Plants

In terms of diets, we also know that specific types of athletes were fed in ways that matched their needs and improved their performance. One such form of sport was the ancient gladiator, and here we learn from Galen, that beans were highly recommended in order to build bulk into such athletes. Galen even goes so far as to state that the bean should be boiled long enough in order to avoid flatulence [28].

On broad beans: “There is also much use made of these, since soups are prepared from them, the fluid one in pots and the thick one in pans. Our gladiators eat a great deal of this food every day, making the condition of their body fleshy – not compact, dense flesh like pork, but flesh that is somehow more flabby. The food is flatulent, even if it has been cooked for a very long time, and however it has been prepared, while ptisane gets rid of all flatulent effect during the period of cooking.”

Whilst Celsus [19] provides us with a clear rank order for their nutritive value, Galen [22] seems unimpressed with vegetables as a whole, stating that they give “little nutriment to the body” and that they are “all unwholesome ”.

“Of vegetables the turnip and navew and all bulbs, among which I include the onion also and garlic, are stronger than the parsnip, or that which is specially called a root. Also cabbage and beet and leek are stronger than lettuce or gourd or asparagus” [19].

“Not only do we eat the seeds and fruits of plants, but also the plants themselves, often whole, but often only the roots, branches or young shoots, according as there is a pressing need for each. It is clear that, as well as giving little nutriment to the body, these are all unwholesome except, as I said, the spiny plants that have just emerged from the ground”[28].

An Experimental Inquiry on Poisoning by Oxalic Acid - 1823

Dr Robert Christison experimented on dogs by giving them 50 grams of pure oxalic acid, which generally causes vomiting, so in order to observe what happens, he sutured the stomach to prevent vomiting. 

He makes observations at different minute marks below:

2’ He began to make violent efforts to vomit, which were frequently repeated, till
12’, when they ceased; and the breathing became full and frequent; sensibility unimpaired; great restlessness,
16’ 30”. Breathing short, and at times suspended for a few seconds; he then hung the head in a peculiar manner, looked very dull, lay down on the side, and would not rise when stirred; at last, when he was set on his legs, he walked easily across the room; suddenly the breathing became very quick and short, and then ceased, although the chest was quite relaxed ; he staggered a few paces, and sank down on the side at
20’, motionless and senseless; the body was now spasmodically extended for a second or two, after which he made a few convulsive gasps; no pulsation could be felt in the region of the heart after the 20th minute.
21’. Death being complete, the body was opened without delay. The heart was distended in its pulmonary cavities, and not contractile; the blood in those cavities was dark, in the aortal florid, in both fluid, and coagulated almost immediately in loose clots.

There are 15 pages of further experiments recorded.

Though Bouchardat (1806-1886) read his first memoir to the Academy of Sciences in 1838, and the final edition of his book appeared in 1875, he came into prominence through important contributions in the decade 1840 to 1850. Like Rollo and all other founders of the dietetic treatment, he considered diabetes a disease of digestion. According to his theory, normal gastric juice has no action upon starch, which is digested in the intestine; but in diabetes, an abnormal ferment digests starch in the stomach, and glycosuria, polyuria, and other symptoms result. He claimed to demonstrate the presence of diastase in the vomitus of diabetics and its absence in that of normal persons. Hypertrophy of the stomach and atrophy of the pancreas in diabetic necropsies were also held to support his theory; and he was thus the first to suggest an influence of the pancreas in the causation of diabetes, and the originator of the attempt to produce it by pancreatectomy in dogs. For sugar determination in urine, he used fermentation, the polariscope, and the Frommherz copper reagent. By the fermentation method he showed the presence of sugar in diabetic blood, but found none in normal blood. At how low an ebb was the Rollo treatment at this time is shown by the pleading and arguments of Bouchardat. He begs all friends of truth to hear him; whatever be the original cause of glycosuria, diabetics, who otherwise all die, are actually saved when his dietetic treatment is used. 

Bouchardat in the clinical field ranks with Claude Bernard in the experimental field. He is easily the most brilliant clinician in the history of diabetes. He resurrected and transformed the Rollo treatment, and almost all the modern details in diabetic therapy date back to Bouchardat. He was first to insist on the need of individualizing the treatment for each patient. He disapproved the rancid character of the fats in the Rollo diet, but followed an intelligent principle of substituting fat and alcohol for carbohydrate in the diet. He forbade milk because of its carbohydrate content. He urged that patients eat as little as possible, and masticate carefully; also (1841) he inaugurated the use of occasional fast-days to control glycosuria. Subsequently he noted the disappearance of glycosuria in some of his patients during the privations of the siege of Paris. 

Though the introduction of green vegetables is credited by Prout to Dr. B. H. Babington, the honor of thus successfully breaking the monotony of the Rollo diet, properly belongs to Bouchardat. He recommended them as furnishing little sugar, a little protein and fat, but especially potassium, organic acids, and various salts. He also devised the practice of boiling vegetables and throwing away the water, to reduce the quantity of starch when necessary. As a similar trick he "torrefied" (i.e., charred and caramelized) bread to improve its assimilation; possibly this is the origin of the widespread medical superstition that diabetics may have toast when other bread must be forbidden. He invented gluten bread; this started the idea of bread substitutes, from which sprang the bran bread of Prout and Camplin, Pavy's almond bread, Seegen's aleuronat bread, and the numerous later products. 

Bouchardat also first introduced the intelligent use of exercise in the treatment of diabetes, and reported the first clinical experiments proving its value. He showed that carbohydrate tolerance is raised by outdoor exercise; and to a patient requesting bread, he replied: "You shall earn your bread by the sweat of your brow." 

There is a modern sound to his complaints of the difficulties of having treatment efficiently carried out in hospitals, of the lack of adequate variety of suitable foods, of deception by patients, and of how, even when improved in hospital, they break diet and relapse after returning home. He advocated daily testing of the urine, to keep track of the tolerance and to guard against a return of sugar without the patient's knowledge. 

He followed Mialhe in giving alkalies, viz. sodium bicarbonate up to 12 to IS gm. per day, also chalk, magnesia, citrates, tartrates, soaps, etc., also ammonium and potassium salts; he found them often beneficial to the patients but not curative of the glycosuria. He told a patient: "You have no organic disease; there is merely a functional weakness of certain parts of your apparatus of nutrition. Restore physiological harmony and you will attain perfect health." 

He used glycerol for sweetening purposes, and introduced both levulose and inulin as forms of carbohydrate assimilable by diabetics, for reasons which well illustrate his intellectual keenness. On giving cane sugar to diabetics, he had found only glucose excreted. Was the levulose utilized or changed into glucose? Levulose proved under certain conditions to be more easily destroyed in vitro than glucose. Accordingly he gave levulose and inulin to diabetics, and found no sugar in the urine. Therefore he recommended levulose for sweetening purposes, and inulin-rich vegetables for the diabetic diet.

Main Works:

• Manuel de matière médicale de thérapeutique et de pharmacie, (1838, fifth edition 1873) – Materia medica manual of therapeutics and pharmacy.

• Eléments de matière médicale et de pharmacie (Paris 1839) – Elements of materia medica and pharmacy.

• Nouveau formulaire magistral, etc. (1840, 19th edition 1874).

• De la glycosurie ou Diabète sucré son traitement hygiénique, Paris, (1875, second edition 1883) – On glycosuria or diabetes mellitus and its hygienic treatment.

• Traité d'hygiène publique et privée basée sur l'etiology, 1881 – Treatise on public and private hygiene, based on etiology.[2]

The object to be attained in the treatment of flatulence is the improvement of the digestive energy and the muscular tone of the stomach. Digestive solution without spontaneous decomposition is what is wanted, and the muscular power should be such as to be capable of expelling by eructation whatever gas may chance to be produced, instead of allowing it to accumulate. The food should be easy of digestion, and taken at regular intervals. Vegetable articles, from their difficulty of digestion, are not unlikely to occasion flatulence with a weakened stomach.