DYSPEPSIA: ITS CAUSES AND PREVENTION.

Dyspepsia has once been called the "American sickness," and although this may be a slander against which many of the inhabitants of our great republic might protest, bad digestion is a disease frequent enough among us to justify us in considering its causes and in ascertaining by what means this curse of modern civilization may be avoided. A Frenchman, under the title "La dyspepsie des gens d'esprit," in the Paris Revue Scientifique of August 18, shows how utterly disregarded are the sanitary rules at the dinners of well bred people in France; and an American lady in a recent edition of a well known New York daily humoristically enlarges upon the offenses committed against health by persons of her own sex while dining in the largest city of the United States. Speaking of the lunch of shop girls up town, the contributor to the American paper deprecates the fact that the young American girls employed in business houses at luncheon time live almost entirely on sweets and food that renders little or no nourishment, rather than procuring at the same cost a repast which, though perhaps less dainty, would be far better for their constitution. "Left to herself," the writer says, "Miss Saleslady, pretty and refined though she may be, day after day and day after day keeps her temper, and waits on her customers, leaning on a slim luncheon of pie and tea. 'It is sweet and nice,' pleaded one girl to me the other day, 'and it goes so much further than anything else.'

"'Not further than bread and milk' I urged, 'and it is surely not half as good for your complexion.'

"'Oh, but the other ladies would laugh at me well if they saw me eating bread and milk for my luncheon. I think myself a bit of something light and nice, like eclairs or a charlotte russe, is ever so much more ladylike and nice.'

"Heaven save the mark! What sort of flesh and blood do they make to put on the slender bones of a growing girl? How will they stand by her, when perhaps she leaves the shop and chooses the life of wife and mother? The answer is easy. When the pie-eating, cooky-feeding girl gets married, put it down in your note book: One more dyspeptic, peevish woman entered the lists of the unlovely."

The contributor to the French review, although also condemning the careless choice of food, more especially points out the evil consequences of eating too hastily; and though M. Julva directs his attack chiefly against the gens d'esprit, i.e., the well bred people of France who neglect the rules of health for politeness' sake, his words apply equally well to the American business man who sacrifices his health during luncheon to the "almighty dollar."

"The feverish activity of modern life," he says, "induces many people to abridge the duration of their repast, and, particularly, luncheon is taken too hastily—a practice the danger of which, as a cause of dyspepsia, cannot be overrated."

This practice might not be so dangerous if, during the short time which we dedicate to our midday meal, we would at least imitate the habit of the Japanese, whom politeness requires to be absolutely silent while eating. When they like a certain dish, they express their satisfaction by graceful gestures addressed to their host, but they think it would offend him if they open their mouth for anything else except eating.

Watch, on the other hand, one of our lawyers at luncheon. He has just dismissed his last client, at the moment when he should be already at court, and in order not to be too late he has to lunch in double quick time. He has to eat his viands without having time to masticate them, and he swallows his big pieces, washing them down with several glasses of wine and water, and hastens to his carriage almost without giving himself time to breathe, in order not to miss his call.

Look at a Parisian dining in town. French politeness forbids him to be silent like the Japanese, and also requires of him not to speak with his mouth full of food. And if this were not enough, French gallantry commands him to serve the ladies first, so that just about when they have finished, he may commence to eat. In addition to this, if he does not want to appear ill bred, he must reply to all their questions, which he would not be able to do if he did not gulp down his morsels unchewed. What wonder, then, that most men have to suffer from eating dinner in such a manner, while all discomfort could be avoided, if the viands were served to one guest after the other in succession?

We don't want to exaggerate. There are privileged stomachs which can stand all that. But there are many to which half-masticated food is a real poison.

The unconscious dyspeptic constitutes an extremely frequent variety. Dyspeptics rarely complain of suffering from the stomach; many of them will even say to you that their stomach is excellent. But let us remember the old fable of Menenius Agrippa: The whole organism suffers when the stomach is ill treated.

Premature calvity (baldness), some eruptions of acne (pustules of the skin), a slight dyspnœa (difficulty in breathing) when mounting stairs, a blush of heat on the cheeks a quarter of an hour after luncheon, a violent craving for smoking after the repast, a feeling of sleepiness, which, however, quickly fades toward ten o'clock in the evening, little inclination to work during the first hours after awakening in the morning, all these symptoms, or any part of them, show that you have before you a candidate of the disease known as bloating of the stomach or the gout. According to the wise enumeration of Moliere, who was evidently prompted by Renaudot, such a person begins with bradypepsia (slow digestion), then suffers from dyspepsia (bad digestion), afterward from apepsia (indigestion), and later lyentery (a lax or diarrhea in which food is discharged only half digested), and at the last the vicious circle is often completed by obesity, uric affections of the liver or bladder, and all the other diseases belonging to that class.

Unfortunately, we are still far from the time when the public will appreciate that "prevention is better than cure." Perhaps this fundamental principle of health will be honored during the 20th century. At present it certainly is not. Meanwhile, those who have ruined their health by modern city life take recourse for their cure to a holiday, hasten to places where they find mineral waters, or try laxatives or milk diet to improve their condition. They wish to do something for their health once or twice a year. How much better, if they had not been acting against their health all the year round.

It is extremely difficult to teach our people to eat healthily. You will find no difficulty to persuade them to take medicine. People have always time to swallow a pill, but you will certainly have trouble to teach them to chew with leisure. How many people who find time every year to spend the season at Vichy will tell you it is quite impossible for them to spend five minutes more every day at luncheon time. And nevertheless they would regain these few minutes a day with interest, if they would avoid that host of maladies which will stop them one day in the midst of their occupations. I have seen a good many of my clients getting entirely rid of their rheumatic pains and gout and ceasing to suffer from sleepless nights by observing the following simple rules.

In order to chew meat conveniently—and this is one of the main points—one must accustom one's self never to mix meat and bread in the same mouthful. Take a small mouthful, chew it about thirty times, then swallow that part which has been reduced to pulp, and so on until all has been masticated. In doing this you will soon find out that roasted and broiled beef or mutton requires a longer trituration than boiled meats or stews; you will also perceive that fish is more easily masticated than meat, and you will finally understand why certain dyspeptics are forced to limit their food to fish, eggs, and milk diet. In fact, milk diet serves no other purpose than to furnish a perfectly digestible nourishment.

One of the indirect and unforeseen benefits of a careful mastication is that people gradually become accustomed to be satisfied with a comparatively small quantity of food, for as slow chewing is always more or less tedious, those who observe this rule soon cease to be great eaters, and also learn quickly to accustom themselves to another very important rule, viz., to drink moderately while eating. Two glasses of liquid will then quite suffice for a person who would drink four if he ate his viands swallowing them down without chewing.

Many obese dyspeptics when they once commence to carefully and to take liquid moderately while eating lose weight with an astonishing rapidity and become cured of the bloating of the stomach without being finally obliged to have recourse to the rigorous dry diet of Prof. Bouchard.

Wine and water, the French national drink, is an extremely frequent, and very often misunderstood, cause of dyspepsia. A good many people would enjoy excellent health if they were satisfied with pure water, that favorite drink of the aged. It is quite perplexing sometimes to see at the same table three neighbors, drinking at their dinner, the one wine, the other beer, and the third tea. How much better would it be if people, instead of choosing their habitual drink according to the place that they come from, would select it more with regard to their individual constitution! I know many who, after having, for fifty years, quietly ignored the fact, have come to the recognition that for them, wine, even if diluted with much water, is absolutely hurtful, and who, by giving it up, and by taking pure water, tea, or cider, to which Prof. C. attributes great success in his practice, instead, have got rid of their ailments almost as if by enchantment.

In conclusion, I should like to say a word with regard to salt, this panacea of arthritic persons (persons suffering from arthritis, swelling of the joints, as in gout).

For many years I have been laboring under the wrong impression, that salt is placed on the table merely for the purpose of salting boiled eggs, which the cook cannot salt in advance. Great mistake! The wisdom of nations has discovered that there are people for whom a great quantity of salt is a necessity, and that there are others who would become ill if they were to eat viands that are much salted. The salt cellar is there in order to enable every one to salt his food according to his own requirements. Many people are led by their natural instinct to salt their viands in a proportion to suit them. But there are others, among them, above all, the well bred persons previously mentioned, who treat eating with disdain and for whom the whole attraction of a repast is the charm of conversation, and to them the idea of having recourse to the salt cellar never occurs.

Whether salt is needed in order to add acid to the gastric juice or whether it has an antiseptic action in the digestive channel, I do not know. Certain, however, it is, that it possesses very appreciable laxative qualities, and under its influence those who go to drink the waters at Wiesbaden often see their intestinal functions restored to a surprising degree.

It is just as well, however, and even better, to take one's Vichy at home, and nothing is more simple than to use one's Wiesbaden at home, by using the salt cellar. The cure may then be completed by distributing over a whole year the thirty warm baths which have to be taken during the season at that watering place. The bath at 40° Celsius is a real boon for arthritic persons. The warmer it is, whether salt or not, the better it acts in producing an exuberant perspiration, and the less is one apt to catch cold when leaving it.

The above by no means exhausts the vast subject of dyspepsia and arthritis. But without ignoring the utility of thermal waters, of morning promenades, of dry frictions and gymnastics, the sufferers should, above all, be advised to minutely masticate their food, to limit the amount of liquids at meal time, to use salt, which will by no means increase their thirst; and in certain cases to abstain entirely from alcoholic drinks. Those who observe these rules may with impunity dine out, although those so-called great dinners, where all rules of health are left aside, are absolutely baneful for a great number of the inhabitants of our cities.