments from analogy may be very plausible, and are certainly very allowable, when the subject presents no other mode ; but they are not conclusive. We cannot judge of the mode of digestion in the human stomach by that of animals, particularly the granivorous and ruminating animals. Carnivorous animals most resemble man in their digestive apparatus. One thing is certain, and it is capable of demonstration in the stomach of the subject of these experiments, that old and new food, if they are in the same state of comminution, are readily and speedily mixed in the stomach.

Dr. William Beaumont

Not all attention was negative. In 1834, an advertisement for Graham bread appeared in New-York as 'It Is' , a manual and guide to living in New York City. The guide pointed interested parties to Pierce and Luke, bakers who sold the bread at their bakery located at the intersection of Broadway and Leonard Street. The first published recipe for Graham bread appeared in 1835, emphasizing the use of finely ground, pure wheat meal.  In that same year the Minnesota Farmers’ Institute’s Annual reported on the differences between Graham and white bread, recommending “the use of some graham bread in families of growing children,” though warning that the bran in the bread could be “irritating to a delicate digestive system.”

The next office of the pancreatic juice to be spoken of is that connected with the digestion of fat. Eberle, it appears, was the first to announce, which he did as far back as 1834, that the pancreas possessed the power of emulsifying fat. He experimented, however, only with the glandular tissue of the organ, and never obtained its secretion. His annoucement also could not have received much attention, as it is not until after the publication, in 1848, of Bernard's extensive series of experiments, commenced in 1846, of Bernard's extensive series of experiments, commenced in 1846, that hte pancreas is found to be spoken of by physiologists in connection with the digestion of fat. Before Bernard's researches nothing was known about the nature of the pancreatic secretion, and nothing had been shown to connect it with the digestion of fat. Bernard is therefore fairly entitled to the credit of discovering the function of the pancreas now about to be referred to.

It appears that Bernard was led to the prosecution of his researches upon this subject through observing, whilst conducting some experiments for the purpose of comparing the phenomena of digestion in the animal and vegetable feeder, that after the ingestion of fat the lacteals coming from the intestine almost up to the pylorus were found to be injected with milky chyle in the dog, whilst in the rabbit chyle only made its appearance in the lacteals some little distance down. With this, he noticed a corresponding difference in the point of discharge of pancreatic juice into the intestine, and thus was prompted, whilst seeking for an explanation of the phenomenon, to give attention to the pancreas. In this manner he was led to endeavor to collect the pancreatic juice, and, having succeeded in this, to examine its action upon fat.

The effect produced when pancreatic juice is freely shaken with oil or fat is to form a liquid having the appearance of milk. The pancreatic juice emulsifies or brings the fatty body into a minutely divided state; in which it afterwards remains suspended in the liquid in the same manner as is noticed in milk. The minute globules into which the fat has been separated have no disposition again to coalesce and rise and form an oily layer at the surface, as they do when saliva or any ordinary watery liquid may happen to have been used instead. In this state of minute subdivision the fatty matter is found to be adapted for absorption and passage into the lacteals, the effect of its presence in the lacteals being to give to the contents a milky character, which they do not possess when no absorption of fat is going on. 

 In October, 1857, I placed four hearty, well men upon oatmeal porridge as an exclusive diet. It was seasoned with butter, pepper and salt. Cold water was drank between meals, and a pint of coffee, seasoned with sugar and milk, was taken at each meal. The men were the most healthy and vigorous I could procure. All regarded themselves as perfectly well, and none had ever suffered any severe illness. Their ages ranged from twenty-three to thirty-eight years. I required them all to live with me continually, night and day, and to take no food or drinks other than what I gave them. They were to receive $30 per month each, with board and lodging. I subjected myself to the same rules and regulations, asking of them nothing but what I would and did do myself. This gave them a confidence and pride in the work, each striving to outdo the other in the strict observance of the rules. 

At noon on the 9th of October, the rigid diet began. The noon and night meals of the first day were greatly enjoyed by all. Retired at 9 p. m. and slept soundly and well. All were called up at 6 a. m. next morning. Meals were taken at 7 a.m., 12 m. and 6 p. m. On the afternoon of the second day, all began to be more or less flatulent. Bowels bloated, and wind in motion in the large bowels. Each had a constipated movement of the bowels during the middle and latter part of the day, accompanied by much wind. Before the exclusive oatmeal diet began, each had one regular movement of the bowels every morning.

At 4 p. m. gave the men a walk of about two miles, which helped to work off the flatulence. All retired at 9 p. m. and slept soundly. 

At 6 a. m. of the third day, all were called and required to take a cold sponge bath. Before the bath, a dull, heavy feeling pervaded the entire party ; this was partially relieved by the bath. Very flatvdent ; bowels more or less distended and uncomfortable. Ate quite heartily at the 7 a. m. breakfast, each drinking the pint of coffee allowed.

 At 8 a. m. walked the men out for about two miles. This somewhat cleared away the dullness, and worked off the flatus. There was a general feeling of thirst during the forenoon, which was satisfied by a free indulgence in cold water. 

Dined at 12 m. At 2 p. m. all were feeling quite bloated and very uncomfortable. Gave them a two mile walk, which to some extent relieved the distended, duU feelings. Not one had a passage of the bowels on the third day. Appetites still good, but not ravenous, as on the first day. Retired at 9 p. m. A stupid, heavy feeling pervaded the household. Very flatulent, with colic pains. 

The fourth day, all rather dull and quite flatulent, with occasional colic pains. All had movements of the bowels in the latter part of the day, accompanied by much wind. Appetites good. 

The fifth day found all about the same as on the fourth day, except that the symptoms were aggravated. Each had a small, constipated movement in latter part of the day and evening. 

The sixth day, all the derangements of the fifth day were more pronounced. Each had a small, difficult movement during the latter part of the day and evening. Very flatulent. 

The seventh day, the derangements of the sixth day were stdl more marked. Flatulence and constipation increasing. Each had a very small, hard movement during the latter part of the day and evening.

I will indicate the boarders by the letters A, B, C and D. They exercised daily. Morning and evening walk of two mHes. Rising hour, 6 a. m. Retiring hour, 9 p. m. The following table will show their symptoms under the diet named, from the 8th to the 34th day, inclusive : —

It was found that whenever soldiers were thrown largely upon the use of hard bread, or army biscuit, as a diet, a peculiar train of abnormal manifestations presented themselves. These are : — 

1. Constipation. 

2. This constipation is preceded, accompanied and followed by fermentative changes and the development of intestinal gases and yeast plants (Saccharomyces and Mycoderma) in the food in the stomach and intestines. 

3. These fermentative changes are always worse towards evening and during the night, and go on increasing from day to day till : — 

4. Finally the gases and yeast plants and other products of fermentation developed, produce so much irritation, commotion, distention and paralysis of the intestinal walls, that diarrhoea ensues, which soon becomes chronic, and is not at aU amenable to the treatment of ordinary diarrhoeal conditions. 

5. Accompanying the fermentative changes is always a paralytic tendency, more or less strongly marked. This is manifested in the alimentary canal, and especially in the larger intestines ; next in the extremities, the legs prickling and " getting asleep," frequently, with ringing in the ears and a numb, mixed up or confused feeling in the head, etc. These are manifestations pertaining to the history of the disease known as Locomotor Ataxy.

6. A cough, accompanied by more or less hoarseness, usually sets in, especially during the night and on rising in the morning. It is also accompanied by the expectoration of a thick, cream-colored, sweetish mucus. 

7. This is followed by more or less constriction in breathing with frequently palpitation of the heart on any excitement. 

8. After the diarrhoea sets in, there is generally a remarkable tendency to fibrinous depositions in the heart (Thrombosis), and to the clogging up of the pulmonary vessels with fibrinous clots (Embolism), with pains and aches in extremities and back. 

9. The diarrhoea is not so likely to come on when the men are actively engaged, as it is when they go into camp and are less active. The active exercise seems to aid in working the starchy food out of the stomach into the bowels, where it is digested before it gets to fermenting badly. To demonstrate more positively that these abnormal conditions had their origin in the too exclusive use of Army biscuit as a food, it was determined to institute a series of experiments upon the exclusive use of this kind of food, as tried upon strong, healthy men, in a healthy locality, and free from the enfeebling influences of Army life. Accordingly, on arriving at Cincinnati, Ohio, I engaged the services of three strong, vigorous men of good habits and in the prime of life, for this purpose. The experiments were conducted with watchful care from day to day, and the results were most convincing and conclusive in favor of the previous observations made upon the soldiers, as will be seen from the following daily records of the experiments. , . , October 12th, at noon, began feeding the men exclusively upon Army biscuit. For drink used water, to which at dinner and tea about one ounce of good whiskey was added. Gave the men the whiskey, as they were used to taking about two or three drinks daily.

On the evening of the 9th, after giving my boarders a good beefsteak supper, I paid them off and discharged them from a diet drill to which they had submitted with a good grace for 28 days. These three subjects are all strong, healthy men in the prime of life, who had been used to the substantial diet of the active business men of our Western cities. From the commencement of the army-biscuit diet, up to the time when the discharges assumed a yeasty, chronic diarrhoea type, 19 days elapsed in one case, 18 days in the second and 20 days in the third case. The fermentative condition, and the production of alcoholic and acid yeast (Saccharomyces and Mycoderma), commenced and showed themselves in a marked degree on or about the 6th day, and increased until the army-biscuit diet was discontinued. 

The first abnormal condition brought about by this diet was constipation, with a partial suppression of the biliary and intestinal secretions and lessened peristaltic action. This left the alimentary matters in the stomach and intestines an unusual time, during which fermentative changes were started. This fermentative condition increased daily, till the alimentary canal became filled with alcoholic and acid yeasts in a state of rapid multiplication and development, disengaging large quantities of carbonic acid gas which distended the bowels with flatus. 

Just previous to the commencement of the diarrhoea and afterwards, there was a general paralytic tendency : this was especially marked in the intestinal walls, they losing their normal sensibihty and contractility under the irritant and poisonous action of yeast plants, carbonic acid gas, vinegar and other products developed during the fermentation of the amylaceous alimentary matters. In severe forms of the disease produced by this kind of feeding, the large intestines and sphincter become frequently so paralyzed that the feces pass involuntarily. About the time the diarrhoetic discharges commenced, there came on a huskiness and hoarseness of the voice, and a dry, constricted feeling about the larynx and pharynx. This was accompanied by a scalded, smarting soreness of the throat, as if it were inflamed, which extended into the bronchial tubes, together with the secretion of a thick, ropy, sweetish expectoration and considerable night and morning cough, with oppression and tightness about the chest. On examining the throat and larynx, the surfaces were found to be Avhiter than usual, showing that the parts were more deadened than inflamed.

This affection differed from all colds, it being caused by partial death or paralysis, instead of by over-action or inflammation. It continued while the diarrhoea lasted. There was also palpitation of the heart and oppressed breathing, on any excitement. I have noticed the same pulmonary derangement in all well-marked cases of chronic diarrhoea, or consumption of the bowels. During these experiments, the boarders were not allowed to perform any manual labor, or permitted to take any exercise besides the two to four mile walks, morning and evening. I was constantly with them, day and night, to observe all the symptoms and conditions ; to make such tests and microscopical examinations as were necessary to determine the various states and changes that were taking place and to indicate the latitudes and departures from the normal state. Had they been allowed to labor and take vigorous exercise, the fermentation and consequent consumption of the bowels would have been deferred to a later date. Vigorous exercise would have shaken and worked the food down out of the stomach into the small bowels, where it is digested, before any very serious fermentation had set in. Such as did set in, however, would have finally culminated in the disease as before, but under a much slower rate of progress. On the tenth day of the feeding, all the men began to show quite evident signs of semi-paralysis of the nerves of the extremities. This gradually increased until the army-biscuit diet was discontinued. During the last few days of the feeding the symptoms of locomotor ataxy were strongly marked, and the disease was progressing with alarming rapidity. The eyes were growing more and more dim, and the deafness and ringing in the ears were becoming strongly manifested.