The doctrine of hyperpyraemia as enunciated by Dr. Francis Hare is really a counterblast to the three theories we have just discussed. Whereas they expend their energies anathematising mainly the nitrogenous factor of the diet - the building material so-called of the body - Dr. Hare singles out the carbonaceous or heat-producing portion as the peccant element.

Definition Of The Term

The term "hyperpyraemia" is derived from the Greek word pureia (fuel), and is applied by Hare to a condition of the blood in which the circulating fuel - the heat and energy producing material - is in excess of the capacities of the organism for physiological disposal. The body, therefore, is practically saturated with combustible material, and only awaits a fortuitous spark to create a conflagration, which manifests itself as disease in some form, and to obviate such a catastrophe the carbonaceous income must be reduced. He usually effects this by greatly lessening the supply of carbohydrates, and although he may also at the same time diminish the proteins, they are generally in excess. A reference to Folin's theory of metabolism will enable us readily to appreciate the reasonableness of such a doctrine, which otherwise would be in apparently open hostility to what had hitherto been considered incontrovertible facts.

The Salisbury Diet

I shall revert to Hare's method of dealing practically with the problem at a later period in the discussion, but meanwhile we must consider for a moment a somewhat similar practice with which Hare's might easily be confused, This is known as the Salisbury diet, which in its strictest form consists of lean beef and water, and was adopted in a purely empirical manner with the object mainly of preventing intestinal fermentation and the consequent absorption of toxic matters. In practice it differs from the hyperpyraemic doctrine chiefly in an enormous increase of the protein intake and a reduction almost to the vanishing point of fats and carbohydrates.

Salisbury alleged that starchy and fatty foods did not digest nor assimilate, but decayed and fermented, filling the organs with yeast, carbonic acid gas, alcohol, and vinegar, which afforded no nourishment to the system but induced disease and early death. He made the most extraordinary experiments on robust hardy working men whom he hired for the purpose, first, according to his own statement, producing disease in them by compelling them to subsist on the ordinary everyday diet, and then testing them with the elements of this diet administered one item at a time. In this manner he discovered that beef was the most easily digested, nourishing, and sustaining article of diet, and that the ailments of his hired men could be cured by putting them on a diet of broiled lean beef and hot water. He repeated his experiments on hogs, no less than one thousand of which he bought, and after feeding dissected, with a view to determining the most easily digested materials and those likely to yield the smallest number of toxic by-products.

His treatment of the sick consisted in the daily administration of four pints of hot water and, for a time at least, nothing else but 3 pounds of animal food, preferably minced beef. There were three meat meals each day, at 8 a.m., 1 p.m., and 6 p.m., and one and a half hours before each meal, and again three and a half hours after the last, one pint of hot water was taken. In addition to this it was imperative that a rest of nearly one hour's duration should be taken both before and after each meal.

He claimed that the hot water washed out the stomach, stimulated the liver and kidneys, promoted peristalsis, purified and liquefied the blood, washed out the uric acid, lightened the labours of the heart, because pure liquid blood was being circulated instead of sluggish, sticky, and congested material, diminished pain, and restored sleep. Some of these statements are clearly fantastic, as is also his dictum that man is two-thirds carnivorous and only one-third herbivorous, because he possesses twenty meat teeth and only eight effective vegetable teeth. For this reason he contended that his diet should consist of two parts of animal food to one part of vegetable material, whereas the ordinary diet of everyday life contains about one-twelfth part of meat to eleven-twelfths of vegetable, fruit, and cereal.

He permitted the addition of a little white of egg to the meat, and if this diet is too restricted, then he allowed a piece of stale bread cut thin and toasted, with tea or coffee, without sugar or milk, as a substitute for water. As an alternative to the mince, not more than 1 pound of nicely broiled tender steak was suggested, with the addition of a little raw or well-stewed celery as an agreeable bon bouche.

It is well to enunciate the theory underlying the Salisbury diet, because it is in direct opposition to the allegations made by the vegetarians that the end-products of flesh foods in the system are of the most poisonous character, whereas those of carbohydrates and fats are simply carbonic acid and water, which are absolutely harmless. The fleshless feeders proceed on the assumption that the digestion and assimilation of the non-nitrogenous foods is carried to a complete finish, and they shut their eyes to the possibility of the formation of other acid end-products of a less innocent character. The occasional brilliant results obtained from a Salisbury diet after the patient has been unable to tolerate a mixed diet are a sufficient refutation of such a view.

The Salisbury System contrasted with Hare's

It will be noted that while the Salisbury diet is administered with the object of diminishing the harmful effects of food in the alimentary canal, the hyperpyraemic theory applies to the food after it has been absorbed into the blood. Hare declares that excess of carbonaceous material in the blood is an essential, though by no means the only factor in many diseases, especially those of a paroxysmal character - migraine, asthma, epilepsy, bilious attacks, gout, and some catarrhs. He contends that carbonaceous compounds are much more likely to accumulate in the blood than proteins, because the latter are excreted rapidly as urea. An excess of protein is easily disposed of because it tends to stimulate metabolism, and exercise and exposure to cold are essential factors in its metabolic disposal. Hence, in the absence of exercise and cold - conditions which in this ease-loving generation obtain to a large extent in the present day - an abundant supply of carbonaceous foods will cause hyperpyraemia unless fat be formed, and this can only happen to a limited degree.