A Paper Read Before The Physiological Section Of The British Medical Association, August, 1901, By Ernest Van Someren

Mr. President and Gentlemen:

Being a general practitioner, it is with some trepidation and an apology that I present myself before this section. The reasons for my doing so are: First, that I believe that a hitherto unsuspected reflex in deglutition has come to light which has an important bearing on health, the prevention of disease and on metabolism. Second, that any theory whatever, based on a possible physiological function, claiming to diminish, as this does, the amount of sickness and suffering now existent, should have serious investigation. Third, that I desire to enlist your skilled help in the consideration of the theories I have doubtless crudely erected on my premise.

According to the "Encyclopaedia Britannica," "Luigi Cornaro (1467-1566) was a Venetian nobleman, famous for his treatises on a temperate life. From some dishonesty on the part of his relatives, he was deprived of his rank and induced to retire to Padua, where he acquired the experience in regard to food and regimen which he has detailed in his work. In his youth he lived freely, but after a severe illness at the age of forty, he began under medical advice gradually to reduce his diet. For some time he restricted himself to a daily allowance of 12 ozs. of solid food and 14 ozs. of wine. Later in life he still farther reduced his bill of fare, and he found that he could support his life and strength with no more solid meat than an egg a day. So much habituated did he become to this simple diet that when he was about seventy years of age the addition, by way of experiment, of 2 ozs. a day had nearly proved fatal. At the age of eighty-three he wrote his treatise on the 'Sure and Certain Method of Attaining a Long and Healthful Life.' And this work was followed by three others on the same subject, composed at the ages of eighty-six, ninety-one, and ninety-five, respectively. 'They are written,' says Addison ('Spectator,' No. 195), 'with such a spirit of cheerfulness, religion, and good sense, as are the natural concomitants of temperance, and sobriety,' He died at the age of ninety-eight." Some say of 103 !

Now, was Luigi Cornaro right? Did he make use of a physiological process unknown to us of the value of which he was not cognisant? To live to an advanced age, must we be as temperate as he, reducing the quantity of our food to a minimum required by Nature?

That we all eat more than we can assimilate is unquestionable. How can we determine the right quantity? Instinct should guide us, but an abnormal appetite often leads us astray. Nature's plans are perfect if her laws are obeyed. Disease follows disobedience. Wherein do we disobey?

We live not upon what we eat, but upon what we digest; then why should undigested food, recognisable as such, be deemed a normal constituent of our solid egesta?

Something like the following must be a common experience to general practitioners, especially to those practising on the Continent. The patient comes to see us and volunteers the information that he or she has the "gout," "rheumatic gout," or "dyspepsia." Symptoms are asked for. The case is gone into carefully for causation. An appropriate diet and an appropriate bottle of medicine prescribed. As the patient leaves the room, we may, or may not, call attention to the fact that both teeth and saliva are meant to be used. The patient returns, better, in statu quo, or worse. If better, he remains so while under treatment, and relapses when he returns to ordinary habits. If unaffected, or worse, we try again and again, until we despair, then take or send him to a consultant. Temporary benefit, possibly owing to renewed hope, results; but finally the unfortunate gets used to his sufferings, and, if he can afford it, is sent to join the innumerable hosts that wander from one Bad to another, all Europe over, trying, praising, and damning each in turn. Their manner of living is, of course, at fault.

Nature never intended that man should be perpetually on a special diet and hugging a bottle of medicine, nor did she ordain that he should go wandering over the map of Europe drinking purgative and other waters.

Though early yet to speak with certain voice, it would seem that we are provided with a Guard, reliance on which protects us from the results of mal-nutrition. There seems to be placed in the fauces and the back of the mouth a Monitor to warn us what we ought to swallow and when we ought to swallow it. The good offices of this Monitor we have suppressed by habits of too rapid eating, acquired in infancy or youth.

Last November my attention was called by Mr. Horace Fletcher, an American author living in Venice, to the discovery in himself of a curious inability to swallow, and a closing of the throat against food, unless it had been completely masticated. My informant stated that he noticed this peculiarity after he had begun to excessively insalivate his food, both liquid and solid, until all its original taste had been removed from it. Any tasteless residue in the mouth, being refused by the fauces, required a forced muscular effort to swallow. He further told me that since adopting this method of eating he had been cured of two maladies, adjudged chronic, the suffering from which rendered him ineligible for Life Insurance. His weight now became reduced from 205 lbs. to 165 lbs. He had practised no abstemiousness, had indulged his appetite, both as to selection and to quantity, without restraint, and for the last three years had enjoyed perfect health.

After his cure, he was accepted without difficulty for insurance, the last examination finding him an unusually healthy subject for his age. Having leisure, he had spent three years in investigating the cause of his cure, had pursued experiments upon others, and had extended his inquiries, both in America and Europe, until our meeting in Venice. He had also published a statement and inquiry in book form, entitled "Glutton or Epicure,"which had been reviewed by the "Lancet."