NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
174
was passed in the fæces per man daily ; with 6.5 grms. 0.43 grm.
passed in the fæces per man daily.
(v) It will be noticed that a larger quantity of NaCl was eliminated in the
urine and fæces than was present in the intake during the period
that the prisoners were getting 6.5 grms. daily. The excess derived
from the salt stored in the body, over the four days we have taken
into consideration, is very small—only 3.89 grms. for the batch of five
men, or 0.78 grm. per man. However, if we take the " transition
day "—the period before salt equilibrium is established—into consi-
deration, the excess works out to 15.25 grms. per man over the
five days. This excess is of course not entirely due to salt stored
up in, the body, but is simply the remains of the salt from the pre-
vious day's supply which had not yet been eliminated. We have not
taken the " transition day " into our reckoning.
(vi) There is no doubt that a considerable quantity of salt is eliminated by
the perspiration in hot climates like India. In our first period this
formed 11.6 per cent. of the total, or 2.37 grms. per man daily ;in
the second period it was not possible to calculate the amount eli-
minated by the sweat as the total intake of salt was not sufficient to
maintain salt equilibrium. It is highly probable that the quantity
of salt got rid of by the skin depends on the total amount of the salt
intake. When this is considerable thirst is raised, and the inges-
tion of large quantities of water increases the action of the skin ;
under the opposite conditions the skin does not act so freely, and
therefore smaller quantities of salt will be excreted by it.
(vii) The enumeration of the red blood corpuscles shows a decrease with the
decrease in the salt intake. This decrease we did not expect, and
it is at variance with our results obtained from experiment on
animals in the laboratory, where the conditions were more under
control than in the jails. Further, the limit of error in blood counting
is high—quite up to 5 per cent., and the count involves a great deal
of labour when batches of five men are made use of. The method
we prefer, and the one made use of in the laboratory is by means.
of the high-speed electric hæmatocrite, to determine the percentage
volume of the corpuscles under different conditions of salt intake
This we found impossible to carry out in the jails visited. Further
work will be necessary on the question whether the intake of salt
causes an
(viii) (ix) (x)
increase or decrease in the number of the blood corpuscle
before any definite statement can be made.
175
2. The effects of a gradual decrease in the amount of salt in the diet.
Five Ooriya prisoners observed during fifteen consecutive days.
Batch B.
Total
quantity
of urine.
Chlorides
of urine. Chlorides
of fæces.
Weight
of pris.
R.B.C.
average
count.
Salt
intake.
Chlorides of
sweat.
c.c.
grms.
grms.
lbs.
grms.
grms.
Average per
man daily.
Five prisoners,
Ooriayas.
8,970
89.00
2.36
98.8
4,550,000
99.71
2.51
10,100
91.00
3.65
98.8
99.71
9,020
80.72
2.75
98.8
99.71
8,180
76.54
1.60
98.7
99.71
D o .
.
8,130
62.80
2.31
97.6
4,570,000
73.8
=1.09
9,190
62.49
3.80
97.9
73.8
8,880
62.12
3.02
98.2
73.8
8,550
72.58
3.26
98.1
73.8
Do.
.
8,390
44.46
3.16
97.9
4,520,000
49.2
=0.41
gr
m.
6,610
46.27
3.14
97.8
49.2
8,000
43.16
2.02
97.7
49.2
7,500
43.20
2.16
97.5
49.2
What do we learn from this investigation ?
With practically 20 grms. of salt daily per man:—
(i) 84.5 per cent. is absorbed and passed out in the urine.
(ii) 2.5 per cent. is unabsorbed and passed out in the fæces.
(iii) 13.0 per cent. is absorbed and eliminated in the sweat.
(iv) average body-weight = 98.8 lbs.
(v) average quantity of urine passed = 1,816 c.c.
(vi) average number of r.b.c. = 4,550,000.
With 14.76 grms. of salt per man daily:—
(i) 88.1 per cent. of the salt is absorbed and passed out in urine.
(ii) 4.2 per cent. is unabsorbed and passed out in the fæces.
(iii) 7.7 per cent. is absorbed and eliminated in the sweat.
(iv) average body-weight=97.9 lbs.
(v) average quantity of urine passed=1,740 c.c.
(vi) average number of r.b.c.=4,570,000.
176
With practically 10 grms. of salt per man daily:—
(i) 90 per cent. of the salt is absorbed and passed out in the urine.
(ii) 5.3 per cent. is unabsorbed and passed out in the fæces.
(iii) 4.7 per cent. is absorbed and passed out in the sweat.
(iv) average body-weight=97.7 lbs.
(v) average quantity of urine passed=1,225 c.c.
(vi) average number of r.b.c.=4,520,000.
These results are very similar in type to those recorded in (1) of this table,
but are more gradually obtained. There occurred a gradual fall in body-weight
and a decrease in the amount of urine secreted after each successive decrease
in the quantity of salt given in the dietaries.
The same constant quantities of salt are eliminated by the bowel : in the three
sets of observations these were 0.51, 0.62 and. 0.52 grm. per man daily, from
which it would appear probable that practically all the added salt of the diet is
absorbed, and that the salt passed in the fæces is derived from that contained in
the constituents of the diet, i.e., from the undigested food materials.
These observations also bring out the gradual drop in the amount of salt
eliminated by the skin as the quantity ingested is decreased. Thus with the
diminishing quantities of salt our table shows 2.51, 1.09 and 0.41 grms. per man
daily as the amount unaccounted for in the urine and fæces. This result is very
similar to that shown in (1) of this table.
3. The effects of decreasing and increasing the amount of salt in the diet.
Five Ooriya prisoners observed during fifteen days.
Batch C.
Total
quantity
of urine.
Chlorides
of urine.
Chlorides
of fæces.
Weight
of pris.
R.B.C.
average count.
Salt
intake.
Chlorides of
sweat.
c.c.
grms.
grms.
lbs.
grms.
grms.
Average per
man daily.
Five prisoners,
Ooriyas.
9.150
85.52
3.56
98.6
3,420,000
99.71
=2. 88
8,220
101.19
1.33
98.6
99.71
8,340
63.55
1.23
98.8
99.71
8,920
83.36
1.34
98.7
99.71
Do
.
6,890
45.09
1.68
98.1
3,450,000
57.4
0.86
grm.
7,900
58.46
2.62
98.3
57.4
7 , 4 3 0
45.32
2.40
98.4
57.4
6,540
54.28
2.58
98.4
57.4
Do
.
7,000
59.50
2.96
98.6
3,533,000
65.6
1.04
grms.
6,370
50.96
1.55
98.6
65.6
6,500
61.00
2.36
98.6
65.6
6,000
55.00
2.86
98.7
65.6
6,800
62.40
3.34
98.8
65.6
178
(3) Practically complete absorption of the added salt takes place whether the
amount is large or small.
(4) The results obtained from the enumeration of the r.b.c. are disappoint-
ing and colourless—the variations shown are within the limits of
experimental error.
(5) The fact that as the quantity of salt ingested increases the skin has to
be called more and more into action in order to assist in its elimina
- t i o n , p o i n t s t o l a r g e q u a n t i t i e s o f s a l t b e i n g u n n e c e s s a r y , a n d m o r e
than can be easily got rid of by the kidneys. The rational indication
would therefore appear to be to give the amount of salt which the
kidneys are best able to deal with, and which throws no great strain
on them.
Our results show : —
With 20 grms. added to diet there is eliminated by
the skin
.
.
.
.
.
.
. 2.58 grms. per man daily.
With 14.76 grms. added to diet there is eliminated
by the skin .
.
.
.
.
.
.
1.09
"
"
"
"
With 13.00 grms. added to diet there is eliminated
by the skin .
.
.
.
.
.
.
1.04
"
"
"
"
With 11.50 grms. added to diet there is eliminated
by the skin .
.
.
.
.
.
.
0.86 „
„
„ „
With 10.00 grms. added to diet there is eliminated
by the skin .
.
.
.
.
.
.
0.41
"
"
"
"
With 6.50 grms. added to diet the total excreted
is greater than intake.
So far as these observations go, therefore, we see that 6.5 grms. per man
daily is too small a quantity, at least when the amount of salt is suddenly reduced
from 20 to 6.5 grms. daily. The addition of 10 grms. of salt to the daily diet
shows the lowest elimination by the skin and would therefore mean, if our deduction
is correct, that the kidneys are easily able to deal with that amount without
falling back to any great extent on the assistance of the skin.
With regard to the optimum excretion of NaCl. by the skin we have exceed-
ingly little information. Crammer1 states that in severe muscular work with
much perspiration it may amount to 1.6 to 2.2 grms, during the day. So far as
we are aware there has been no work done on salt metabolism from this point of
view ; so that we must be guided entirely by what we have found to be the case.
If we accept anything like the usual figures given for the amount of fluid lost
by the skin and the percentage of salt it is stated to contain—1000 c.c. of sweat
containing 0.5 per cent. NaCl —it would mean a much larger amount of salt lost
1 Crammer : Ueber die Beziehungen der Kleidung zur Hauttätigkeit, 1800.
179
per day than Crammer was able to find or than we have shown in the above inves-
tigations : for the very moderate figures taken it would be 5 grms. of NaC1 daily.
This, we consider, is an impossibility unless the NaC1 is reabsorbed by the skin as
evaporation of the sweat—invisible and visible—takes place. At all events our
figures show that nothing like so much can have been excreted from the body by
the skin in the case of the prisoners investigated.
In order to get some light on this point we carried out a few experiments to,
obtain the amount of salt excreted by the skin when profuse perspiration was
present.
A man was thoroughly washed with soap and water and finally with distilled.
water ; his loin cloth was similarly treated. He was then placed in a warm bath
of distilled water and given hard work to cause sweating. The sweat was con-
tinually washed off into the bath, so that little or none of the salt could have been.
reabsorbed. The results showed that there was only a very trifling amount of
NaC1 excreted in the perspiration during the period he was under observation.
This man, however, was only taking an moderate amount of salt—about 10
grms.—in his daily food. We may, therefore, conclude that under normal condi-
tions an excretion of 2 grms. of NaC1 by the skin is a large amount and a good deal
beyond the average excretion.
We have further given proof that, under ordinary conditions of work and
perspiration, the amount excreted. by the skin varies directly with the total salt
intake ; and, with an intake of 20 grms. the amount eliminated by the skin is
decidedly greater than Crammer found in severe muscular labour with profuse
perspiration. We are, therefore, driven to the conclusion that 20 grms. of salt,
from this point of view alone, is far beyond the amount the kidneys care to deal
with.
It is quite evident from the investigations recorded that an addition of 10 to.
12 grms. of NaCl in the daily diet provides all that is necessary for physio-
logical needs, and that anything beyond this amount only causes a retention of
fluids within the body with a fictitious advance in body-weight, thirst and diuresis..
Bearing in mind what this means in the light of the researches of Widal, Marey
and Mendel, that the ingestion of quantities of salt beyond what is necessary is not
to the welfare of the body but much to the contrary, we would, therefore, recom-
mend a reduction of the quantity sanctioned for prison diet scales from the present
25'4 grms. of added salt in the diet to at most 15 grms. of pure NaCl. This
quantity is really much more than is necessary ; however, with a purely
vegetable diet more salt is required than in European diet scales.
We stipulate pure NaC1, as the salt in use in some of the jails is by no means
pure. In Puri jail the material given contains only 84 per cent. of salt, and where.
country salt is used this statement holds good to a greater or lesser degree.
2 A 2
180
4. We now give an account of some observations carried out on two of the
trained assistants engaged on these investigations, in order to determine the
effects of varying the salt intake on the body-weight, and on the amounts of
urine excreted.
No. I ASSISTANT.
No. II ASSISTANT.
Day of
experi-
ment.
Quantity of
urine.
Weight.
Intake of
chlorides.
Day of
experiment.
Quantity of
urine.
Weight .
Intake of
chlorides.
C.C.
Lbs.
Grms.
C.C.
Lbs.
Grms.
1
1,420
127
20
1
1,360
154.5
25
2
1,610
126.5
20
2
1,990
154.5
28
3
1,410
127
20
3
1 , 3 9 0
53.9
25
4
1,220
126.5
20
4
1,410
154.2
25
5
1,790
128
20
5
2,190
154
25
6
1,470
127
20
6
..
..
Nil
7
1,380
26.5
20
7
1,080
153
, ,
8
. .
.
Nil
8
1,060
150
„
9
880
123.5
„
9
1,210
151
,,
10
800
123
, ,
10
720
151
, ,
11
790
123
, ,
11
790
152
, ,
12
900
122.75
, ,
12
1,560
153
15
13
. .
..
10
13
1,280
155
15
14
1,460
123
10
14
1,540
155
15
15
1,160
123¾
10
15
1,540
154
15
16
1,610
123¾
10
16
1,710
154
20
17
1,290
124
10
17
1,550
156
20
Average daily
urine c.c.
Average body
weight lbs.
No. I Assistant—
With 20 grms. NaCl added to his diet .
.
1471
1 2 6 . 9 3
,,
nil „
,, ,,
,, ,,
,,
.
.
842
123.06
,, 10 ,,
„
, ,
,, ,,
,,
.
.
1380
123.62
No. II Assistant—
With 25.75 grms. NaCl added to his diet
. .
1668
1 5 4 . 2 2
,,
nil
, ,
,,
, , ,,
,, , ,
. .
9 7 6
1 5 1 . 4 0
,,
15
,,
,,
, , ,, ,, , ,
.
.
1430
1 5 4 . 2 5
„
20
,,
,,
,,
,, ,, ,, .
.
1630
1 5 5 . 0 0
181
These observations were most carefully carried out and are absolutely reliable.
They confirm the results already obtained from work on prisoners. Another
point of importance noted was that both Assistants got diarrhoea when 20 and 15
grms. of NaCl were added to their diet. Large quantities of salt have a well-
known tendency to hurry on the food materials by increasing peristalsis of the
bowel. This in itself is an indication for the cutting down of the very excessive
quantity of salt given in the jail diets-25 grms.
5. Investigations on five Bengali prisoners as to the elimination of salt
when the quantities of Burma rice and Mung dal varied in each diet.
Diet I.
Burma rice. 26 ozs.
.
.
.
.
•
•
•
observed for four days. .
Mung dal .
.
.
6 „
.
.
.
.
Total intake of salt = 485.00 grms.
Output in urine.
.
. 114.45 grms.,=85.4 per cent.
.
in fmces , ..
10.92 „ =2.2
•
leaving 12.4 per cent. eliminated in sweat or 2.98 grms. per man daily.
This corresponds with the results obtained on a similar diet in Puri Jail
giving an average of 0'54 grm. in the feces.
Diet IL
Burma rice. 16 ozs.
.
.
.
.
.
.
observed for six days.
Mung dal.
.
8.4
.
.
.
.
.
.
Total intake of salt = 718.10 guns.
'
'
•
Output in urine .
-
. 632.35 grms.=88.06 per cent.
in freces.
.
26.46
= 3.7
leaving 8.24 per cent. eliminated in the sweat.
This means 0'88 grm. NaCl per man daily in the feces, a higher figure than
is usually obtained.
Diet III.
Burma rice. 32 ozs. )
•
'
•
'
-
.
observed for six days.
.
Mung dal . . 4 77
.
.
.
.
Total intake of salt =638.10 grins.
Output in urine .. 536.25 grins.-- 84.01 per cent.
,,
in faeces ..
.
11.40 „
= 1'78 „
•
•
•
•
•
leaving 11.18 per cent. to be eliminated in sweat.
182
This means that 0.38 grm. NaCl per man daily is passed in the fæces, a lower
figure than is usually obtained.
Our reasons for giving this series are the increase in the amount of salt
passed in the fæces when the dal is increased, and the diminished amount of salt pre-
sent when the amount of dal is decreased. We found under the ordinary conditions
of jail diet that the amount of salt appearing in the fæces was practically constant
at 0.5 grm. per man daily ; we now find that by varying the amount of dal in the
diet a corresponding variation takes place in the elimination of salt in the fæces.
This would appear to show that the salt of the fæces is largely derived from the dal
in diets of the Lower Bengal type, and that dal is, therefore, less thoroughly digest-
ed and broken up than the other constituents of the diet.
A great many investigations besides those referred to have been made on the
effects of increasing and decreasing the amount of salt in the daily food of prisoners ;
in fact, the estimations of the chlorides in the excreta were made in all the meta-
bolism experiments. Nothing save the points already brought out in the examples
we have given is at present evident.
One fact with regard to the Behari type of diet we may mention, viz., that the
amount of salt passed in the fæces is higher than in the diets of Lower Bengal,
being nearly 1 grm. per man daily. This we would expect from the larger amount
of salt contained in wheat and maize than in rice, and the greater actual amount
of the diet that is unabsorbed and passed in the fæces. The outstanding features
of the results of these investigations on salt metabolism are the very high degree
of absorption of salt that does occur, and the comparatively small amount found
in the intestinal excreta.
In Chart XV we give in graphic form the effects of varying the quantity of
salt in the diet on the amount of salt eliminated by the skin, the quantity of urine
excreted, and on the percentage body-weight.
CHAPTER V.
Some side-issues of the investigation.
1. The relationship, if any, that exists between the amount of urine passed and
the quantity of rice in the diet.
A comparison of the urine excreted on different amounts of rice in the diets is
only given when the conditions that obtained were, as far as possible, the same.
The observations were carried out at the same time of the year when, the tempera-
ture, humidity, etc., were fairly constant. The quantity of the salt given in the
diet was always identical.
(a) PRESIDENCY JAIL, CALCUTTA.
(i).—Five prisoners under observation for seventeen days.
1st period of five days.
Per man daily.
Remarks.
D I E T —
Burma rice
.
.
. 26 ozs.
Urine 1760 c.c.
Salt in diet a little
higher than usual.
Mung dal
. .
.
.
6 „
2nd period of six days.
D I E T —
Burma rice
.
.
. 16 ozs.
Urine 1573 c.c.
Ditto.
Mung dal
.
.
.
8.4 „
3rd period of six days.
D I E T —
Burma rice
.
.
. 32 ozs.
Urine 1958 c.c.
Salt usual quantity.
Mung dal .
.
.
.
4 „
These three results were obtained in August 1908, when the humidity was high and
the variations of temperature and humidity small. If we neglect the action of
the dal they would appear to show a relationship between the quantity of rice
and the amount of urine excreted.
(ii ).— Five Bengali prisoners under observation for twenty-two days.
1st period of twelve days.
Per man daily.
Remarks.
D I E T —
Burma rice
.
.
. 24 ozs.
Urine 1726 c.c.
Salt usual quantity.
Mottar and Massur dals
.
6 „
2nd period of ten days.
D I E T —
Burma rice
.
.
. 20 ozs.
Urine 1632 c.c.
Ditto.
Mottar and Massur dals
.
6
„
183
184
These observations were made in October 1908 while it was still sultry, and
they again show a decrease in the amount of urine passed when the quantity of
rice in the diet was lessened.
(iii).— Ten Bengali prisoners under observation for fifteen days.
1st period of five days.
Per man daily.
Remarks.
D I E T —
Burma rice
. .
. 25 ozs.
Urine 2514 c.c.
Salt usual quantity.
Massur and Arhar dals
.
6
„
2nd period of five days.
DIET—
Burma rice
.
.
. 20 ozs.
Urine 2545 c.c.
Ditto.
Massur and Arhar dals
.
6
„
3rd period of five days.
D I E T —
Burma rice
.
. . 18 ozs.
Urine 1929 c.c
Massur and Arhar dals
.
6 „
These observations were carried out in the cold weather. The quantity of
urine passed by the prisoners is very high. While the results with a diet
containing 20 ozs. of Burma rice show practically the same quantity of urine
excreted as with 25 ozs. those with 18 ozs. exhibit a great fall.
(iv).— That the quantity of dal does not seem to cause any variation in the amoun
t of urine excreted would appear from the following: —
Ten Bengali prisoners under observation for fifteen days.
1st peri od of fi ve days.
Per man daily.
Remarks.
D I E T —
Burma rice
.
.
. 20 ozs.
Urine 2545 c.c.
Salt usual quantity.
Massur and Arhar dals
.
6 „
2nd period of five days.
DIET—
Burma rice
.
.
. 20 ozs.
Urine 2544 c.c.
Ditto.
Massur and Arhar dals
.
5 „
3rd period of five days.
D I E T —
Burma rice
.
. . 20 ozs.
Urine 2607 c.c.
Ditto.
Massur and Arhar dals .
7
„
185
The average quantity of urine passed per day by these prisoners shows prac-
tically no variation for different quantities of dal, so long as the salt and rice of
the diets do not change, and the climatic conditions are the same.
Note the very large amount of urine passed by these prisoners even during
the hot months of the year. From the results stated it appears probable that a
casual relationship can be traced between the amount of Burma rice in the diet and
the quantity of urine excreted.
We have only one set of observations, in which different quantities of country
rice formed part of the diets, other conditions all being identical.
(b ) PURI JAIL.
Four prisoners under observation for ten days.
1st period of five days.
Per man daily.
Remarks.
DIET—
Country rice .
. . 26 ozs.
Urine 1807 c.c.
Salt 17 grms. daily.
Massur dal
.
.
. 6 „
2nd period of five days.
DIET—
Country rice .
.
. 20 ozs.
Urine 1512 c.c.
Ditto.
Massur dal .
. . 6 „
These observations were carried out in the cold weather in January 1909.
They show a marked fall with a smaller quantity of rice, and also a far less amount
of urine excreted than was the case with prisoners, who were under much the
same climatic conditions, but were given Burma rice to eat.
(c) BUXAR JAIL.
(i) Five prisoners under observation for fifteen days.
1st period of five days.
Per man daily.
Remarks.
DIET—
Burma rice .
.
. 14 ozs.
Urine 1929 c.c.
Usual quantity of salt.
Wheat ata .
.
. 10 „
Mung dal
.
.
. 6 „
2nd period of five days.
DIET—
Burma rice .
.
. 12 ozs.
Urine 1865 c.c.
Usual quantity of salt.
Wheat ata
.
.
. 10 „
Mung dal
.
.
. 6 „
3rd period of five days.
DIET—
Burma rice .
.
. 10 ozs.
Urine 1697 c.c.
Ditto.
Wheat ata .
.
. 10 „
Mung dal .
.
. 6 „
2 B
186
In these observations the conditions were identical, except for the varying
amounts of Burma rice. The same relationship is noticeable between the amount
of rice and the quantity of urine excreted. Again will be evident the large
amount of urine that these prisoners passed daily ; the work was carried out in
January 1909, i.e., in the middle of the cold weather.
( ii) Reference to table XI (Buxar Jail ) bears out the same contention when the same
batches of prisoners on varying amounts of Burma rice are taken.
Thus—
BATCH X, TABLE XI.
Per man daily.
Remarks.
D I E T —
Burma rice
.
.
. 14 ozs.
Urine 1929 c.c.
Usual salt.
Wheat ata .
.
. 10 „
Mung dal
.
.
.
6 „
D I E T —
Burma rice .
.
. 12.6 ozs.
Urine 1761 c.c.
Ditto.
Wheat ata .
.
. 10. „
Mung dal .
.
.
6. „
BATCH Y, TABLE XI.
DIET—
Burma rice
. . 12 ozs.
Urine 1893 c.c.
Ditto.
Wheat ata
.
. 10 „
Mung dal .
.
.
6 „
DIET—
Burma rice
.
.
8 ozs.
Urine 1711 c.c
Ditto.
Wheat ata
.
. 10 „
M u n g d a l .
.
6 „
(iii) The only batch of prisoners in Table XIV—where varying quantities of rice
with makkai ata were in use—shows the same thing.
BATCH P.—TABLE XIV.
Per man daily.
Remarks.
D I E T —
Burma rice
.
. 12 ozs.
Urine 2028 c.c.
Usual salt.
Makkai ata
.
. 10
„
Mung dal
.
.
6 „
D I E T —
Burma rice
.
. 10 ozs.
Urine 1871 c.c.
Ditto.
Makkai ata
.
. 10
„
Mung dal
.
. 6
„