This section is from the book "Practical Dietetics With Special Reference To Diet In Disease", by William Gilman Thompson. Also available from Amazon: Practical Dietetics with Special Reference to Diet in Disease.
The nutritive strength of beef tea has formed a subject for much discussion. The assertion is often made that it is a comparatively useless preparation, and it is said that a pint of it contains scarcely a quarter of an ounce of anything. Hassell estimates that fourteen pounds and a half of beef would be required to make enough tea to counterbalance the daily nitrogenous waste of one man. If rightly made, however, it may be nutritious, although the quantity of albuminous material which can be dissolved in it at any time is much less than that which exists in a similar volume of milk or in an egg. The preparation of beef tea should be conducted as follows: Tender lean raw beef is chopped into small pieces about a quarter of an inclvin diameter and macerated in cold water for five or six hours. The~water is to be added in the proportion of a pint to a pound of lean beef; ten drops of hydrochloric acid are then added, and the solution is gradually heated up to 1600 F., but not more, for from fifteen to thirty minutes. This is best accomplished by placing the vessel in a larger outer vessel of boiling water.
The water of the outer vessel communicates its heat to the Inner one, but the contents of the latter does not boil because the evaporation from its surface prevents its temperature from rising to that of the outside water, which is nearer the fire. Various forms of water baths, which the French call "bain marie" or milk scalders, are sold which are conveniently adapted for the process of making beef tea.
The prolonged soaking of meat in cold water dissolves its mineral ingredients - chiefly chlorides and sulphates of potassium, and also extractives, principally creatin and creatinin and some lactid acid derived from the muscle fibres. There may also be a little albumin present, but the albumin of meat or muscle is very sparingly soluble in simple aqueous solutions, and hence it does not diffuse out readily into the water, but the addition of hydrochloric acid converts the insoluble myosin into an acid albumin called syntonin, which is soluble in water.
In making beef tea, more or less fat is apt to be derived from the meat which floats upon the surface and presents a very unappetising appearance. This should always be skimmed or strained, and if it collects on cooling, the operation can be repeated. A crust of bread dipped beneath the surface will remove the supernatant layer of fat. The materials which are present in beef tea prepared in this manner are not very nutritious, but they are mildly stimulating to the mucous membrane of the stomach and to the nervous system, and it is probable that they are for the most part absorbed directly from the gastric mucous membrane without passing beyond into the intestine.
It is always desirable to give special attention to the proper flavouring of food for fever patients. In cases where a fluid diet is necessitated for many days in succession, much depends upon the willingness of the patient to take the food offered him, and a dread of too frequently recurring intervals of feeding and the positive dislike which the monotonous taste of certain meat preparations begets, react unfavourably upon the digestion. It is advisable to consult the individual taste of patients in this regard, and when they positively assert that they cannot take beef tea or bouillon or meat extracts in any form, their opposition may often be overcome by adding the expressed juice of some fresh vegetables of which they are fond. Carrots, turnips, celery, parsnips, and endives may be boiled alone or with an aromatic herb, such as parsley or green mint, and afterwards chopped fine and their juice expressed by squeezing them in a muslin bag. Such juices added to beef tea and broth impart an altogether different flavour, which may be varied from time to time by changing the vegetables (Yeo).
The total quantity of albuminous material which can be obtained in the manner above described in a reasonable bulk of fluid is very little, but in febrile conditions it is usually good for the patient to ingest abundant water, and there is no objection to part of the fluid being taken in the form of beef tea. On the other hand, if patients have absolute anorexia they are soon wearied by the effort of swallowing, and it is preferable to give nitrogenous food in some more concentrated form.
In fever, albuminous and gelatinous solutions aid in maintaining strength and diminish the tendency to exhaustion, and for this purpose the chief value of beef tea and beef essences is found to exist, rather than for furnishing additional substance to the tissues.
The objections to the use of beef tea are that its preparation requires time and care, and the taste soon becomes monotonous. It may be advantageously given, however, with vegetable extracts or beaten eggs, or gelatin may be put in to stiffen the mass into a jelly, which, when properly seasoned, is palatable. It may also be thickened with broken crackers, and with the addition of a little butter, pepper, and salt, it becomes much more nutritious; or sago, arrowroot, or chocolate may be mixed with it.
For infants the tea may be made weaker than for adults by using half a pound of lean rump steak to the pint of water.
Bouillon, or the French pot au feu, is of little more value as an aliment or heat producer than beef tea or extractum carnis. It is a good vehicle for giving beaten or dropped eggs, flour, etc. It stimulates the nerves, but in a much less degree than alcohol. It has the advantage over the latter and over condiments that it is never poisonous. A good meat puree may be made by adding a tablespoon-ful of scraped beef to three or four tablespoonfuls of bouillon, warming over a brisk fire until the meat turns of a faint drab colour, and seasoning with pepper and salt or a little butter.
Beef broth is agreeable to invalids, but on the whole it is less nutritive than that made from chicken, veal, or mutton. As ordinarily made, it contains, besides salts and extractives, ½ per cent each of fat and albumin and 1 per cent of gelatin.
Liebig's extract of meat, or extractum carnis, consists of the flavouring extractive matters such as kreatin, isolin, decomposable haematin, and salts. Some of these substances are excrementitious, and on this account Masterman compares it to urine, although it contains less urea.
A pound of mutton is represented by two fifths of an ounce of the extract. It contains no albumin or fibrin, and has in all but 2 per cent of solids, hence its nutritive power is practically nil, but when regarded as a stimulant and so used, it removes fatigue, strengthens the action of the heart and nervous system, and improves the func-tional activity of the stomach, and in this manner aids the digestion of foods. There is no occasion for taking it in large quantities, and when this has been done, symptoms of slight ptomaine poisoning have been observed, such as heaviness and stupor (Yeo). The extract has the advantage of keeping for years without decomposition, and it has been found that sometimes in cases of shock, especially after wounds received on the battlefield, its stimulant action has been considered almost equal to that of alcohol, and, bulk for bulk, it is certainly greater.
Johnson's fluid beef is a digestible preparation, somewhat less disagreeable in taste than many extracts of meat.
Valentine's meat juice is a much-used preparation which resembles Liebig's somewhat in its properties.
Valentine's meat juice is a clear fluid of a deep claret-colour, having a meaty odour and strong meaty taste. It is prescribed in doses of one half to two teaspoonfuls, diluted in eight times its bulk of cold water, or it may be mixed with cracked ice. Its taste, which is disagreeable to many patients, is easily disguised by the addition of half a tumblerful of milk, or it may be mixed with light, farinaceous gruels (after they have cooled to 1300 F.), or used to re-enforce soups and broths or cod-liver oil. Like Liebig's extract, it may be given by the rectum. An ounce of this preparation is said to represent the concentrated pure juice of two pounds of the best lean beef or the condensed essence of three fourths of a pint of natural expressed beef juice. Among other ingredients it contains haemoglobin and some albumin. It keeps well in all climates when tightly corked. It should not be diluted with hot water, strong liquors, or acid medicines, as these substances alter it and lessen its value.
It may be given in champagne and in tea which is not too hot.
Bovinine is the concentrated expressed juice of raw lean beef obtained without use of heat or acid. It is claimed that each ounce represents nearly one pound of beef, that it contains 26 per cent of coagulable albumin, and that it keeps well without decomposition owing to the addition of glycerin and alcohol. It is said to contain egg albumin also. It may be given per os in doses of a teaspoonful or more, or in ounce doses with pancreatin for rectal injection. Not being predigested, it may be pancreatinised like milk just before its administration in cases where it is desirable to give absolute rest to an irritable or ulcerated stomach.
Bovinine has been used topically for injection around indolent ulcers with the idea of improving local nutrition, but it is doubtful whether this procedure is of any value.