NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
187
The evidence obtained from investigations on the Behar prisoners in Buxar
jail who ate Burma rice would thus appear to support the view that a relationship
exists between the amount of rice in the diet and the amount of urine passed.
(d) BHAGALPUR JAIL.
Is the evidence of the Bhagalpur results of the same nature ?
(i) On Table XVI will be found Batch I—five Behari prisoners on similar
diets, except for the varying quantities of country rice. They show the following
results:—
TABLE XVI.
Constants.
Varying quantities of
country rice.
Quantity of urine
per man daily.
Batch I.
Wheat ata
.
. 10 ozs.
Country rice . 14 ozs. 1622 c.c.
Arhar dal
.
.
6 „
+
„ „
. 10 „
1557 c.c.
Vegetables
.
.
6 „
„ „
.
8 „
1561 c.c.
Here is the same tendency to a diminished excretion of urine as appeared in
the other results. In this case also the amount of salt in the diets was constant
throughout.
(ii) Table XVIII has one batch of prisoners—Batch III—in which the only
variation in the diets is in the amount of country rice. The following shows the
results:—
TABLE XVII.
Constants.
Varying quantities of
country rice.
Quantity of urine
per man daily.
Batch III.
Makkai ata .
. 12 ozs.
Country rice . 14 ozs. 1340 c.c.
Arhar dal
.
.
6 „
+
„ „ 10
„ 1280 c.c.
Vegetables
.
.
6
„
„ „
8 „
1423 c.c.
The quantity of urine secreted by the batch when 8 ozs. of country rice was
given is higher than with the other quantities, otherwise the results point to the
same conclusion.
We may again call attention to the much lower quantity of urine passed by
the prisoners in Bhagulpur jail than was the case in Buxar ; the same observation
was made on comparing the quantities passed in Puri jail and in the Presidency
jail, Calcutta. In Puri and Bhagulpur jails country rice was the variety in use
whereas in the Presidency and Buxar jails Burma rice was given.
The climatic conditions were very similar so far as the investigations in Buxar
and Bhagalpur jails are concerned, both jails being under investigation during the
months of January and February 1909 when the air was dry and the temper-
ature quite low for India.
2 B 2
188
From these observations it would appear probable that a larger quantity of
urine is secreted when the intake of rice is high than when it is low. What the
cause is—beyond the mere fluid taken in with the rice—it is difficult to say.
If the cause were only the amount of fluid taken in with the cooked rice and the
water capable of being formed from the constituents of rice, we should expect less
fluids to be drunk, and that matters would thus right themselves. It seems
possible, therefore, that rice per se has a diuretic action on the renal organs.
Whether this is so or not, the evidence we have produced is strongly in favour
of the view that the amount of rice present in the diet does influence in a
marked manner the quantity of urine excreted. What its significance is, if any,
we leave for the future to unfold, We may remark that we did not obtain
anything like the same results regarding the amount of urine excreted when the
dal, wheat or makkai ata of the dietaries were given in varying quantities.
2.—The relative influence, if any, on the excretion of urine exerted by Burma rice and
Country rice.
Intimately connected with the apparent influence of large quantities of rice
in increasing the flow of urine is the question, whether the two varieties of rice do
so to the same extent.
It will be evident from the figures given in Chapter II and in Section I of this
Chapter that, under as far as possible the same conditions, the amount of urine
passed is, on the average, much greater when Burma rice is given than when coun-
try rice forms part of the diet.
From an analysis of all the results obtained, when the conditions of
temperature, humidity, intake of salt and intake of rice were as nearly as
possible similar, we have computed that the average amount of urine excreted
by prisoners in the four jails examined was as follows:—
Presidency Jail, Calcutta
.
. over 2000 c.c. per man daily in the cold weather.
Buxar Jail, Behar
.
.
. over 1800 c.c. „ „
„ „
Puri Jail, Orissa .
.
.
. under 1600 c.c. „ „
„ „
Bhagalpur Jail, Behar .
.
.
„ „ „ „ „ „
That is, in the two jails where Burma rice was in use the average excretion of urine
by the prisoners is on a decidedly higher level than in the two jails where country
rice was the variety given in the dietaries.
This may be a mere coincidence and may have nothing to do with the
different kinds of rice, being due to some other factor at present unknown.
While we have no desire to draw any far-reaching conclusions from these results,
we cannot help thinking that there is present in rice some substance that acts as
a diuretic, and that this exists in greater amount in Burma than in country
rice. What the significance of such a diuretic action may be we are at present
189
unable to say; but it will be readily admitted that if a diuretic influence does
exist, its continuous action from the massive amounts of rice in the daily diet of
Bengali prisoners cannot be for the welfare of the kidney epithelium. The
supposed influence of Burma rice in the causation of Beriberi—a disease often
associated with œdema—might form an interesting problem from this point of
view.
In order to see whether the greater effect of Burma rice on the flow of urine
would hold under absolutely the same conditions, two batches of prisoners in the
Presidency jail, Calcutta, were kept under observation for a fortnight, one week
on Burma rice and the next on country rice with the following results :—
One batch of the Bengali prisoners under observation for five days.
Per man daily.
Remarks.
D I E T —
Burma rice
. .
.
. . 20 ozs.
Urine 2545 c.c.
Usual quantity of
salt.
Massur and Arhar dals
.
.
. 6 „
Vegetables
.
.
.
.
. 6 „
The same men under observation for five days.
DI E T —
Country rice .
.
.
. . 20 ozs.
Urine 2015 c.c.
Usual quantity of
salt.
Massur and Arhar dals
.
. . 6 „
Vegetables
. .
.
. .
6 „
a difference of over 500 c.c. per man daily, seemingly due entirely to the variety of
rice in the diet as all other conditions were absolutely the same.
We may, in connection with the effect of Burma rice on the excretion of urine,
draw attention to the results shown on Table XXV. Here we had two batches of
four men in each on a "meat" diet containing only 4 ozs. of Burma rice per man
daily. The usual quantity of salt was given, and the observations were made at
the same time as those recorded in this section. The results show a great diminu-
tion in the amount of fluid excreted, the average for the two batches over the period
being 1284 c.c. per man daily, i.e., only about half the amount excreted by
the men on Burma rice 20 ozs. shown above. As would be expected there was a
marked increase in the solid constituents of the urine—the sp. gr. ranging up to
1023 as compared with an average of 1008 for those on the rice dietaries.
3.—The quantity of fæces passed by prisoners on Bengal Jail dietaries.
(a) On diets of the Lower Bengal jail type
—
(i) Five Bengali prisoners observed for 17 consecutive days, average
weight of fresh fæces per man daily 14 ozs.
(ii) Twenty Bengali prisoners observed for 14 consecutive days, average
weight of fresh fæces per man daily 15.2 ozs.
190
(iii) Sixteen Ooriya prisoners observed for twelve consecutive days, aver
-age weight of fresh fæces per man daily 14.1 ozs.
(iv) Four prisoners observed for eleven consecutive days, average weigh
t of fresh fæces per man daily 14.4 ozs.
Therefore an average of
—
5 × 17= 85
.
.
.
.
.
.
.
.
. 14 ozs.
20 × 14=280
.
.
.
.
.
.
.
.
. 15.2 „
16 × 12=192
.
.
.
.
.
.
.
.
. 14.1 „
4 × 11= 44
.
.
.
.
.
.
.
.
. 14.4 „
Total of 601 observations gives an average of 14.6 ozs. of fresh fæces passed
per man daily.
These observations were made only when the prisoners were on the (practi-
cally) full Lower Bengal jail diet.
(b) When the amount of rice was reduced to half the ordinary quantity the
weight of the fæces passed fell very considerably.
Thus—
(i) Four Ooriya prisoners observed for eleven consecutive days, average
weight of fresh fæces per man daily 10 ozs.
(ii) This fall on decreasing the amount of rice is further shown in the
following:-
Four Ooriya prisoners observed for five consecutive days.
D I E T —
Country rice .
.
.
.
. 26 ozs.
Fresh fæces 12 ozs. per man daily.
Arhar dal
.
.
. .
.
3
„
Vegetables
.
.
.
.
.
6 „
Goat's flesh .
.
.
.
.
4
„
The same four prisoners observed for six consecutive days.
DIET
—
Country rice
.
.
.
. 13 ozs.
Fresh fæces 6.7 ozs. per man daily.
Gram dal
.
.
.
.
.
3
„
Vegetables
.
.
.
.
. 6
„
Goat's flesh and fish
.
.
. 5
„
(c ) The quantity of fæces passed in diets of the Behari type
—
( i ) Thirty Behari prisoners under observation for a total of eighty-seven
days—
D I E T —
Country rice
.
.
. . 16 ozs.
Fresh fæces 18.56 ozs. per man daily.
Different dals
.
.
.
.
6 „
Wheat ata
.
.
.
.
. 10 „
Vegetables
.
.
.
.
.
6 „
This is decidedly higher than with the Lower Bengal jail type of diet.
(ii ) This is also brought out in the case of Ooriyas when the ordinary amount
of 26 ozs. of rice was reduced by half and wheat ata given instead.
191
Four Ooriya prisoners observed over eleven consecutive days, average
weight of fresh fæces per man daily 16.64 ozs.
We may, therefore, conclude that the weight of fæces passed daily by prisoners
on the Bengal jail dietaries is in round numbers one lb. per man daily, i.e., from
three to four times the weight of fæces passed ordinarily by a European on his diet.
A reduction in the quantity of rice entails a decrease in the weight of the
fæces, but the weight of the fæces seems to be greater when wheat ata is sub-
stituted for an equal quantity of rice.
4.—The average amount of the nitrogen contained in the fæces.
In a large number of observations on the estimation of the total nitrogen of
fæces we found the percentage of nitrogen present to be wonderfully constant
and seldom very much outside the figures 1.2 to 1.8 per cent.
The average for some hundreds of estimations on the ordinary Bengal jail
dietaries works out at 1.6 per cent. of nitrogen. If we calculate what this means
for the amount of fæces passed by the Bengali and Behari it will be seen how very
similar the figures are to those obtained from the urine method of estimating
protein metabolism—
Thus, the Bengali passes 420 grins. of fæces, which would mean an average
of almost 7 grms. of nitrogen per man daily, or about 50 per cent.
of the total nitrogen of the diet.
The Behari passes 500 grms. of fæces, which would mean an, average of about
8 grms. of nitrogen per man daily, or a little less than 50 per cent.
of the total nitrogen of the diet.
These figures, which are only rough averages of a large number of observa-
tions, correspond with those obtained from the analyses of the urine taken in con-
junction with the nitrogen intake ; viz., a little over 50 per cent. of the protein of
the Bengal jail dietaries is absorbed.
In connection with the more or less uniform percentage of nitrogen found in
the fæces analysed it is worthy of note that some1 writers prefer to speak of differ-
ent foods as large or small fæces-producers, rather than as being capable of
incomplete or complete absorption.
5.—The average amount of uric acid excreted in the urine by prisoners on the Bengal
Jail diets.
It is universally accepted that the amount of uric acid in the urine depends on
the nucleins and not on the ordinary proteins of the dietaries, so that the relation-
ship between the total nitrogen and uric acid excreted has practically no signifi-
cance. That is, the two methods of nitrogenous metabolism—purin metabolism
and the general nitrogenous interchanges—are independent of one another
.
1Hutchinson : Food and the Principles of Dietetics, also Prausnits, Zeitsch , f. Biologie 1897. .
192
In a purely vegetable diet such as that of the prisoners in Bengal a high uric
acid excretion would not be expected, as vegetable food contains only small
amounts of purin bodies. The pulses, however, do contain a fair quantity of
nucleins.
We have made a good many observations on the amount of uric acid excreted
by Bengali prisoners and find the quantity to be very much what would be
expected from a vegetarian diet. Thus, in 690 uric acid determinations the
amount excreted per man daily was, on the average, 0.44 grms.
The variations met with were small and never fluctuated for the Bengal types
of diets outside 0.35 and 0.57 grm. per man daily. These figures include deter-
minations on prisoners on both the Bengali and Behari types of diets—the inter-
change of ten ozs. of rice for ten ozs. of wheat ata does not appear to make any
difference in the amount of uric acid excreted. The dais excepted, rice, wheat ata
and vegetables may be looked on as almost forming a purin-free diet so that the
uric acid is derived almost entirely from the dals—the exogenous—and from
tissue metabolism—endogenous—the breaking down of nuclein-containing sub-
stances.
The method of estimation made use of in all our uric acid determinations was
that introduced by Gowland Hopkins 1, which is by far the most accurate and
simplest process.
6.—Xanthin or alloxur bodies or Purin bodies, including uric acid with a number of
closely allied substances.
The Xanthin bases—xanthin, hypoxanthin, guanin and adenin—like uric
acid have an endogenous source which is probably the nuclein of the tissue-cells,
and an exogenous source furnished by the food-stuffs which contain nucleins and
purins. According to Camerer, Salkowski, Walker, Hall and others the amount
of xanthin bases in the daily urine amounts to from 30 to 50 milligrammes
i n E u r o p e a n s .
We have carried out a number of observations with Walker Hall's purino-
meter and find the average quantity of purin bases excreted per man to be about
48 milligrammes per day. This amount seems rather high, but it represents about
9 per cent. of the uric acid excreted, on the same diet by the same prisoners, which is
nearly the usually accepted amount. Von Noorden states that the quantity of
these bodies rarely amounts to more than 8 per cent. of the uric acid excreted at
the same time. Accepting Walker Hall's method as giving accurate results, it is
very likely that the dads of the Bengali diet supply a fairly large amount of purin
bases.
We did not go into any detail on this point, and simply state the results
obtained from an investigation carried out on twenty prisoners observed for nine
consecutive days.
1 Journ. of Path. and Bacteriology, 1893.
193
7.—The percentage of urea to the total excretion of nitrogen.
In a very large number of the observations in which the total nitrogen of the
urine was determined, an estimation of the urea present was also made. The pro-
cess followed was that of Mörner-Sjöqvist as modified by Bödtker1 which gives
accurate results.
Careful examination of our results as to the percentage of the total nitro-
genous excretion that appears in the urine in the form of urea does not reveal any
marked difference from the ordinary accepted standards.
The urea nitrogen is, however, higher than would be expected from a purely
vegetarian diet.
In European diets the relative value of urea is given at 88 to 90 per cent with
flesh diet, 85 to 87 with a mixed diet, and about 80 per cent. with a vegetable
diet. We find that on a dietary of the Lower Bengal jail type the percentage
of urea-nitrogen is about 90 per cent. of the total nitrogen of the urine.
Twenty Bengali prisoners, observed during twelve consecutive days had
their urine pooled : the nitrogen in the form of urea formed 90.1 per cent. of the
total nitrogen of the urine.
We found, further, that the addition of a little meat or flesh made very little
difference in the relative value of the urea; however, the amount of meat in the
diets in the particular observations in which the urea was estimated was very
small, and the diet could hardly even be called "mixed" in the European
acceptation of the term.
On the whole we may say that in Bengalis a slightly higher percentage of the
nitrogen of the urine is eliminated in the form of urea than is usually stated to
be the case with Europeans on vegetarian or even mixed dietaries.
8.—The relation of ammonia nitrogen to the total nitrogen of the urine.
This is a side-issue to which we paid special attention, and a large number of
observations were made on the quantity of free ammonia excreted by the prisoners
on different diets.
In Europeans the quantity of ammonia excreted daily varies on a mixed diet
from 0.6 to 1.0 grm. It is lower on vegetable, higher on animal foods. It is gener-
ally accepted that the quantity of ammonia nitrogen bears a certain relation to the
total nitrogen, forming from 3 to 5 per cent. It is known that the cereals, by
their freedom from organic alkaline compounds, do not alter the acid reaction of
human urine, and do not diminish the excretion of ammonia, while green vegetables,
with their high percentage of alkaline salts, do so in a most marked manner.2
Ammonia is a product of protein hydrolysis, and an increase in the amount of
protein assimilated may lead in two ways to an increase in the excretion of am-
monia first, because, more protein being broken down, more of each of the
1 Zeitschr. f. Physiol. Chemie. 1893.
2 von Noorden : Physiology of metabolism.
2 C
194
hydrolytic products, and of ammonia with the rest, will be formed—this will not
lead to any rise in the percentage of nitrogen passed out as ammonia; secondly,
because some of the ammonia, which would otherwise be passed out as urea, will be
excreted in combination with the sulphuric and phosphoric acids formed by the
breaking down of protein—this will lead to a rise in the percentage of nitrogen
passed out as ammonia as well as in the absolute amount. The quantity of
ammonia in the urine varies with the amount of acid radicles requiring neutralisa-
tion: if there be abundance of base taken with the food, less ammonia is re-
quired and it sinks to a low level in the urine. It does not, however, disappear
entirely. The reason given for this by Spriggs1 is that ammonia, being a normal
metabolic product and therefore circulating in the blood, must pass through the
kidneys: thus some of it will be excreted before it can reach the liver and have
an opportunity of being turned into urea.
Investigations to determine the total amount and percentage of the nitrogen
of the urine passed out as ammonia:—
TABLE XXIV.
(i) Twenty prisoners in the Presidency jail, Calcutta, were kept under obser-
vation for twenty days. The urine of these prisoners was pooled and samples
tested for ammonia. Special care was taken in all these investigations to see that
no decomposition had taken place. Usually the samples were put up immediately
at the end of the twenty-four hours' collection, and no sample was accepted
unless it was acid in reaction.
BATCH.
Average
quantity
of urine
per man
daily.
Average
total N. of
the urine
per man
daily.
Average
NH 3
per man
daily.
Total N.
of urine
for period.
Total NH3
of
urine for
period.
Total N.
NH3
for period.
C. C.
Grms.
Grms.
Grms.
Grms.
Grms.
Twenty Bengali prisoners
.
. 2406
8.09
1.01
1754
8.91
.95
1840
8.90
1.16
1803
9.18
.96
1862
9.79
.90
1925
9.81
1.09
1707
9.73
.68
1974
9.45
.90
2070
9.09
1.02
150-20
14-45
11-90
1976
8.40
.85
2066
8.87
.70
1943
8.85
9.2
2063
8 05
1.01
1892
7.52
.47
1754
7.69
.47
1920
8.43
.56
2057
9.44
. 8 0
1 Spriggs: Med.—Chi. Trans. Lond. 1904 LXXXVII, p. 325.
195
From these figures we find that the percentage of the total nitrogen excreted
in the form of ammonia is 7.92 or 0.85 grm. per day. This is decidedly higher
than would be expected from the results given for Europeans.
The diets on which some of the prisoners were during these observations
contained meat and fish, so that they were not entirely vegetable in character.
(ii) Twenty Behari prisoners under observation for fifteen days: the urine was
pooled and samples tested for ammonia.
The diet consisted of Burma rice, wheat ata, mung dal and vegetables—
no meat or fish was given.
Results tabulated in three periods of five days in each.
BATCH.
Average
quantity
of urine
per man
daily.
Average
Total N.
of urine
per man
daily.
Average
N H3
per man
daily.
Total N.
of urine
for
period.
Total
NH 3
of urine
for period.
Total N.
NH 3
of urine
for period.
C. C.
Grms.
Crms.
Grms.
Grms.
Grms.
Twenty prisoners Beharis
.
.
1895
8.52
.782
26.48
2.451
2.018
1756
8.65
.804
1760
9.31
.865
From these figures we find that the percentage of the total nitrogen that is
excreted in the form of ammonia is 7.62 or 0-817 grm. per man daily. This per-
centage is again higher than would be expected.
(iii) Twenty Behari prisoners in Bhagulpur jail under observation for fourteen
days; the urine was pooled and samples tested for ammonia.
The diet consisted of the ordinary Behari constituents—no flesh or fish
being added.
In all forty-five NH 3 determinations were made on the pooled urine with the
following results:—
Average quantity of
urine per man daily.
Average total nitrogen
per man daily.
Average NH3 per
man daily.
N—NH3 per man
daily.
C. C.
Grms.
Grms.
Grms.
1570
9.26
0.829
0.682
That is the percentage of the total nitrogen that is eliminated in the form of am-
monia is 6.82 or 0.829 grms. per man daily.
2 C 2
196
By collating these results we see at a glance their full import
—
(i) 20 Bengali prisoners on mixed diet excreted 0.85 grm. NH 3 per man
daily, which is 7.92 per cent. of the total nitrogen of the urine.
(ii) 20 Behari prisoners on, Behari diet excreted 0.817 grm. per man daily,
which is 7.62 per cent. of total nitrogen of the urine.
(iii) 20 Behari prisoners on Behari diet excreted 0.829 grm. per man daily,
which is 6.82 per cent. of the total nitrogen of the urine.
While the observations show that the addition of meat and fish causes a higher
actual and relative excretion of nitrogen in the form of ammonia—and in the
Bengali prisoners on mixed diets this would have been still more marked, had it not
been that certain diets containing no animal food are included—the important
point would appear to be the consistently high proportion of the total nitrogen
that is eliminated in the form of ammonia, whatever the diet may be. It will be
further noticed that this proportion is lower the higher the level of nitrogenous
equilibrium reached, i.e. , the percentage of nitrogen eliminated as ammonia
varies inversely with the total nitrogen excretion.
The question naturally arises as to the explanation of this high ammonia
factor in the urine compared with the generally accepted 3 to 5 per cent. in
Europeans. If we had found a low percentage of the nitrogen excreted in the
form of urea we might have looked on a relative acidosis as affording a plausible
explanation ; but such we have seen not to be the case. We have no explanation
to offer further than to remark that it has been noticed by other observers that a
fall in the level of nitrogenous metabolism to 7 or 8 grms. seems to be accompanied
by a rise in the proportion of ammonia—as a normal event, and quite apart from
the presence of urinary organic acids1. While this may be true for Europeans we
are more inclined to believe that intestinal putrefaction and the absorption of
indoxyl2 compounds requiring for their neutralisation strong bases, and among
these ammonia, is a much more likely explanation. This view is borne out by the
researches of Dr. I. M. Mullick2 on the urine examination of some 500 students
and seemingly healthy individuals in Calcutta, amongst whom he found that
about 40 per cent. had indican in their urine much in excess of what may be
considered the normal amount.
9.—The relative absorption of protein from a diet containing an animal protein by
Hindus and Mahomedans.
It is generally believed that Mahomedans, who are accustomed to an animal
protein in their daily diet, are better able to absorb the protein from an animal
food than are the Hindus who are very largely vegetarians.
1 Spriggs : Quarterly Journal of Medicine, April 1909.
2 M ullick : Calcutta Medical Journal, May 1909.