NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
154
This is fairly close to the result already obtained in the previous investiga-
tion, and would probably be still closer if we could make allowance for the effect
of the diminution of the Burma rice of the diet by 10 ozs. per day for the batch
of five men.
We therefore find from this line of experiment that the addition of a certain
small amount of animal diet does cause a large increase in the absorption of
nitrogen from the diet. But, as we shall see in the next observation, this increase
is by no means constant even for the addition of the same amount of meat, and
that it also depends largely on the composition of the " basal diet " to which the
meat is added.
(iii) Investigations to show that the increase in the amount of nitrogenous
metabolism may be no real measure of the amount absorbed from a highly assimilable
form of protein which has been added to a " basal," diet.
Thus, taking the diet
—
Burma rice
.
.
.
. .
40 ozs.
as the basal diet
for five Behar
prisoners,
Wheat ata
.
.
.
. .
50 „
Mung dal
.
.
.
.
.
30 „
Vegetables
.
.
.
.
.
3 0 „
we have seen by Table XI, Diet V, that this diet affords an intake of 391.50
grms. nitrogen of which 233.73 grms. nitrogen are absorbed.
Now to this " basal " diet were added 16 ozs. of goat's flesh when the
following results were obtained :—
BATCH P.
Quantity
of Urine
.
Weight. Total N.
of Urine.
N. of
Burma
rice.
N. of
Mung
dal.
N. of
Wheat
ata.
N. of
Vege-
tables.
N. of
Goat's
flesh.
c.c.
lbs.
grms. grms. grms. grms. grms. grms.
Five prisoners, Beharis .
7,820 117.8 48.51 13.60 34.59 27.75 2.36
10.43
8,100 117.7 50.22 13.60 34.59 27.75 2.36
10.43
9,930 117.8 47.54 13.60 34.59 27.75 2.36
10.43
10,480 118.0 49.65 13.60 34.59 27.75 2.36
10.43
8,500 117.8 48.99 13.60 34.49 27.75 2.36
10.43
Total intake of nitrogen. = 443.65 grms
Total output—
N. of Urine
.
. . =244.91 grms.
. 5 grm. daily
.
.
. = 12.50 „
Total N. metabolism
. . =257.41 „
257.41 grms.—233.73 grms.=23.68 grms. is all that would appear to be ab-
sorbed from 52.15 grms. of nitrogen in the form of mutton—only 45.40 per cent.
of its nitrogen, which is absurd.
155
What has happened is that more of the protein of the wheat ata, rice and
dal has passed out unabsorbed which causes a seemingly very low absorption of the
protein of mutton. In order, therefore, to be able to show by this method anything
like a normal absorption of an animal protein when added to a purely vegetable
diet, the bulk of the diet must not interfere, and the level of nitrogenous absorption
from the vegetable part of the diet must not be high.
Summary of Section 4.
There is no necessity to add an animal protein to a diet of the Behari type.
The level of protein metabolism is already high, fully two grammes of nitrogen
superior in the case of the wheat diet to that of prisoners in Lower Bengal, and we
do not consider it necessary to further increase it. On the other hand, if arrange-
ments could be made for the substitution of fish twice a week in place of part of the
dal and ata, we believe it would be to the advantage of the prisoners' health. This
we would only recommend for prisoners in those jails where a local supply of fish is
easily and cheaply obtainable. In Buxar and Bhagulpur jails it would be a fairly
simple matter to have a supply of fish procured by prison labour from the Ganges
which is within easy distance from the jails. If this could be done an economy
could be effected by the saving of the dal, wheat or makkai ata twice a week, and, at
the same time, the monotony of the prison fare would be relieved. We think that
the suggestion is important, more particularly for the large central jails where long-
term prisoners are confined, and where plenty of cheap labour is available.
If it were found feasible we would recommend that the wheat or makkai ata be
reduced in proportion to the amount of protein available from the fish.
Also the question of the quantity of dal must be taken into consideration. We
have shown 6 ozs. of dal to be the maximum amount that can be given ; but there
is no necessity to give this maximum. Reference to Tables XX and XXI will
show that, with the amount of dal reduced from 6 ozs. to 5 ozs. the protein
metabolism of the prisoners is on a higher level than obtains when the full quanti-
ties of the constituents of the present diet is consumed. Further, there is no
doubt that dal in any form has a decided tendency to produce diarrhœa and
intestinal disorders, and that the 6 ozs. of the jail diet is a far larger quantity
than is consumed by the civil population of the district.
We would, therefore, recommend a diet of the following types:—
Burma or country rice .
.
.
. 12 ozs.
Wheat ata .
.
.
.
.
. 10 „
or makkai ata 12 ozs.
Different dal in use
.
.
.
.
5 „
Vegetables
.
.
.
. .
.
6 „
This might be looked on as the general scale of Behari diet.
X 2
156
With fish available, if it be found economical we would suggest that 5 ozs. of
fish be given twice a week, replacing 2 ozs. of wheat or makkai ata and 1 oz. of dal.
THE SUGGESTED SCALES.
General diet.
Diet on two days a week.
Burma or country rice .
12 ozs.
Burma or country rice
12 ozs.
Wheat ata
.
.
10 „
Wheat ata
.
.
8
„
or
or
Makkai ata
.
.
.
12 „
Makkai ata
.
. 10 „
Various dal available
.
5
„
Various dal available .
4 „
Vegetables
.
.
.
6
„
Fish
.
.
.
5
„
Vegetable
.
. 6 „
The general diet offers in round numbers :—
Protein
.
.
.
.
.
.
.
.
.
. . 93 grms.
Carbohydrate
.
.
.
.
.
.
.
.
.
. 550 „
Fat .
.
.
.
.
.
.
.
.
. .
. 32
„
which is superior in practically all its constituents to the dietary of Lower Bengal,
and, being partly made up by wheat, is very much more assimilable. The impor-
tant part, however, is that the protein absorption obtainable from this diet is a
good deal higher than that from the full Behari diet at present in force ; so that less
residue remains to provide for micro-organismal growth. The carbohydrate
element is still too high for natives of a hot climate from whom hard labour is
not demanded ; nevertheless, it is decidedly superior in this respect to the ordinary
jail standard. If the suggested supply of fish meets with approval it will cause a
reduction of the carbohydrate to more nearly a proper amount and, at the same
time, increase the percentage of assimilable protein very considerably.
We need hardly say that, if it is decided to add a little animal protein to the
diet, and fish is not available, goat's flesh will do equally well. The expense of
this, however, we are afraid will be considerable, if not entirely prohibitive.
The fish diet two days a week offers in round numbers :—
Protein
.
.
.
.
.
.
.
. .
.
. 100 grms.
Carbohydrate
.
.
.
.
. .
.
.
.
. 480 „
Fat .
.
.
.
.
.
.
.
.
.
.
. 30 „
a very superior diet, as a high percentage of its constituents is assimilable.
Nothing now remains with regard to the work done on the nutritive value of
the dietaries of Lower Bengal and Behar jails, but to discuss a few of the questions
that have cropped up during the enquiry—these we have tabulated under Section
(5)—and to give our general conclusions.
We shall now take up the relative value of the different forms of food-stuff
in use.
157
SECTION 5.
(i) Relative value of Burma and Country rice.
This subject will be found referred to in the work recorded on prisoners in the
Presidency jail, Calcutta, and Buxar jail.
In the Presidency jail, Calcutta, where the prisoners have been getting Burma
rice only from the time of their incarceration, the protein absorption from the
different diets containing Burma rice was on the average higher than that observed
in Puri jail, where locally grown rice was always in use.
Further, on placing two batches of prisoners in the Presidency jail on abso-
lutely similar diets, but replacing the Burma by country rice, there was a distinct
fall in the actual amount of protein absorbed from the diet. Thus a batch of 10
healthy Bengali prisoners on a diet of Burma rice, mixed massur and arhar dal and
vegetables, gave an average nitrogenous metabolism of 7.60 grms., while the same
prisoners under exactly the same conditions, save that country rice replaced the
Burma rice, showed a fall in nitrogenous metabolism to just 7.00 grms.
This would appear to mean that the protein of Burma rice is more easily ab-
sorbed than that of country rice—at least in those who are accustomed to its use.
On the other hand, we have given evidence that in Behar jails the country
product is accompanied by the better protein absorption—see comparative Charts
IX and XIII. There were other factors, however, to be taken into consideration,
so that the difference in the rice may not be the whole explanation of the better
absorption from diets containing country rice.
We are inclined to believe that to those accustomed to it, the Burma variety
is distinctly superior to the country rice as placed on the market. We think that
a good. deal of the inferiority of country rice is due to its very dirty condition, and to
bad cleaning. There is no doubt, however, that the prisoners prefer the home-
grown product, ard, as we have seen, this is an asset not altogether to be neglected.
That Burma rice, when properly treated, is just as likely to maintain
the prisoners in health as is the Indian variety, is shown by the health returns of
prisoners in the Presidency jail, Calcutta, where nothing but Burma rice has been
used for the past three years. From our results as to its relative nutritive
value we have no hesitation in recommending the more extensive use of Burma
rice in Bengal and Behar jails.
(ii) The relative value of the different dal s.
We have practically nothing to add to what will be found under the work re-
corded in Tables II, III and XIII. Given in what we have called the optimum.
158
quantity, there appears to be very little difference in the amount of protein absorp-
tion from diets containing different dals, with the exception of gram dal. This con-
tains a much lower percentage of protein than the other types, and its protein does
not appear to be so easily absorbed. Any difference that exists in the protein
absorption of the different dals is, in all probability, due to a difference in the
relative difficulty of thoroughly cooking them.
The cooking of dals and of the different constituents of the dietaries is a most
important question, and one we have been unable to touch; but there can be
no doubt that the very deficient protein absorption from the jail dietaries is
intimately connected with the way in which the food is prepared.
(iii) The relative values of wheat and makkai ata.
The relative values of these two food-stuffs have already been fully discussed.
When 12 ozs. of makkai ata are given in place of 10 ozs. of wheat ata we found that
it made an average difference of about one gramme of nitrogen in the amounts
absorbed from the two diets with varying quantities of rice. This works out to
over 10 per cent. of a decrease in the of nitrogenous metabolism. When
equal quantities of makkai and wheat ata are given in substitution for one another
(Buxar jail) we saw that the level of protein metabolism was decreased 1.6 grms.
on the average, the makkai ata being used with varying quantities of rice. On
contrasting, however, the proportion of protein of makkai with that of wheat
ata, in a diet containing 10 ozs. of each, we obtain a full explanation of the lower
absorption from makkai ata : the protein of makkai ata is to that di wheat ata as
9.55: 12.24, i.e., as 1 : 1.2, and we found that under the same conditions the average
absorption from a diet containing makkai was to that of a diet containing wheat
as 8.03: 9.69, i.e., as 1: 1.2 (see Charts III and V).
It follows from this that the protein of makkai ata is, under the same condi-
tions, as well assimilated as that of wheat ata. This is an important result,
as it is generally stated that makkai is much less easily absorbed than wheat how-
ever, our investigations do not bear out that contention, but show, on the contrary,
that practically the same percentage of the protein of the two food-stuffs is
absorbed when they are given under the same conditions.
The fact that the ratio of the percentages of the protein of makkai ata and.
wheat ata tallies with the ratio of absorption of those proteins affords a valuable
check on the accuracy of the figures on which the charts are founded.
We present on Chart XIV composite curves obtained by averaging the results
of the investigation carried out in Buxar and Bhagulpur jails on diets of makkai
159
and wheat ata, when the rice was in varying quantities in the several diets.
This chart shows very clearly the relative value of makkai and wheat ata, so far
as protein absorption is concerned, makkai being given in quantities of 11 ozs.
and wheat ata in quantities of 10 ozs. Both curves present the same features in
almost every detail, showing the gradual rise as the rice is increased from 8 to
10 ozs., the sudden increase in protein absorption from 10 to 12 ozs., an,d the
typical fall after the amount of rice has been increased beyond the optimum.
The point on the chart for 14 ozs. is calculated ; as in Bhagulpur jail this figure
was irregular from a fall in the amount of makkai ata consumed.
General summary of results obtained.
1. We have shown the worth of the dietaries of Bengal in grms. of proximate
principles, and pointed out that their real nutritive value is very different from
their apparent worth. The chemical values of the diets in round numbers are, in
protein, for Lower Bengal diets 93 grms. and for Behar 106 grms. ; the real nutritive
value for Lower Bengal is 49 grms. and for Behar 60 grms. In other words a little
over 50 per cent. of the protein is absorbed from the dietaries when given in full
quantities.
2. We discussed the causes of this low absorption and have shown that one
important factor in retarding the metabolism of protein from the full diet is bulki-
ness, affecting both types of diet.
We brought forward much evidence to show that a mere decrease in the bulk
of the diet was sufficient to permit of a greater relative and absolute absorption
of protein ; and, working with varying quantities of the different food-stuffs, we
gradually worked out the amount of each food-stuff that should be given in a diet,
in order that the absorption from that diet may be at a maximum—this we called
the optimum amount.
For diets of the Lower Bengal type the optimum quantity of rice we found
to be 18 ozs. and of dal 5 ozs. (about) per man daily.
In Behari diets the optimum amount of rice is 12 ozs.
"
"
"
" wheat ata 10 ozs.
"
"
"
" makkai ata 12 ozs.
"
"
"
" dal 6 ozs.
We showed that the absorption from the diets, in which the food-stuffs were
combined in the proper quantities, was very much superior to that of the present
scales of dietaries ; also that the percentage absorption was very much higher—
a great gain, as a much lessened amount of nitrogen remains to undergo intestinal
160
putrefaction. Further, we showed that, by giving the several food-stuffs in the
quantities which we suggest, the acknowledged excessive carbohydrates of the diets
are brought down to more nearly physiological amounts, and that the intestinal
juices are given a fair opportunity of discharging their duties, so that intestinal
fermentation will be checked and a better absorption of carbohydrates will be
obtained. If we had any means of investigating the metabolism of carbohydrates
we should, in all probability, obtain a curve very similar to that given in Chart II
which shows the actual absorption of protein from diets containing different
quantities of rice. It is quite fair to assume that the conditions present in the
diets that entail so defective an absorption of protein will also tend to prevent
the full value of their carbohydrate elements being made use of. These condi-
tions will remain in force until the food has passed those parts of the intestinal
canal where absorption of both protein and carbohydrates is possible ; but,
having arrived at the large bowel, the carbohydrates are rapidly broken down
by fermentative processes, and their potential energy is dissipated, so that
estimation of the carbohydrates passed out in the fæces is of no value as a
criterion of the percentage of that element wasted and lost to the economy.
This is not the case with the protein element, for the nitrogen left over from
absorption must pass out in the faeces in some nitrogenous form, either inorganic
or organic, as, for instance, in the form of organised micro-organisms, for whose
growth it forms the essential pabulum. The estimation of the nitrogen of the
fæces, therefore, gives a true indication of the amount of residual waste from
the protein of the diet. We have confirmed our results by this method particu-
larly in the cases of Presidency jail, Puri jail, and Midnapore jail.
We have given graphic records of the effects on protein metabolism obtained
from diets providing varying quantities of the different elements when all but
one constituent of the diet remained constant. In this way, we have been able
to plot out the curves of the absorption, of protein for different types of diets.
In all these investigations we worked with the diet as a unit, and did not accept
the assumption that there would always be the same actual absorption from the
"basal" or our "constant "part of the diet, with varying quantities of the food-
stuff under investigation. In fact, we have shown that the above-mentioned
assumption, while practically true for diets of the European type where an average
of 90 per cent. of the protein is absorbed, does not hold good for dietaries of the
Bengal type. It is not possible to work out an absorptive protein co-efficient for
the several food-stuffs, and find that this percentage of its protein will be absorbed
under varying conditions. We find, on the contrary, that the absorptive co-
efficient varies more or less inversely with the bulk of the diet, and with the
amount of vegetable protein present in the diet ; and it is only after a great
reduction in bulk, and in diets whose protein metabolism. approaches the lower
161
physiological limits that the addition of more of a food-stuff will show an increased
protein absorption corresponding to a co-efficient of absorption similar to that
obtained in European types of diets.
A great deal of work has been done on the effects of adding wheat ata or an
animal protein to the Lower Bengal dietaries and an animal protein to the
Behar diets.
These effects we have fully discussed in the summaries of the sections dealing
with them and we have nothing more to add on this subject.
3. We have stated that, while the addition of an animal protein is not by any
means essential, at the same time there is little doubt that, if it were econo-
mically possible thus to permit of a reduction of the amount of dal in both Lower
Bengal and Behar dietaries, the general health of the jails would improve. From
investigations on the microscopic compositions of the fæces it would appear that
the dal granule is the most difficult of all to break down, and that the slightest
lowering of the general health is usually accompanied by the passage of undigest-
ed dal. This has clearly been shown by Lane* in the microscopic examination
of the fæces of prisoners for intestinal parasites ; the presence of more or less
harmless parasites being sufficient to cause the passage of large quantities of
unchanged dal granules. It is easy to replace part of the dal in Bengal jails by
wheat ata without increasing the cost—and this we have recommended. But in
Behar jails the amount of wheat or makkai ata is quite sufficient and cannot be in-
creased with good effect. The only way, therefore, of being able to reduce the dal is
to give some form of animal protein, and we have suggested fish. It would only
be necessary to do this in the large central jails where long-term prisoners are
confined, and in the two central jails that we examined fish should be easily pro-
curable at little over the cost of prison labour, if proper arrangements were made.
These changes in the feeding of prisoners would require to be carefully con-
sidered from the standpoint of cost before being generally introduced. However
with regard to the other suggestions put forward there need be no hesitation.
The quantities of rice in the Bengal and Behar diets must be reduced ; the former
by 8 ozs. and the latter by 4 ozs. per man daily.
We are very strongly of the opinion that 6 ozs. of dal is far too great a quantity
and should like to see it reduced to 4 ozs. in both types of diet ; this can be done
easily in Lower Bengal by replacing it by a corresponding quantity of wheat
ata, or wheat ata and fish in those jails where it is found more economical to give
fish on two days per week or oftener. In Behar jails, particularly in the large
central jails, we hope that it will be possible to give fish twice a week in
order that the excessive amount of dal necessary may be further reduced.
* Major Clayton Lane, I.M.S. : Intestinal Parasites, I. M. G., 1909.
162
If this be not feasible we strongly recommend that the 6 ozs. of dal be
reduced to 5 ozs. per man daily.
The dietaries we recommended would, therefore, be:—
I.—Lower Bengal Jails.
Rice, Burma or country
. .
.
.
. 18 ozs.
Dals, various kinds available .
.
.
. 4 „
Wheat ata .
.
.
.
.
.
. 4 „
or
Fish in place of wheat ata twice a week
.
. 4 „
Vegetables
. .
.
.
.
.
. 6 „
II.—Behar Jails.
On two days
a week.
Rice, Burma or country .
. .
. . 12 ozs.
12 ozs.
Wheat ata
.
.
.
.
.
.
. 10 „
8 „
or
Makkaiata
.
.
.
.
.
.
. 12 „
1 0 „
Dals, various kinds available .
.
.
. 5 „
4 „
Vegetables
.
.
.
.
.
. . 6 „
6 „
Fish or goat's flesh .
. .
.
. . ..
5 „
[ Re salt—see later.]
The usual condiments, etc., as at present in use.
4. We have discussed these diets from the standpoint of the interests of the
prisoners, and have brought forward evidence to show that the suggested changes
are entirely to their advantage, and to the benefit of their general health. This
we consider is the all-important consideration, as it would be no saving to the
State, to look at the problem from the economical point of view alone, if a reduc-
tion in the cost of dieting were made, and it entailed greater sickness or any lower-
ing of the general health. Fortunately, in this matter the interests of the prisoners
and of the public, who have to pay for the prisons, are not at variance, for
we are able to suggest much superior types of diet which will cost the State
less than at present.
The general effect of our suggestions would be to decrease the quantity of
rice all over Bengal by 6 ozs. per man daily. The other changes from the point
of view of cost may be neglected, as the addition of wheat ata would counter-
balance the decrease in dal in Lower Bengal ; however, if fish were procured by
prison labour there would be a distinct gain in both Bengal and Behar. On the
whole there would be a saving of one-fourth the cost of all the rice consumed.
163
From data supplied by jail officers we find that rice costs on an average one
anna per man daily, so that there should be a saving of 3 pies on each prisoner
per day. Calculating on a basis of 16,000 prisoners in Bengal, from rice alone
this would work out at a saving of over three-quarters of a lac of rupees yearly.
Besides this, if our suggested means of obtaining fish were possible, there would
very nearly be a similar saving on dal, wheat and makkai ata.
The details would require to be worked out with regard to local conditions,
but we have no doubt that in most of the central jails, and in many of the smaller,
fish could be cheaply obtained. On the whole there would certainly be a lac of
rupees saved every year—and probably much more, if the diets which we have
shown to be much superior in every detail to the present standards were
introduced.
5. With regard to the cooking of these vegetable food-stuffs we have not
been able to make any observations ; but from the evidence afforded by other
observers we would recommend that the dal be ground to meal before being
cooked. We hope to be able to make some investigations on this important
subject later. As already mentioned, lentils given after soaking and boiling show
over 40 per cent. of the protein unabsorbed ; whereas when ground to lentil meal
only from 8 to 10 per cent. of the lentil protein passes out in the fæes.
Y2 2.