Any opinion I give must simply be my own. I should be inclined to think it unnecessary to prescribe any quantity of protein whatever. By that I do not mean to say how much should be consumed, because in our food products, say bread and butter, there is enough to meet all requirements as shown by these investigations, but at the same time the experience of past generations shows that we can at least, without any noticeable disadvantage, consume considerable quantities of protein. For instance, I should not advise stopping all use of meat. I should be inclined to take the same attitude toward protein as toward fats and carbohydrates. We must have enough food to maintain the energy that is consumed, and I think the same liberty can be taken toward protein as toward the other two. We do not quite know just what is the effect of compelling the system to eliminate large quantities, and so long as we do not know I do not believe we can take a very definite standpoint on the question. It is generally believed that such diseases as gout are more or less directly due to high living, but we can not prove it, and moreover it is a question whether protein consumption and meat eating are at all identical. Such products as uric acid are formed in large quantities by meat eaters, but they are not formed when such products as milk and eggs are taken; consequently, I should say that we do not know.
In regard to such disease as consumption, I have no personal experience, but if the point is merely to build them up and give them a large amount of reserve material, we can see that it is entirely unnecessary to feed large quantities of milk and eggs, because the nutrition of milk and eggs is at once eliminated, and presumably the rest of that food is stored as fat and carbohydrates, and so I should be inclined at least to consider it worth while to try whether fat and carbohydrates would not produce just as good results.
There are several here I think who have to do with feeding people in hospitals, and one lady with tuberculosis patients, and I should like very much for my own information to know whether these patients take and digest and seem to flourish under this high feeding of eggs and milk. I myself have to visit a poorhouse where there are 100 tuberculosis patients. Eggs are 40 cents a dozen in winter, and the state must pay for them. Still the prescription is 3 and 4 eggs a day and a large quantity of milk. If it is not necessary, it is of immense importance to the whole country to know it, for other patients need the money which now goes for this purpose.
I am trying to feed consumptive patients as economically as possible, to give them the things they like and must have and to do it all on a certain sum. Our patients are fed in the following way. They have breakfast at 7.30. We expect them to take half an hour for that meal, and they may stay as much longer as they like. At 10.30 they have their lunch of milk and eggs, no limit to the quantity of milk and eggs or egg nog. At 12.30 we have dinner. A number of patients at that meal take a raw egg and milk. At 3.30 they are called to lunch, milk and eggs. At 5.45 supper, milk and eggs again and just as much as they can eat besides. At 8.30 milk and eggs again. Some of those patients during the night take milk and eggs. We give them cereal twice a day, for breakfast and supper, cooked eight hours in a double boiler. They are very fond of that, but we find that if they know there is steak they do not take so much. The same at dinner with soups. I find they do not take as much, for they think they must save space for roast beef. Vegetables they are fond of. I try to give them as much as they can eat. They seem to have an idea that they must eat plenty of rare beef and milk and eggs. I have heard patients who have been cured, come back and say to the others "Now eat all the meat and milk and eggs that you can and never mind the other things." Farther than that I cannot tell. The patients look healthy and no one would have any idea that they were a lot of sick people.
Would Dr. Folin say that we can not help getting from any food as much protein as the system needs and so there is no such thing as balanced rations?
If you eat enough bread and butter to give 2500 calories, I believe you would get enough protein. Be sparing of the butter if fat is too great. It is exceedingly difficult to get any diet that does not contain nutrition that is equal to the metabolism.
The one point that you would need to consider would be fuel value and in regard to that there is now perhaps a little difference of opinion. The work done by the department of agriculture is probably the safest guide at present.
Dr. Folin's is the most important contribution to the subject made in a long time. It clears up some matters, throws light on others, and I think when work has gone on for a time longer we shall know a great deal more about this subject. I like his attitude in not drawing frenzied conclusions from so many and interesting results. I never want to forget that whenever we find a race living on a small amount of food, or largely on vegetable diet, it is not a capable race. The Italian peasants who live on corn meal and a little fish do little work, yet bring them to this country and give them better diet and they do a great deal more and better work in a day. The second and third generation develops a larger man than his father or grandfather. We find that the Japanese eat just about the same amount of protein as the standard covers.
One point which every one has very carefully left out of this discussion is the food of the child. All these experiments in lowering the food protein must be practiced on our own and not on the children's diet at present.