NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
24
At every change of diet the same routine was observed, i.e.,
the prisoners were kept on the diet two or more days before collec-
tion of their excreta for analyses.
III.The feeding of the prisoners was carried out on the following plan :—
The amount of each separate item of the diet was weighed dry
before cooking, again weighed after cooking, and then distributed
to each separate batch of prisoners under observation. Any cooked
food that remained uneaten was weighed, and its amount in the
dry form calculated and subtracted from the total dry material of
the diet. The total value of the diet in proximate principles.
was then determined by analyses of the food materials actually
in use at the time of the experiment.
IV.The collection of the excreta :—The pooled urine and pooled fæces
of the prisoners forming the batch were collected, measured—or
weighed as the case may be—and samples were taken as required.
This was done usually for five days, sometimes more, for each
set of observations.
In the investigations carried out in Calcutta, there was no
difficulty as the excreta were sent to the laboratory every morning ;
but for jails hundreds of miles away from Calcutta we had to make
special arrangements. The plan that we finally adopted and which
gave very satisfactory results, was to have the urine and fæces.
measured or weighed, as the case be, on the spot and samples put
up at once : for nitrogen with the usual amount of pure sulphuric
acid ; for ammonia with calcium hydrate ; for urea with
the barium hydrate and chlorate mixture, then the ether and
alcohol solution was added : the fæces were weighed, thoroughly
mixed and samples weighed and put up with sulphuric acid for
nitrogen ; or dried, weighed, and put up. By following this method
we eliminated all source of loss of nitrogen from decomposition,
and were able to make a week's collection before sending the
samples to the laboratory. This was a matter of some importance
for some of the jails dealt with were over 300 miles from
Calcutta—one being 411 miles away.
The samples obtained in this way were collected in reagent
bottles with ground-in glass stoppers ; for safety, the stoppers were
sealed and tied tightly in, and the bottles were packed in a parti-
tioned box—a partition for each bottle—with saw-dust, and care-
fully guarded the whole way to the laboratory to prevent breakages.
We had practically no breakages with these samples.
In the Presidency Jail, Calcutta, Midnapore Jail and Puri Jail
we estimated the total nitrogen of both urine and fæces. In the
remaining jail we decided to rely on the total nitrogen of the urine
for our results. Our reasons for so doing were that we found a
good deal of difficulty in separating the fæces corresponding to the
diet given, owing to the fluid character of the stools. It was
also very difficult to deal with the large volume of fæces passed
by the prisoners, and the unpleasant nature of the work was a
serious source of objection to its being properly performed.
Our main reason, however, for giving up the fæces estimations and relying on
the urine—thus following Chittenden's method—was that we found that, so long as
the prisoners were healthy and taking their food properly, very similar results
were obtained whether we worked with the fæces or the urine.
In order to make allowance for the nitrogen that had undergone metabolism
in the body but was eliminated by the skin, or in the stools in the remains of the
digestive juices and intestinal débris, we decided to add 0.5 gramme of nitrogen
per man daily to the total nitrogen of the urine. This may be a little too low,
but it does not affect the results to any appreciable extent.
As indicated above, we had to eliminate all source of error by examining only
prisoners in good health and at once rejecting anyone who showed signs of
sickness. On several occasions we have rejected a whole batch and the work done
on it for this reason.
Another factor that we had to take into consideration was the gain or loss
in body-weight. Although it is practically certain that, in a very large proportion
of cases, a temporary gain in body-weight is not accompanied by a retention of
nitrogen, but is due to retention of water or storing of fat, still we decided to reject
all observations—in which the urine was relied on—when anything more than a
trifling difference in the average weight of the batch existed between the first and
last day of observation. As a matter of fact while there was, in every instance, a
gain in weight as soon as the prisoners were placed on a weighed-out dietary, after
the first few days the average weight of a batch remained practically constant.
In this connection the very large bulk of the stools passed and their average
wei ght was a very marked feat ure ; furt hermore, i t was not i ced how very si mi l ar
the percentage of nitrogen present in the mixed fæces of a batch was from day to
day whatever the weight the stools happened to be, or whatever the diet given.
This has been observed by other workers* and, without pressing the point, it was
found that the percentage of nitrogen of the fæces was fairly uniform under
different conditions, while the amount of total nitrogen varied largely with the
total weight of the stools passed.
* Prausnitz, Zeitsch f. Biologie. 1897.
26
We have now traced the history of Bengal Jail dietaries as recorded in the
excellent papers cited, and indicated the different factors that led up to the pre-
sent investigation. We have given in brief outline an account of the scope of
the present enquiry with some discussion on the difficulties to be overcome, and
an indication of the way in which we have attempted to arrive at the nutritive
value of jail dietaries and their modifications. We have discussed what the real
value of a diet consists in, viz. , the amount of nitrogen it presents that is capable
of absorption and assimilation, and the amount of energy it is able to furnish
(deducting that lost to the body in the urine and fæces, and the important loss
from excessive gastro-intestinal fermentation). We have given a short résumé of
the present investigations carried out on the different races of people examined
in the several jails of the province, with a description of ou methods of work.
Nothing now remains but to give an account of the results obtained with the
conclusions at which we have arrived. In doing so we shall approach the sub-
ject as "independent enquirers seeking the truth unconcerned where the evidence
may lead us, and shall endeavour to put all aspects of the question that come
before us in an equally strong light."
Before proceeding to do this it is our pleasing duty to tender our best thanks
for the kindness shown us, the interest taken in the work, and the able assistance
in its fulfilment, invariably given us by those officers of the Jail Department in
Bengal, with whom we have come in contact during the investigations.
The Inspector-General of Jails, Lieutenant-Colonel W. J. Buchanan, I.M.S.,
has earned our best thanks for smoothing the path and giving us a free hand to
make use of the jails as we found necessary. To the Superintendent of the Presi-
dency Jail, Calcutta,—Major Mulvany, I.M.S.—we gave much trouble by
continually asking for prisoners, he never resented our doing so, but, on the
contrary, was always willing to give us every assistance in his power. Captain
Mackelvie, I.M.S., of the Puri Jail, has given us much help in our work in that
jail, and kindly undertook to supervise the six months' experiment on the whole
population of his jail. Captains Gillitt and Hamilton of the Behar Jails assisted
us very ably in the work on the Behari—sometimes much to their own incon-
venience. To Major Maddox, I.M.S., of Ranchi, we are specially indebted for
information concerning the aboriginal tribes investigated in Ranchi Jail.
Lastly, we have to thank Mr. Piffard, Superintendent of Darjeeling Jail, for
making things easy for us among the representatives of the more truculent tribes
of the hills.
To Professor B. Moore of the Bio-Chemical Department of Liverpool Univer-
sity we owe a debt of gratitude for much advice regarding some of the more
knotty points that turned up during the course of the investigations.
PART I.
CHAPTER I.
The Food-Stuffs of Bengal Jail Dietaries.
The food materials in use in the Bengal Jail dietaries are all derived from the
vegetable kingdom; so that, for the time during which they are under confinement,
the prisoners are strict vegetarians. No animal food of any kind enters into their
dietaries, except in hospital and in certain circumstances which will be referred to.
These food materials consist of rice, different dals and vegetables in Lower
Bengal, and rice, wheat ata or makkai ata (maize), different dals (pulses) and vege-
tables in Behar. The rice in use is of two kinds—Burma rice and Country rice.
Burma or Rangoon-rice, the so-called "white" rice, is prepared direct from the
unhusked "paddy"; it is milled by machinery and the husk together with the
pericarp and surface layers of the seed is removed. The result is a clean white rice
grain, deprived to some extent of its outer layers and therefore slightly also of its
protein and mineral constituents.
Indian or Country rice is prepared by soaking the "paddy" for from twenty-
four to forty-eight hours in water, then transferring it to lightly covered cylinders
in which it is steamed for from five to ten minutes; subsequently it is removed
to open paved—usually sun-baked mud—courts and dried by exposure to
the sun. It is either stored as "paddy" or milled at once.
The sample obtained by this process is of a yellowish-brown colour, usually
very dirty from contamination with dust and earth acquired during the drying
process. The outer layers of the grain are not lost so that, weight for weight, it
should contains more protein than Rangoon or Burma rice.
Reference to our table of analyses of the food-stuffs will show that we did not
find the country rice to contain a higher percentage of protein than Burma rice.
This is probably due to the much greater contamination of the former with foreign
material. Our analyses represent the composition of the food materials as
received from the different jails, and as those materials are given to the prisoners.
They were not put through any preparation such as drying, cleaning, etc., but
were simply analysed as received. Rice forms by far the greater proportion of
the ordinary jail diet. The following are the scales in general use in Bengal Jails:—
In Lower Bengal. In Behar.
Burma or Country rice
26 ozs
16 ozs.
Different dals
6 ,,
6
,,
Vegetable
6
,,
6
,,
Wheat ata
10
,,
or
or
Makkai ata
12
,,
27
D 2
Rice is the poorest of all cereals in protein ; when cooked it swells up and absorbs
about three and a half times its weight of water, some of its mineral constituents
being dissolved and lost when the boiled rice is strained. Very little of
the protein is removed when rice is boiled in a large quantity of water and the ex-
cess of water drained off—the ordinary method of cooking rice in Bengal
jails. From analyses of the drained material there appeared to be a loss of about
0.20 per cent. protein.
The percentage of starch in rice is high, up to about 80 per cent. This starch
is present in small and easily digested grains. Fat is very deficient in rice.
According to Continental authorities,* practically none of the starch of rice
is lost from non-absorption, but the waste of protein amounts to about 20 per cent.
These figures, however, were obtained from dietaries in which the quantity of rice
given was only a few ounces—a very different thing from a diet containing twenty-
six ounces, so far at least as absorption of protein is concerned.
The different dals in use in Bengal jails are :
—
Mung, Gram, Mottar, Arhar, Massur and Kalai dals. They belong to the
natural order Leguminoseae and are chiefly characterised by their richness in pro-
tein, being termed for this reason " the poor man's beef. " The chief protein of
pulses is legumin† which closely resembles casein of the milk in its composition.
It is by the addition of dal to the diets in Bengal that their deficiency in protein is
made up. The amount in the dietaries has undergone a gradual increase and is
over six ounces per man daily.
As will be seen from our analyses the percentage of protein is uniformly high,
but varies in the different kinds of dal in use—Mung and Massur containing up to
26 per cent., Mottar and Kalai somewhat less, and Arhar and Gram dal
less still, in round numbers about 20 per cent. When cooked, dal in whatever form
takes up a large amount of water, usually at least three times its own weight,
This increase in water means a corresponding increase in bulk and must, therefore,
be taken into account in considering the real nutritive value of this form of food.
Investigations‡ on the absorption of pea or lentil flour, properly cooked, show
that the protein is all taken up except about 8 or 9 per cent. If, however, the
pulse is not given in a state of fine division, as when the lentils are simply boiled
till they become more or less soft—the method of cooking in Bengal prisons—the
loss of protein has been found to rise to 40 per cent.§ In Lower Bengal, rice, dal
and vegetables make up the whole diet—the only variations possible being the
ringing of the changes in the different kinds of dal.
We have already referred to the value of this diet as regards its digestibility
and absorbability. We know that if the bulk of a vegetable food given be small
* K u m a g a w a , V i r c h o w ' s A r c h i v , C X V I .
† A n u c l e o - a l b u m i n ( M a l y ' s J a h r e s - B e r i c h t ) , s e e H u t c h i s o n , p a g e 2 2 9 .
‡ Strümpell, Deut. Archiv. f. klir, med. 1876.
§
S t r ü m p e l l , l o c . c i t .
29
and the proportion of contained cellulose scanty, digestion is very complete and
that under contrary conditions, low absorption is to be expected. Unfortunately
the dietaries of Bengal jails are very bulky and contain a large amount of cellulose
so that digestion and absorption is very imperfect : we have rarely found more
than 55 per cent. of the protein of the ordinary jail diet absorbed when the
full diet was consumed. This is in general agreement with the findings of other
observers as the following table, compiled by Hutchison, shows :—
Relative absorption of the protein of various foods
—
Diet.
Protein not absorbed.
Meat
2.3 per cent.
Lentil flour
10.5
” ”
Dried peas
17.0
”
”
Beans
30.3
”
”
Potatoes
32.0
” ”
Lentils (soaked and boiled)
40.0
”
”
The fact that in Bengal jail diets the absorption of protein is on an even lower scale
than that given in the above list can be quite satisfactorily explained by the ex-
treme bulkiness of the prisoners' full diet when cooked ; as evidence of this we find
that diminution in the bulk of the diet is at once accompanied by an increase in
the percentage of protein absorbed.
One factor in the causation of this deficient absorption of protein, besides those
already referred to, is that the presence of a large amount of starch in the intestines
appears to be unfavourable to the absorption of protein.
Hutchison attributes this to the fermentation of part of the starch leading to
the production of acids that unduly quicken the intestinal movements, and hurry
the contents through the small bowel where absorption is most active, into the
large bowel where absorption is at a minimum.
That active fermentation does take place on jail dietaries there is plenty of
evidence to show, and there is no doubt that one reason, why a diminution in the
bulk of these diets is followed by an increased protein absorption, is that the exces-
sive fermentation is lessened, and the intestinal contents are not so hurried on,
more, relatively and actually, of the protein of the diminished diet being absorbed.
According to Hutchison the total capacity of an ordinary sized European stomach
is about 1,200 grammes and the weight of the ordinary cooked jail diet is at least
4,000 grammes, so that the stomach would be required to be filled to the extreme
limits of its capacity three times a day in order to get through the total amount.
Of course the habitual ingestion of these bulky diets leads to distension of the
stomach and bowels with a consequent disproportionate abdominal development.
This increase in the capacity of the stomach allows of more food being taken
and also, when the bulk of the food is decreased, gives rise to the feeling,
30
for a time, of non-satisfaction and hunger. This, however, soon passes off
when a more nutritious diet is prescribed, the stomach returning to something,
like its normal capacity and the feeling of emptiness disappearing.
The wheat ata or flour of the diets for Behari prisoners is prepared from the
whole grain by prison labour by means of small grinding stones. If a grain of wheat
be cut and examined microscopically, the following parts can be made out :
—
1. The germ or embryo representing about 1.5 per cent. of the whole grain.
2. The kernel or endosperm consisting of two large masses of nutritive
material. It makes up 85 per cent. of the grain.
3. The bran—an outer envelope composed mainly of cellulose impregnated
with mineral matter. It forms about 13.5 per cent. of the grain.
In the method of stone grinding the bran is removed, the meal or flour consisting
of the products of the germ and endosperm together. The exclusion of the bran
from the flour entails a loss of mineral matter and some protein from the inner or
aleurone cells.
This flour is baked into "chuppaties" of different sizes—five ounces of wheat
ata providing about six and a half ounces of "chuppaties." The "chuppatie" is
non-aërated and is somewhat of the appearance of a thick pancake.
The chemical analyses of the wheat sent from the different jails show greater
variation than any other of the food materials. This was largely due to the vary-
ing amount of moisture and to the amount of contamination present ; some of the
samples were coarse, dirty and badly cleaned, and naturally gave low results. It is
quite probable, however, that wheat grown in different districts shows variation in
chemical composition. This is a side of the question which we did not investigate ;
neither did we seek to distinguish between the different sorts of wheat grown in
Bengal and Behar.
In wheat we get the closest approach in the percentage of its proximate prin-
ciples to the ratio of nitrogen to carbon essential for a suitable diet.
Further, the fact that it does not when cooked absorb a high percentage of
moisture enhances its value compared with other cereals and particularly with rice.
It would, therefore, appear probable that large quantities of " chuppaties " could
be consumed without danger of their bulk interfering with absorption. This
may be true if they were given alone or with a concentrated form of food such
as meat, fish, etc., but it does not hold good for the combination exemplified in the
dietaries of Behar jails.
We found that, combined with constant quantities of rice, dal and vegetables,
up to about ten ounces of wheat ata per man daily the absorption was at a maxi-
mum ; beyond this amount a diminution in the amount of protein undergoing
metabolism took place. Whether this would be the case if the wheat ata were
baked and aërated. by European methods we are not prepared to say ; but there
31
can be no doubt that the tough, tenacious " chuppatie " is less easily penetrated
by the digestive juices than is the lighter, aërated bread of Europeans. When
chuppaties are given in fairly large amount with large quantities of rice, dal and
vegetables there is much waste, and our results show a percentage absorption of
protein in the Beharis very little better than is found in prisoners in Lower Bengal
where wheat forms no part of the diet. Of course the Behari dietaries contain a
very much larger quantity of protein than Lower Bengal diets, so that the actual
amount of protein undergoing metabolism per man daily is greater.
Makkai—Indian corn or Maize ground to flour—forms part of the diet of
Beharis during some seasons of the year. Twelve ounces replace ten ounces of
wheat ata, when makkai is available, in the ordinary jail dietary. It is prepared in
the same manner as wheat ata and is similarly baked in the form of small, very
thick, masses with little cohesion. Our investigations show that its protein is quite
as well absorbed but it does not contain so high a percentage of protein as wheat.
It is not liked nearly so well by the prisoners ; they complain that it gives them a
sensation of weight in the stomach and heart-burn. In Darjeeling jail makkai is
given in the form of porridge, which looks much more digestible than the hard,
gritty masses of the Beharis' diet. The results, however, are not very dissimilar
although to some extent in favour of the Darjeeling method of cooking.
The ordinary vegetables in season are used in the jails. Each jail has usually
a well-managed vegetable garden so that good vegetables are nearly always to be
had.
We made no variation in the amount of vegetables sanctioned—six ounces per
man daily—we accepted this scale as quite sufficient.
The following tables give the percentage composition in proximate principles
of the samples of food-stuffs received from the different jails.
Special attention was paid to the question of the amounts of protein present—
the most careful precautions being taken to obtain accurate results for the samples
analysed. The analyses made from the same sample gave practically identical
results.
In Table G we have given the average composition of all the different food
materials obtained from the several jails of Bengal, with their heat value in calories
per ounce calculated from the percentage composition of the proximate
principles, and also as obtained by actual determination from the food-stuffs.
The calculated heat value will be seen to be somewhat lower than the heat
value determined by Professor Benedict from samples sent from India.
This is what would be expected : we have calculated the heat value on the
percentages of the protein, carbohydrate and fat present, taking no notice of
non-digestible material, whereas the experimental method gives the total heat
value for everything combustible in the sample.