We must now return to the subject of nitrogen starvation to show how difficult it is for a white man to nourish himself when he migrates to a hot climate to which he is unadjusted. He cannot live as the natives, for, as we have shown, they are usually so overcrowded as to be in a serious condition of nitrogen starvation themselves. In addition, their foods and methods of preparation are nauseating to him and, therefore, lead to indigestion and gradual impoverishment. He must then import special foods, use special cooking arrangements, and live apart from the life of the country. He cannot live on the country as true colonization demands.
We have shown that the increased exhaustions demand as much if not more nitrogen than at home in accordance with modern medical practice which resorts to forced feeding with nitrogen in all wasting or exhaustion diseases, tuberculosis, typhoid, most insanities, neurasthenias, including alcoholism and all the rest of the long list; yet there is a false popular idea that we must use less nitrogen because the natives use little. Every one presumes that the natives are properly fed, but we have shown that they are always starving or underfed. It will be a long time before this false idea disappears, for all such popular errors persist with wonderful tenacity.
A iong time ago, before we knew anything of tropical diseases or the damages due to the climate, it was thought that all our troubles were due to overeating, because the only marked and noticeable habit of the English was the fact that they ate more than the starving natives. In those days nothing was known of the uses of the liver, and not so very much is known now, by the way, and the unknown has always exercised a great and exaggerated mental influence. All kinds of diseases and conditions were attributed to the liver being "sluggish," "overloaded" or "out of order." The idea has become a fixed one in the popular mind and will not disappear. By means of it quacks reap a golden harvest by ascribing all diseased conditions to the liver, and giving little liver pills or any old thing to "act" on the liver. One man has publicly stated that our army collapsed at Santiago and was taken to Montauk because every soldier who went there had a "swelled liver." Those who talk grandiloquently of a "deranged liver" do not know what it really is. Now, we know that while some chronic liver affections may be due to poisons brought from the stomach and intestines, tropical abscess is due to bacteria or other germs brought in through broken surfaces in stomach or intestine.
We formerly starved in summer and prayed for cold weather so that we could eat. If we had only eaten better, we need not have prayed so hard. In the Santiago campaign there was a medical officer who insisted upon every one being starved and who believed that to eat heartily was fatal. He preached his doctrine continually until every one believed him, and they restrained their appetites even when they could eat, and many were hungry days at a time. It was noticed, nevertheless, that the doctor himself had not sufficient self-control to restrain his appetite, but ate large quantities of all kinds of stuff, at all hours, and whenever he was inclined. Out of a dozen men or more in the mess, he was the only one who escaped sickness - all the others collapsed. The men who survived were convinced that they would have been worse off still, or even dead, if they had not starved themselves. Overeating, by the way, is possible, but it is harmful only in the idle and sluggish. The climate merely results in exhaustions and never originates a case of cholera, dysentery or typhoid.
Col. Chas. R. Greenleaf, says that only exceptionally does food cause intestinal troubles in the tropics, and * that the ration is not responsible for these infections either by its variety, character or quality.
* Report of Surgeon General, 1900.