the quantity and quality of the juices poured out on a given amount
of nutrient material. The energy used up in gland metabolism must be
deducted from that of food taken in. The remainder will then indicate
the value of the food to the organism; that is to say, will give the
amount available for use by all the other organs exclusive of the
digestive apparatus. From this point of view those materials must be
taken as less nourishing and less digestible which are in large part
used up to make good the expenditure entailed by their digestion on
the part of the alimentary canal; that is to say, those food-stuffs
are less useful whose nutritive value little more than covers the cost
of their digestion; consequently, it is of great practical importance
to compare from this aspect the same foods differently prepared--for
example, boiled and roast meat, hard and soft boiled eggs, boiled and
unboiled milk, etc.
A discussion of some further medical questions may here be taken up.
The first concerns the therapeutic use of the neutral and alkaline
salts of sodium. In clinical, pharmacological, and physiological
text-books it is stated now, as ever, that these salts promote a flow
of gastric juice. We may look in vain, however, for any experimental
foundation to support this doctrine. The experiments brought forward
cannot be regarded as conclusive. When Blondlot sprinkled sodium
bicarbonate upon flesh, or Braun and Grützner introduced sodium
chloride solutions directly into the blood, they began with methods
either false in themselves or far removed from normal conditions. In
this case, however, the gaps in the experiment were happily made good
by the clinician, for the experiment appeared to be confirmatory of
clinical experience. That sodium salts (the chloride and bicarbonate)
are useful in disorders of the digestive apparatus there can be no
doubt. How do they act, however? It appears to me that here, as in
some other cases, medical science has fallen into error. When we
know that an effect takes place it does not by any means imply that
we know the mechanism by which it occurs; and although medicine is
broad enough and comprehensive enough to make free use of empiricism
in practice, yet it often thinks in narrow grooves when it turns to
the explanation of facts. It frequently tries to explain complicated
healing processes in the simplest way, on supposed physiological
data. And this is true in the present case, which affords an example
of prevalent medical reasoning; the alkalies work favourably in
digestive disturbances--therefore they are succagogues. Naturally
the stomach, under the influence of alkalies, sometimes begins to
secrete a greater quantity of juice. This means, however, that it
has recovered from a disordered state and has returned to normal
conditions. Consequently, the effect is due to the fact of recovery,
and not to a direct influence of the alkalies. This latter, however,
must be specially proved.
Public-domain text, read in full here on John Shaqi.
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