[ Presented to the Connecticut Homoeopathic Medical Society, May 1932].
EUGENE UNDERHILL, JR., M.D.
“Dispense with moderation food to the body and to the mind repose. One must choose in all things a mean just and good.”.
These lines from the Golden Verses of Pythagoras were probably written around 700 B.C. Twenty-seven centuries have gone but the Golden Verses still shine in all their splendor, teaching the highest ethics and affording a complete program for daily living which, if we would only follow, would transform this earth into a paradise.
With all due respect for Hahnemanns psora theory and for some of the theories of modern medical science we must none the less admit than man collectively, if not apparently always individually, is his own destroyer and the creator of his own misery. We must look within, not without for the essential causes of disease.
The unrestrained mind follows desire and what do we find? Excesses on every hand. The purpose of food is to build, nourish and sustain the body, but how many of us confine our eating to the real needs of our daily living? Excesses in food and drink and perversions of the appetite will in time over-tax the organs of elimination and dam up the tissues. Slowly and insidiously the process goes on, the gouty joints, the enlarged liver, the obesity, the did not come in a day.
Many are the factors that go to make up the totality of the environment, that terrible something that keeps humanity seemingly almost in chains, enslaved and ensnared in the tangled web of destiny.
But there is a brighter side after all. It is not only the wealthy and the leisure class who can control their environment- and most of them make a terrible mess of it, each individual has it in his power every day to make more or less modification and improvement in himself and in his daily living. Man is a creature of habit first, last and all the time. He is routine in the extreme, routine in everything he thinks and does. It is well to step out of the rut once in a while and and walk up the hill alone and in silence. Improvements can be made, the daily grind can be modified, the diet can be changed, habits can be corrected. The trouble is not one will do all these fine things for us.
Some of the great philosophers have eaten neither meat nor fish nor flesh of any kind. They have refused to shed the blood of any creature either in person or by proxy. Partaking of the herbs of the field and he pure fresh fruits of the tree and vine they have cleansed and purified their bodies, rendering them more worthy vehicles for the higher expression of the mind and spirit. On the other hand we read of savage and barbarian chieftains drinking the blood and eating the flesh of their greatest enemies to increase and augment their own daring and ferocity.
Was this entirely a superstition? There is evidence to show that food can affect man not only physically but mentally and morally as well. in certain championship prize fights where a predetermined weight has to be reached to prevent disqualification, after the official weighing-in ceremonies, the contender, who has been running it off and sweating-in ceremonies, the contender, who has been running it off and sweating it off, has been promptly treated to a generous quantity of beef broth and to a large, very rare beef steak.
Why the meat and the broth? why not give him apple sauce and whipped cream? Can it be that the trainer and his advisers think it could possibly make a difference in this the twentieth century? “Upon what meat doth this our Caesar feed that he is grown so great?”.
There are certain soils which just meet the nutritional requirements of the natural flora which thrive thereon. The flora has adapted itself to the soil and the climate and in turn the natural fauna of any region has adapted itself to the available flora. Thus there is a correlation between the soil, the flora and the fauna, an interdependence as it were, a circulation between the mineral, the vegetable and the animal kingdoms.
It has been observed and the wild creatures, when there is an abundance of their natural food, are mixed eaters only to a very slight degree. There is apparently in most cases some one food of choice and doubtless that food is best adapted to the needs of the organisms which feed upon it. As the supply of this nutriment becomes more and more limited there is noticed a gradually increasing consumption of the next food in the order of preference and so on until is reached where articles ordinarily rejected will be consumed with avidity, but there is a limit-some apparently valuable foods will remain untouched even to the point of starvation and death.
Adaptability requires time and in one or two generations a given species can be modified only to a quite limited degree, although individuals within the species are distinctly more flexible than the average. An observed characteristic of wild life is that after eating to satiety a rest or nap is generally in order.
Wild creatures have no physicians but they are protected by natural unperverted instinct. When sick or injured they rest and fast and sometimes partake of a small quantity of some laxative herb, and the treatment shows a high percentage of successful results. There have been instances where wild animals have, by natural instinct, been led to consume medicinal herbs and other substances which in all probability have acted in accordance with the law of similars.
A farmer in northern Pennsylvania buys young registered calves each year and pastures them on a large tract of land from May to November and in ordinary times sells them at a good profit. They have no shelter, they are fed no grain. They are their own caretakers and what happens? Grazing in the sunny meadows, resting in the shady woods, feeding on the grasses, bushes and leaves and drinking the pure mountain water, these calves have built flesh and bone. Sleek of coat, fleet of foot, what perfect specimens they are. That farmer is a real scientist, he fences in his land, turns the calves loose and nature does the rest, efficiently and with simplicity.
Coming now to the question of diet in acute illness how are we to proceed? homoeopathic physicians are more and more regarding acute disease as a flare-up of latent psora and as an eliminative effort on the part of the constitution. If we accept this view and then proceed to give the patient “good nourishing food” every two or three hours we are, to say the least, inconsistent. Why should an active, well person enjoy only three meals a day and the acutely sick individual be given six or eight feedings in twenty-four hours “to keep up his strength”? If the patient is weak why is he weak? Is it due to lack of food or to the debilitating and enervating effects of the toxaemia?
It is little short of remarkable how acute troubles remain uncomplicated and proceed to uneventful recovery simply by keeping hands off. Prescribe rest in bed in a well ventilated, sunny room, proper attention to bathing, enemas for the bowels if necessary and no food. We will, of course, allow the patient water to drink if he wants it, or he may have cracked ice to chew if the prefers.
If acidulated drinks are refreshing or are especially desired the juice of half a lemon or a lime (without sweetening) may be occasionally added to a glass of water. Nothing else is required until the acute symptoms have subsided and the demand for food becomes strongly insistent, then proceed slowly and with caution.
The only way to satisfy oneself as to the sanity of this procedure is for each physician to try it for himself in case of personal illness, in acute sickness in his own family and in the daily practice of his profession in respect to all forms of acute illness. Give this profession if respect to all forms of acute illness. Give this method a years trial and then go back to the old routine-if you can.
For the timid a less radical diet may include raw fruit or fresh, raw, unsweetened fruit juices. In case such are prescribed it is well to allow only one kind of raw fruit or fruit juice at a feeding and only two or three such meals in twenty-four hours. Fruits are quite active chemically and there is more dangers of incompatibility from mixing fruits than from mixing vegetables. If desired a different fruit can be given each time and this is often an advantage.
It is, of course, well to consult and observe the patients cravings, aversions and aggravations in regard to food and drink. These idiosyncrasies are more to be trusted in acute conditions than in chronic disease where perversions of the appetite have become more or less fixed through years of unhygienic eating.
Whenever fruit juices are prescribed it is important that only the unsweetened freshly expressed raw juice is used. Cooked, bottled, preserved or pasteurized juices are a poor substitute and the acutely ill can well afford to do without them. Among the fruits that may be prescribed on this basis, as a concession to the weakness of the flesh, may be mentioned apples, pears, grapes, peaches, pineapples, oranges, lemons, limes and grapefruit. Other fruits in season may be allowed.
Honeydew melons, cantaloupe and watermelon may also be permitted, remembering that melons will not always agree and sometimes even act as mild intestinal irritants. Oranges will wholly disagree with some patients, especially those suffering from liver involvement.
The more expressive an acute illness, either in the form of fever, eruptions, or discharge, the more effectual and complete is the cleansing process. The young, as a rule, are the most susceptible to these acute manifestations and the most satisfactorily cleansed by them. As life advanced susceptibility and flexibility decrease while pathology and structural changes increase until chronic disease slowly, almost imperceptibly fastens itself it appears to repel, in ever increasing degree, the invasion of acute disease. The Vital Force itself less and less, the house cleaning is neglected.
Why is the death rate in pneumonia so appallingly high? There is no need to dodge the issue. At least ninety per cent of all who die from this disease have been sacrificed on the altar of ignorance. They have been murdered by the “scientific” treatment and the “good nourishing food”. Give the patient and his digestive machinery a complete and sorely needed rest. Watch and wait and use a little good old-fashioned commons sense.
Provide such nursing care as any worthwhile wife or mother can give and confidently expect full and complete recovery without complications and without sequellae. The present death rate in acute disease in general and in pneumonia in particular is absolutely inexcusable and is explainable only on the ground that “food rush in where angels fear to treat”. Stay out! Let nature alone. If she calls for her give her what she asks for, namely, the similimum, the indicated remedy.
In considering diet in chronic disease many problems are presented for our consideration. The diet as well as the treatment must be carefully individualized but this must be done in accordance with sound principles based on a rational philosophy.
Diet fads and diet insanities are multiplying every day to the bewilderment of the physician and often to the determent of the patient. Read a dozen up-to-date works on the subject of nutrition and you wont know where you stand. The last word on diet remains unuttered and apparently there is not such thing as a last word on any subject. It would seem that we are only beginning to learn a few first principles in the science of nutrition and present theories and views may have to be modified or abandoned as new discoveries are made.
The caloric value of foods and the caloric requirements of individuals are being seriously questioned. The vitamin content of foods is of far greater importance than their caloric value. In the absence of the essential vitamins starvation may occur in the midst of apparent plenty.
The mineral salts are also essential to normal function and are regarded by many as the very quintessence of the whole problem of nutrition. Some of the mineral salts exist in the human body in the most infinitesimal trace, but that trace is none the less essential to physiological well being.
We often hear of deficiency diseases, it being understood that there has been either a mineral salt or a vitamin deficiency in the diet which through the habit of years has finally resulted in a definitely diseased state of the constitution. Such diseased states should and do respond to a essential mineral salts as built up by the vital processes of animal and plant life. The crude inorganic mineral salts are practically worthless unless given in potentized form, when they become actively and truly potent for good if prescribed on the symptoms and in accordance with the principles of correct homoeopathic practice. Now that the vitamins are being isolated in crystalline form we may expect new miracles of healing when they are potentized and fully proven.
Acidosis is a word that is doing yeoman service these days. “Doctor, what seems to be the trouble in my case?” The doctor, looking as wise as a serpent but not quite as harmless as a dove, relies, “You are suffering from acidosis,” and the patient is content. The normal reaction of the blood is slightly alkaline. As certain chronic diseases such as diabetes and tuberculosis come on, the alkaline-acid balance is disturbed, the alkalinity being relatively decreased and the acidity proportionately increased. In malignant diseased and the acidity proportionately increased. In malignant disease a reverse condition is present, namely, that of alkalosis, an excess of alkalinity.
Just where do we stand after all? Acidosis, alkalosis, focal infection, endocrine imbalance and finally our good old friend psora. Perhaps the last is as good as any for us to hide behind and it serves the additional purpose of a password among the brotherhood of the true Hahnemannian fraternity.
Now let us suppose we have taken the case and have decided on the remedy and are about to dismiss the patient. “Doctor, what about my diet?” Some people are simply bound to ask embarrassing questions; they cant help it. I well remember how tired I used to feel when this question was asked.
Just another point or two before offering a few suggestions in the dietetic management of the chronic case. In taking the case be sure to include the patients present dietary habits. For purposes of remedy selection it will be necessary to know the desires, aversions, ameliorations and aggravations in respect to food and drink. This, however, will be insufficient to give an insight into the real eating habits of the individual patient. Request the patient to bring, each time he comes to the office a complete list of all food and drinks taken at each meal and between meals. This list should cover a period of about two days.
Explain to the patient that he is to make no change whatever in his diet until after he submits his menus for your study and that you will disturb him and his household as little as possible by making a few corrections in his present meals rather than prescribing a radically different and completely new diet. Examination of a number of such dietaries will make one sometimes wonder that some patients are as well as they are, or even that some of them are alive at all.
Observe how exceedingly unbalanced, one-sided and habitual is the average persons intake of food and drink. Note the evidence of pampered and perverted appetite. Consider these factors in relation to the etiology of the individual case and also in relation to the apparently indicated remedy. Certain patients have obviously eaten their way into their present diseased state and they should, in so far as possible, eat their way out and back to health.
suppose we have a neurotic case calling for some remedy such as Ignatia, Nux vomica or Chamomilla and the patients diet outline shows that he is taking, let us say an average of five or six cups of coffee a day. Consulting the repertory we find, under the rubric “aggravation from coffee” over forty remedies listed, five of them in the highest grade, namely, the three mentioned and also Cantharis and Causticum. How are we to interpret our findings and what is to be the rationale of our procedure? We may find that coffee was one factor if not the chief causative factor in bringing about the present disorder. Coffee may have been largely responsible for the nervous state and for the production of the symptoms indicating the remedy.
Such an opinion is not to be hastily arrived at on seeing a certain article of diet written all over the patients menu, but only after considering the totality of the case from all standpoints including the relation of the indicated remedy to any pronounced food habits. Would it not seem unwise in such a case to prescribe the remedy and not to correct the diet? If the cause or an obviously important factor in the production of the symptoms is allowed to continue its undermining influence how can we expect to cure the patient?.
We are perhaps inclined to take too narrow a view of the word “aggravation” as used in the rubrics of the repertories. The word aggravation may imply several things, namely causation of the trouble, perpetuation, increase or exacerbation of the disorder and finally interference with remedy action. Using the rubric “aggravation from coffee” once more as an illustration, coffee may have helped to bring on the symptoms of a certain remedy, or the taking of coffee may aggravate or augment a condition that was brought on from other causes. Finally, the action of the indicated remedy may be interfered with or aborted owing to the inimical relationship existing between the medicine and the coffee. This view of aggravations and ameliorations applies not only in respect to food and drink but in relation to many other factors throughout the entire repertory of the materia medica.
The average chronic patient will soon show improvement through dietary correction and improved management of the daily routine of life. First remove the obstacles to recovery and then prescribe the indicated remedy. There is seldom the necessity for a prescription at the first interview. Saccharum lactis will often do wonders in connection with sound advice and it is such a sensible and safe prescription. How many lives and how much suffering might be saved if all physicians were to prescribe placebos more often and drugs only on clearly defined indications when really necessary.
In general it is both convenient and wise to base dietetic corrections on the patients present daily menu. Gradually modify the diet and simplify the life and in so far as possible suggest constructive changes in the daily routine. Give each patient a health education while he is under your care. When one member of the family comes for treatment all other members should benefit in some measure from your sound and constructive professional advice. In many cases it is well to find out which meal means the least to the patient, if he had to go without one meal a day, which would it be? Usually he will specify either breakfast or luncheon. Advise him then to be very strict at that particular meal, taking some cleansing food such as raw fruit or raw fruit juice or if he prefer a raw vegetable salad. This procedure is especially advisable in rather toxic cases at the very outset and before prescribing the remedy.
In very toxic cases the no-breakfast plan may be in order or even a further restriction to one meal a day may sometimes be indicated. As long as excess of intake occurs there is apt to be more or less storage of toxic and waste products taking place in the tissues. Restriction of intake and intervals of real rest from food favor the elimination of stored toxins and the dissolving out of accumulated debris. At first such periods of rest from food will often produce a feeling of gnawing emptiness and a sensation of weakness.
It is well to explain to the patient that these sensation are in no sense due to starvation or to lack of food per se, but to the dissolving out of stored poisons from the tissues and the consequent circulation of the free toxic products through the blood and lymph channels pending their elimination from the body. The effects of fasting on the appearance of the tongue and the odor of the breath are frequently observed but seldom understood. A patient may be toxic in the extreme though his tongue may be clean and his breath inoffensive. Now place him on a short fast and follow it up with a cleansing dietetic routine and his tongue may become heavily and foully coated and his breath offensive to the last degree.
What is the explanation of this phenomenon? Simply this elimination of toxic substances from the tissues through the mucosa of the tongue, throat, oesophagus, stomach and intestines. The action is favourable if not too rapid and intense and the patient is to be congratulated and encouraged to keep up the good work. Failure to properly cleanse the interior of the body and to keep it clean is one of the great reasons for our failure to really cure a respectable percentage of our chronic cases.
There are many ways to proceed in the correction of the diet. Let each physician read widely and study deeply and gradually build his own philosophy on sane, sound principles. It will be necessary to guard against routinism in prescribing diet as in prescribing medicine. The routine way is the easy way for the physician but it is only occasionally and accidentally the best that can be done for the patient. Individualize the remedy, individualize the diet. Fit the treatment to the patient and not the patient to the treatment.
Another diet modification that often proves highly beneficial in selected cases is to prescribe a mono-diet meal once or twice a day reserving the mixed diet for dinner or supper-whichever is the hearty meal. a mono-diet meal is simply one food or one correct food combination. The great advantage of a mono-diet meal is that food incompatibilities are thus easily avoided and disagreement is nearly always prevented.
Certain steps can be gradually prescribed in the correction of the diet and can be easily carried out. Let each step be in the direction of simplicity and more natural foods and habits of eating and if possible let each step be toward the correction of vitamin and mineral salt deficiencies if any such are found to exist. Do not attempt to do too much at once unless a very threatening condition is present when radical measures may be in order. For example in case of extreme cardio-renal hypertension where uraemia or cerebral haemorrhage is a grave possibility proceed as in an acute illness. Stop all food, giving only water with perhaps occasionally a little lemon or lime juice. Rest in bed and one or two enemas a day may also be required. In less urgent cases of this type prescribe a fairly strict cleansing diet and advise out-of-doors exercise carefully avoiding over- exertion and over-exposure to the sun until the hypertension is definitely relieved.
The following steps in diet correction and simplification may prove both helpful and suggestive in the management of the average chronic case. These modifications on the daily menus submitted by the patient for the physicians inspection and advice.
1. Insure sufficient alkalinity in the diet by limiting the intake of highly acid forming foods such as tea, coffee, cocoa, meat, fish, eggs, cheese, etc.; substituting such basic and alkaline foods as fresh raw fruits, raw vegetable salads and in selected cases fresh, raw, unpasteurized milk.
2. Eliminate from the dietary all unnatural, patented, processed and manipulated articles such as the numerous breakfast foods, most of which are demineralized and devitalized to a serious degree.
3. In place of white sugar, white flour and polished rice prescribe natural brown sugar, honey, maple syrup, whole wheat flour products and natural brown rice.
4. Advise against the over-seasoning of food. Particularly restrict the use of vinegar and hot sauces, strong spices and condiments. Restriction of these stimulating and irritating substances is of decided importance not only in cases of hyperacidity and gastro-intestinal conditions generally, but also in case of nervous origin-functional neurosis, hysteria, etc. Advise against the use of iodized and so-called free running salt as these contain injurious chemical that may possibly interfere with the recovery process and the curative action of the indicated remedy. Plain bag salt may be allowed in extreme moderation although vegetable salt and celery salt are much to be preferred. Lemon and lime juice are healthful substitutes for vinegar. A well balanced normal, natural diet contains all necessary flavoring substances. Seasoning is largely a question of habit and perversion of the appetite.
5. Prohibit the use of soft drinks and artificial beverages of all kinds, including all intoxicating liquors, many of which are insidiously violent in their effect on the body chemistry. Pure water, orange juice, fresh unsweetened lemon or limeade and pure, fresh, unpasteurized apple cider are all real health drinks provided no preservatives have been added.
6. Where there is an inordinate desire for sweets, we will, of course, expect the homoeopathic remedy to correct the abnormal craving to some extent, but the habit factor cannot be ignored and medicinal action may be hindered as long as such a pronounced dietetic error remains uncorrected. Unsulphured dates, figs, raisins and sun-dried fruits may be allowed in moderation as healthful substitutes for candy.
7. Correct the habit of eating and picking between meals. Nothing should be taken between meals or at bedtime with the possible exception of raw fruit.
8. Instruct the patient to avoid eating when there is no appetite or relish for food, and if for any reason a meal is omitted there is seldom any need to make up the deficiency.
9. Drinking at meal time is largely a habit and is wholly unnecessary, although not perhaps harmful. The obese patient will do well to restrict liquids at meal time.
10. Advise a small variety of foods at any one meal but a large variety over the period of a week, and a vast variety of natural foods in a months time so that there may be no possible vitamin, mineral salt or chemical deficiency.
11. Restrict or eliminate for the most part the use of canned, bottled and preserved foods. Home canned fruits where natural brown sugar has been used for sweetening may be allowed. Canned tomatoes retain their vitamins better than most other vegetables and fruits and are often to be preferred to the hot-house product. encourage, is so far as possible the use of fresh natural foods.
12. Many patients will respond immediately when the diet is corrected along the lines of food compatibility. These rules are as follows:.
a Proteins (meat, eggs, fish, cheese, etc.) can be combined with raw fruits, raw or cooked non-starchy vegetables and with fats and nuts. (Proteins should not be combined with starches or sweets.
B. Starches can be combined with sweets, non-starchy vegetables and with fats. (Starches and sweets should not be combined with acid fruits or with proteins).
C. All non-starchy vegetables can be combined with either starches and sweets or with proteins, fats and nuts.
Starches require alkaline conditions for proper digestion. Proteins require acid conditions. Theoretically the two types of food will not digest at the same time and fermentation results. This is a sorely mooted point among authorities on dietetics. In This is a sorely mooted point among authorities on dietetics. In some cases it does not seem to matter but in cases of ulcer of the stomach and hyperchlorhydria the observance of correct food combinations according to these simple rules may become of extreme importance. Patients suffering from intestinal fermentation and flatulence will do well to carefully observe this principle of food compatibility.
Time will not permit the discussion of corrective diets for deficiency diseases but the subject merits earnest study on the part of every physician.
Results in chronic work can be improved at least twenty-five per cent by intelligent management of the diet. They can be still further improved by thoughtful attention to the daily routine of life.
Sufficient sleep, proper amount and kinds of exercise and adequate time spend out of doors, all these are obviously important. Carefully regulated and controlled exposure of the body to air and sunlight will make a vast difference especially in anaemic cases.
Simplify and untangle the life in so far as conditions warrant and circumstances permit. Introduce the patient to the real joys of simple, wholesome living and you will go far toward bringing him back to health and happiness. One of the most frequent and obvious faults among people generally, both in sickness and in health is that of overeating. Another is hurried eating. Still another is the taking of food when excited, worried or sorely vexed in spirit. Correct the habits of eating before it is too late. Clam the mild and restrain the appetite.
“Let thy heart feed no more on vain desires”.
The greatest enemy of the aspiring Hahnemannian is Doubt. There is no ease or peace of mind for him until he escapes from Doubting Castle. At first he doubts the correctness of his own or his patients observation, doubts his choice of the remedy or of the potency, doubts the duration or even the reality of its action, doubts his diagnosis and prognosis; but especially is he doubtful of the efficacy of a high potency and a single dose. If he persevere conscientiously, however, influences only by the results of pure experiment, one by one these doubts are swept away. It is only requisite to cultivate the true scientific spirit which is characterized by an open mind, fidelity to right methods, and faith in the uniform action of the eternal laws of nature.
This faith in the supremacy of Law is the most marked characteristic of all truly great scientists. They know that if right methods are used, right conditions complied with, the result cannot fail to be good. They work patiently, therefore, surmounting all obstacles. So must the Hahnemannian cultivate this faith until it shall obliterate his doubts. When he is once fully persuaded in his own mind, by the logic of observed facts, that it is right to await the full development of the healing action of a dose of the indicated remedy, and when he is conscious of having complied with all the requirements of the law in the selection of that remedy, then he can await that action with patience and satisfaction. He knows that for the time being all has been done that can be done. The remedy must have time to do its work, and it will work. STUART CLOSE, M.D., from unpublished notes.