NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
5
In 1877 another Jail Conference was assembled in Calcutta when it was found
that such diversities existed as to the quantities and nature of the food given in
different jails that it was deemed expedient to make an attempt to introduce a new
scale of dietary. Excluding the recommendations regarding vegetables, fats, salt,
etc., the following scale was laid down as a maximum for adult male prisoners
sentenced to hard labonr.
26 ounces (including 4 ozs. pulse) of sifted flour, and 28 ozs. of grain in the
case of wheat, rice or barley.
Whenever it may be considered necessary 4 ozs. of meat or fish, or an equi-
valent of milk, may be given instead of 4 ozs. of grain.
As Dr. Lewis points out, the principal difference between these diets and those
recommended by the 1864 Committee consists in the adoption of the principle that
the issue of animal food should be left to the discretion of the local jail authorities,
instead of making it a compulsory article of the labouring and under-trial dietary.
On the whole there is practically but little difference between the recommenda-
tion of the Committee of 1864 and of the Conference of 1877 so far as the ultimate
chemical constituents of the dietaries are concerned; but a pound of animal food
per week constituted part of the regular food approved by the former, whereas the
latter left the issue of this article to the discretion of the local authorities. The
Conference, however, increased the rice ration by four ounces daily when meat was
not given, and the vegetables were increased by two ounces per diem.
Lewis says that in March 1879 the Bengali and Behari prisoners were placed
on the diet proposed by the Conferenceand he continues thus: "During this year
the health returns of the prisoners in Bengal were exceptionally unfavourable; and
as the period during which the new dietary was in force coincided with the period
of maximum mortality, it was concluded that the high sickness and mortality
in this particular province was attributable to insufficient food. In consequence
of this inference extra rations were issued from March 1880 to July 1881 when
completely new scales of diets were introduced with the sanction of the Local
Government."
In July 1881 the dietary scale introduced for Lower Bengal was :—
Rice
22 ozs.
4 ozs. of meat or fish could be sub-
stituted at the option of the jail
officer for 4ozs. of pulse on four
days per week.
Pulse (Dal)
6 "
Vegetables
6
"
Oil
½
"
Gram
or
3
"
morning meal
Rice
4
"
Molasses
1
"
Tamarind
½
"
Salt
½
"
The scales for Bengalis and Beharis were alike, with the exception that the
staple cereal in the dietary of the Behari consisted of a mixture of 12 ozs. rice and
10 ozs. wheat flour or a similar mixture of rice and maize.
Lewis remarks on these diets that, "taken as a whole, the nutritive value of this
dietary not only exceeds, under every heading, the 'adapted' scale, which has been
prepared from English Local Prison scales, but, in most cases the amount of food
actually issued is more than is given as a maximum dietary in either the convict or
the Local Prisons in England and Wales. Computed on the English standard
these scales should suffice for men weighing considerably more than the average
weight of natives of Bengal and of Behar — the Bengali scales for a body-weight of
from 123 to 150 lbs.; and the Behari scales for persons weighing 140 to 172 lbs."
We need not follow Dr. Lewis in the discussion of these diet scales further than
to note that he shows that, on a dietary much inferior to this 1881 scale, Burma pri-
soners were exceedingly healthy and over 85 per cent. gained in weight. He further
instances, as an illustration of the caution that should be observed in attributing
exceptional sickness and mortality amongst prisoners to insufficient food alone, the
experience furnished by the Punjab jails. The mortality in certain of these jails
was unprecedentedly high although the special dietaries sanctioned were practically
double the ordinary scales.
Further, the fluctuations in mortality seem to occur quite irrespective of the
nature of the dietary and no appreciable result followed the issue of specially liberal
scales of diet. Nevertheless, as will be gathered from the records of the history of
jail diets in India, there seems to have been a gradual increase in the quantities of
the several food-stuffs sanctioned, in the majority of cases to meet exceptional sick-
ness and mortality, while the sanitary conditions were never thought of. The
whole idea seems to have been to fortify the body against infection by means of
continually increasing the food intake—specially the nitrogenous intake—and no
one at that time ever thought of making any attempt at removing the source of
infection—at least we have no information of any such attempts. The teaching
of Liebig had a marked influence in these increases of jail diets and very great
prominence was given to the necessity of increasing the albuminous or nitrogenous
principles of food in proportion to the amount of work exacted, on the supposition
that the nitrogenous, chiefly muscular, tissues of the body are rapidly wasted as a
result of exertion, and that the non-nitrogenous elements of food were simply useful
in the production of heat. In the endeavour that had been manifested by many
framers of jail dietaries to raise the proportion of the nitrogenous element a large
addition to the pulses had been a favourite mode of meeting the requirements;
but, as Lewis pointed out chemical analysis, however exhaustive, can only
afford such information as will enable an approximate estimate to be formed of
the nutritive value of any food, seeing it is not only what nutriment a particular
7
food-stuff contains that is of moment, but also what portion of it can be readily
digested and assimilated by the body. He adds that it is very doubtful whether
the increase in the nitrogenous elements by raising the proportion of the pulses—
and specially if badly cooked—is of any advantage, and perhaps may even be
injurious.
Dr. Lewis concludes this critical study of Indian jail dietaries by expressing
the opinion that, so far as the actual quantities of proximate principles are con-
cerned, the scales sanctioned have not been insufficient. On the contrary, native
labouring prisoners in every province in India have been, weight for weight, better
fed than either convicts or other prisoners in England. He shows that the lowest
scales are by no means associated with the most unfavourable health-returns, but
that, on the contrary, in those instances where enquiry has been made, the results
in this respect were even better than those associated with the most liberal diets.
The diet that he suggests as sufficient for the maintenance of native prisoners in
good health and at the same time compatible with the exaction of a fair amount of
ordinary hard labour is :—
Protein
.
.
.
.
3 ozs.
= 85.08 grms.
Carbohydrat
.
.
.
.
18½ „
= 524.66
„
Fat
.
.
.
. 1-1½ „
= 28.36—42.54 grms.
with the usual condiments, salt, etc.
This diet he bases on the maximum diet scale of English Local Prisons,
correcting the several quantities for the difference in weight between English
prisoners and native Indian prisoners. It corresponds very closely to the diet
given by Lyon for the Bombay House of Correction.
Expressed in the manner given above as so many grammes or ozs. of alimen-
tary principles we have no criticism to make : the scale is, so far as our knowledge
goes, quite sufficient, in fact, probably greater than is necessary. It is the
method by which these standards for native prisoners are arrived at, and the
deductions that have been drawn from their effects that seem to us fallacious.
It is not possible to deduce a standard of diet for natives of India from the
estimations of the proximate principles of dietaries that have been found suitable
and sufficient for European prisoners. If the proximate principles of the materials
making up the Indian diets were absorbed in the same proportion as is the case in
European diets, we grant that this method of calculating their nutritive value
and this estimation of the quantities required would be permissible. But the
absorbability of the ultimate alimentary principles of Indian food-stuffs is very far
from being identical with that of European food-stuffs—at least when the former
are given in the quantities necessary to make up the proper amounts of those
principles.
8
So that to have estimated the amounts of protein, carbohydrate and fat in a
satisfactory European diet and then, by calculations based on the chemical analyses
of Indian food materials, to work out the combinations of those food-stuffs that
will provide the identical amounts of protein, carbohydrate and fat, will give us
a diet that, by chemical analysis, is identical as regards the quantities of alimentary
principles present, but one from which a very dissimilar amount of nutritive
material is capable of being absorbed.
As we have already said—and to this point we shall have to return—even
the comparatively inferior European food materials show an absorptive co-efficient
of 85 per cent. while the superior Indian food-stuffs' co-efficient rarely exceeds 60
per cent. when they are given in the quantities laid down in the jail dietaries we
have examined.
The fallacy therefore comes in that, in giving any of these dietaries which have
been framed to provide more or less identical amounts of the different proximate
principles that have been in use in Europe, instead of obtaining a similar degree of
absorption a very much lower amount of the nutritive value is made use of ; so
that what is thought—for instance, in a diet such as would be framed on Lewis's
standard—to give a metabolism of over 70 grammes of protein per man daily
in all probability would really only give a metabolism of just about 50 grammes
of protein.
As we shall have evidence to bring forward on this later, at present it is suf-
ficient to say that one of the important causes of this poor absorption is the fact
that, in order to provide a diet containing anything approaching the standards of
European diets in proximate principles, so much of the Indian food materials
has to be given that less than the optimum absorption takes place, the mere bulk
interfering with absorption.
Another point which is clear from what we have said above in connection with
diets framed on European experience, is that, having provided a diet of Indian food
materials that contains a similar amount of the different alimentary principles, and
having found by practical experience that such a diet is sufficient for all the physio-
logical requirements of labouring prisoners, and knowing that this Indian food diet
only permits of say 50 grammes of protein being absorbed while the European
(identical in proximate principles but made up of different food materials) permits
of 70 grammes being absorbed daily, it is surely possible so to arrange a dietary
that it will provide for the absorption of 50 grammes of protein and a sufficiency
of all other constituents without having to lose 20 grammes of protein per man
daily as compared with the European prisoner. This also is a subject to which we
have devoted a good deal of attention.
While making these criticisms on the dietaries that have been framed for
Indian prisoners, and particularly on the work of Lyon and Lewis, we have no wish
9
to detract from the value of their researches for which nothing but admiration is,
possible. No work had been done in their time on the actual nutritive value of
Indian food materials, i.e., the amount actually absorbed from the dietaries—a
circumstance that clearly handicapped Lewis, and one to which he refers more than.
once—it is not to be wondered at, therefore, that the framers of diet scales should.
make use of the only means open to them in their work, and base their stand-
ards on those diets which had been found successful in practice.
The next paper to which reference is necessary is an extremely able article*
on, and critical review of, the subject of Indian jail dietaries by Major R. J.
Macnamara, I.M.S., in 1906. This report, submitted to the Punjab Government,
was to some extent the starting point of the present enquiry as, in transmitting it
to the Government of India, His Honour the Lieutenant-Governor of the Punjab
enquired whether the Government of India were disposed to extend the investiga
tions to other provinces.
In this very valuable report Major Macnamara deals more particularly with
the diet scales of the Punjab, which he considers to be much too high, and sug-
gests new scales of diet based on the work carried out by Dunlop on the Prison
Dietaries of Scotland.
In so far as our investigations touch the food-stuffs in use in the Punjab we are
in absolute agreement with Major Macnamara, and we can heartily endorse his
remarks on the dietaries of the jails of Bengal.
For the same reason, but to a somewhat less extent, this most valuable
report from other points of view, is not of much service in our investigations in
Bengal. It deals to a large extent with the theoretical side of the question and
with the framing of dietaries adapted to Indian jail conditions on the basis
of those found satisfactory in Scotland. It differs, however, in one important
particular from either of the papers already referred to, in that the diets on
which Major Macnamara has based his adaptations were worked out from the
standpoint of the actual nutritive value of the food materials, and not from their
gross chemical composition stated as so much protein, carbohydrate and fat. This
we consider is the only rational method of approaching the subject of the framing
of diet scales. It is futile to talk of the nutritive value of a diet—such as the
Bengal diet—as being superior to an English standard diet, because it offers 42
grains more nitrogen per man daily, if less than 60 per cent. of the nitrogen of that
Bengal diet is absorbed whilst 90 per cent, of the nitrogen of the English standard
diet undergoes metabolism in the system. It is because in India we are dealing
with classes of food-stuffs largely different from those in use in European
countries, and more particularly with very different quantities of any ingredient
* Notes on Indian Jail Dietaries with special reference to the Punjab by Major R. J. Macnamara,.
I.M.S., 1906.
10
common to the diets of both countries, and perhaps also with a people who have
a low power of absorption as compared with Europeans, that we consider that any
adaptation based on European experience is misleading and incorrect.
To much of the valuable information contained in Major Macnamara's paper
we shall have occasion to refer when dealing with other parts of the enquiry, at
present all that we need say is that, until the Punjab jail diets have been studied
from the standpoint of their actual nutritive value, it is impossible to form any
opinion as to their superiority or otherwise, compared with Major Macnamara's
adaptations based on the Scotch dietaries.
With regard to the remarks of Lieutenant-Colonel C. J. Bamber, I.M.S., Sani-
tary Commissioner, Punjab, we cannot do better than quote his closing paragraph :
" In conclusion, I think it will be advisable before making any alteration in the diet
scales of the Province to appoint a Committee to consider the diets of the people
of the different districts of the province, to carry out experiments on the chemical
composition and digestibility of the different food grains in use in this Province,
and then, having fixed upon suitable diet scales, to try them first in one or two
jails in this Province."
The last of the official papers connected with this subject is the correspondence
relating to the dietary in force in the Andamans. We shall have occasion to make
use of the experience gained as to the suitability of the diet scales in force in that
Settlement when we come to consider the proper proportions of the different food-
stuffs constituting satisfactory diets.
The Scope of the Present Enquiry.
The following extract from a letter from the Sanitary Commissioner with the
Government of India to the Government of Bengal gives an outline of the work
required to be carried out :
—
"To begin at once the investigation into the esuitability of the diet scales pre-
scribed for prisoners in the jails of Bengal. He should be required to estimate the
actual nutritive value of the different food-stuffs entering into the dietary of the
prisoners ; this will involve—
(1) Chemical analyses of the foods.
(2) An estimate of the quantities of each proximate principle in the diet
sc ales.
(3) Chemical examination of the excreta.
(4) Chemical examination of the blood .
(5) Also to enquire into the effects of the different kinds of dal on nutrition
and on intestinal disorders.
11
(6) The effects of the large amount of carbohydrate on nutrition and on
intestinal disorders.
(7) The effects of the large quantity of salt which is at present given to
prisoners."
As will be evident a pretty extensive programme was outlined for our guidance in
the investigations. Some of the points we have been barely able to touch on, while
others have been very thoroughly enquired into.
The estimation of the nutritive value of the dietaries has turned out to involve
a very great deal of work and has taken up at least 90 per cent. of the time that
could be allotted to the enquiry from official duties. This part of the work is by far
the most important and of the greatest interest. So far as India is concerned it is
entirely new—except for observations * on four prisoners in the Presidency Jail,
Calcutta, already referred to ; these were on prisoners who were getting fish in their
diet and are not quite comparable with what is found in the case of a strictly vege-
tarian diet. A good deal of work has been done on the Continent and in America
on estimations of the nutritive value of separate food-stuffs and of mixed diets, and
it was thought that by making use of the same methods as employed in those
investigations, this part of the enquiry would be a comparatively simple matter.
Such, however, did not prove to be the case; it was found that new methods of
investigation had to be devised, to meet the difficulties encountered in applying
the old methods to diets composed almost entirely of vegetable matter and
showing an exceeding low co-efficient of absorption.
In the work hitherto done on the nutritive value of food-stuffs and dietaries
in America and Europe the materials under investigation all show a very high
percentage of absorption for the several proximate principles. Thus Rubner
and Atwater's † figures give—
Meats
Fish
Milk
.
.
.
.
. 9195 % of protein absorbed.
Maize
.
.
.
.
.
8 9 %"
Rice
.
.
.
.
.
84 % "
"
"
Peas
.
.
.
.
.
82½%" ,,
"
"
Beans
. .
.
.
.
.
70 % ,,
"
"
Whole Wheat Bread
.
.
.
69½% „
"
"
Potatoes
Cabbage
Carrots
.
.
. .
.
.
.
.
.
. 61—81½% "
"
"
.
.
.
.
.
* Scientific Memoirs, No. 34.
† Food and the Principles of Dietetics. R. Hutchison, M. D.
c `, Z
12
Without going into detail of the investigations carried out on absorption in
these countries we may say with Hutchison that, "taking the general results of
all experiments, it is calculated that the following proportions of the nutritive
constituents will be absorbed from a mixed diet "*:—
Protein.
Carbohydrate.
Fat.
Animal foods .
.
. 98%
1 0 0 %
97%
Cereals and Sugars .
. 85%
9 8 %
90%
Vegetables and Fruit
. 80%
9 5 %
90%
Later experiments, particularly in America, appear to give lower figures
specially for the cereals and legumes; however, we may accept it that the co-efficient
of absorption is very high.
These results were obtained from experiments on batches of one, two, three or
four men observed for one, two or more days. The batch was put on a "basal"
diet—a known diet from which a known amount of protein, carbohydrate and fat
would be absorbed; then to the basal diet the food material to be examined was
added. By calculation from the result of chemical analysis of the excreta before
and after the new food material was added the co-efficient of absorption of the
proximate principles is obtained in the usual way. This is the method—intro-
duced by Bryant and Milner—that we made use of in our investigations. It
was modified to suit the special conditions of our work.
By this method or others on the same lines, the co-efficient of absorption of
the alimentary principles of the separate food-stuffs composing a diet in Europe
and America have been worked out, and fixed figures are published representing
the percentage of protein, carbohydrate or fat that is absorbed from any of the food
materials in use in those countries. Thus for protein according to Atwater† we find
the co-efficient of digestibility given for the several classes of food was follows :—
Soups
.
.
co-efficient of digestibility 97%
Meats
.
. I
Fish
.
Eggs
.
.
.
.
Cereals
.
.
Bread
Crackers (biscuits)
"
"
83—85%
Vegetables .
. i
Fruit
.
.
Legumes (average)
"
"
(about) 76%
The results of our investigations would appear to show that no fixed figures
for the co-efficient of absorption—at least for protein—of the different food
*Hutchison, page 14.
† Atwater: Storrs Agricultural Experiment Station, 9th Annual Report 1896.
14
we were able, by using Bryant and Milner's method, to get figures for the co-
efficient of protein absorption that were at all comparable with those of Rubner,
Atwater, etc.
We found that for different quantities of the food-stuff in the diets.
examined different proportions of their contained protein were absorbed, and that,
instead of finding a figure that represented the percentage of protein absorbed for
varying amounts of rice, wheat, dal, etc., for each separate quantity of rice,
wheat, dal, etc., above a certain amount, a different percentage of its contained
protein would be absorbed. This is a very different result from what would appear
to be the case from the work of investigators in Europe and America; but it is
covered by a simple explanation. If we assume that 85 per cent. is the maximum
of protein absorption possible on a diet of cereals and legumes, then, under ordi-
nary physiological conditions, that 85 per cent. will be absorbed; this is what takes.
place in the class of diets in which investigations on the co-efficient of protein
absorption have been carried out in America and Europe—the quantities added
to the basal diet have never caused the total diet to exceed the amount the
stomach and intestinal juices were capable of dealing with.
Now, when a gradual increase in the quantity or mass of the diet is made,
after a time there is reached a point at which the mass or bulk begins to interfere
with absorption, and any further increase causes greater and greater interference,
so that there is a fall in the percentage of protein absorption from the assumed
85 per cent. to a much lower figure whose value depends on. the greater or less
interference that has taken place; this is what we have found to be the case in
the dietaries of the Bengal jails—the quantities of the several food-stuffs over-
step the physiological limits with the result that absorption is greatly interfered
with and, instead of having an all round absorption of about 85 per cent. as.
obtains in Europe on vegetable diets, we have an absorption, from the ordinary
jail dietaries that barely touches 55 per cent. What is true for these diets as a
whole is equally so for the different food materials composing the diets, whether
these be rice, wheat ata or dal.
For these reasons early in the investigation we had to give up all idea of dis-
covering more or less constant figures that would represent the percentages of
protein absorption from the different food-stuffs composing the jail dietaries. If
such constants had been found then the arranging of jail diets based on the real,
nutritive value would have been a fairly simple matter. As owing to the above
mentioned circumstances this method was found impossible we next turned to the
variations in the nutritive value of the diet scales as a whole in order to discover
what combination of the several items of the diets gave the most favourable results,
and in what quantities these several items should be combined. It will be fairly