Part 37

After the gorging of a heavy meal, the overloaded blood and liver express themselves in a sluggish brain and one feels mentally, as well as physically, logy, or overloaded.

Since both sugar, carbohydrates and protein undergo chemical changes in the liver, it is evident that a diet consisting of an excess of either, must overwork the liver, not only through the nutritive food elements absorbed, but through the toxic substances which must be absorbed,—due to the excessive amount of food not being digested as readily as a smaller amount. If the food remains in the intestines too long, it is attacked by the bacteria always present there, fermentation results and poisons are absorbed and carried to the liver, where they must be broken down and rendered harmless, so as not to affect other parts of the system. If for any reason the liver is diseased, overloaded, or its action is sluggish, it will not promptly oxidize these toxins.

One of the most important corrective agencies for an inactive liver is exercise directed to this organ, to bring a free supply of blood, and deep breathing of fresh air. It is apparent that the blood must carry its full quota of oxygen to assist in oxidizing both the nitrogenous waste and the poisons; and it must be remembered that the liver must oxidize the waste from its own tissues, as well as from other parts of the system.

It is apparent, from the above, that the regulation of diet for an abnormal liver must be more in the quantity than in the quality of food and in the perfect digestion. It depends also upon the activity of the intestines, since the poisonous products of imperfectly digested and fermenting food, not being regularly eliminated, must be absorbed and carried to the liver. It is to free the intestines of the waste containing the toxins that physicians give calomel and other strong cathartics, to work off the toxins. These cathartics also work off foodstuffs from the intestines before they are absorbed, so that the liver has more rest.

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=Torpid Liver or Billiousness.= This condition is due to the sluggish action of this organ and a consequent failure to eliminate the bile through the bile ducts into the duodenum. It may be caused by inactivity and a resultant sluggish circulation of blood, to overwork of the liver, due to overeating, to breathing of impure air, or to insufficient breathing of pure air. It may also result from constipation and a resultant absorption of toxic matter as described above.

Many cases of billiousness are occasioned by obstruction of the opening of the bile ducts into the intestines, which is often occasioned by an excess of mucus in the duodenum. In such cases exercise for the intestines is clearly indicated.

In the bending, twisting and squirming movements which the infant in the cradle makes, the liver is regularly squeezed and relaxed. The same is true in the free movements of an active child at play. If during adult life these same free movements of bending and twisting the trunk were continued daily and correct habits of free breathing of pure air were established, there would be little call for “liver tonics.”

The elaboration of carbohydrates in the liver is an important part of its work and in case of inactive liver the sugars and starches should be limited, allowing that function to rest. Yet it is a mistake to allow a diet too rich in protein. The best method is to cut down the quantity of a mixed diet.

Two glasses of water an hour before breakfast followed by brisk exercise for the vital organs and deep breathing are important. The daily action of the bowels is imperative. In extreme cases a fast of two or three days, with a copious use of water, is recommended. Following this fast the diet should consist of easily digested foods, eliminating those containing starch and sugars in too great proportions, and it should be as limited as possible, consistent with the actual necessity for rebuilding and for energy.

Some authorities restrict fats in a diet for billiousness but the presence of fat in the duodenum stimulates the flow of pancreatic juice, which in turn stimulates the secretion of bile.

Lemon stimulates the action of the hepatic glands and thus tends to increase the liver activity.

There is a prevalent thought that eggs and milk cause sluggish liver action. There is no physiological reason for this if too much food is not eaten. One often loses sight of the fact that milk is a food as well as a beverage, and that when milk constitutes an appreciable part of the diet other foods should be limited accordingly.

The =DIET= may be selected from the following:

=Soups.=—Light broths and vegetable soup with a little bread toasted in the oven.

=Fish.=—Raw oysters, fresh white fish.

=Meats.=—Mutton, lamb, chicken or game.

=Farinaceous.=—Whole wheat or graham bread and butter, toast buttered or dry, toasted crackers, cereals in small portions.

=Vegetables.=—Fresh vegetables, plain salads of watercress, lettuce, and celery.

=Desserts.=—Gelatins, fruits, cornstarch, ice cream, junket, simple puddings,—all with =very little sugar=.

=Liquids.=—Hot water, lemonade, orangeade, toast water, buttermilk, loppard milk and unfermented grape juice,—not too sweet.

=AVOID.=—All rich, highly seasoned foods, candies, cheese, pies, pastry, pan cakes, or any fried foods, salmon, herring, mackeral, bluefish, eels, dried fruits, nuts and liquors of all kinds.

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The diet for gall stones need have no reduction in protein nor carbohydrates, since the oxidation, or the chemical action upon sugars is not interfered with. The presence of fat in the duodenum increases the flow of pancreatic juice which, in turn stimulates the flow of bile, so olive oil is often recommended in case of gall stones.

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is a serious disturbance of nutrition. It is known and tested by the appearance of sugar in the urine. However, the conclusion should not be drawn that one has diabetes if the urine test for a day shows sugar. This may be due to an excess of carbohydrates, particularly of sugar in the diet a day or two previous and all trace of it may disappear in a day. If continued tests for some period show an excess, nutritional disturbances are indicated.

The most usual form of diabetes is diabetes mellitus. It is supposed to be due to a disturbance in the secretions from the pancreas. Experiments have shown that the general process of putting the carbohydrates in condition to be absorbed into the blood is controlled by a secretion from the pancreas.

The difficulty which confronts the dietitian is to prescribe a diet without carbohydrates which will keep up the body weight and not disturb the nutritive equilibrium. The diet must consist of protein and fat and one danger is in the tendency to acetic and other acids in the blood, which involves the nervous system. The patient has a craving for sugars and starches, but the system cannot make use of them, and the heat and energy must be supplied by fats. While, as a rule, the craving for certain foods is an indication that the system needs the elements contained in it,—this is true in the craving of the diabetes patient for carbohydrates,—yet the desire must not be gratified, because of the inability to digest them.