212 Appendix. 



AS A DIET. 



A consideration of the composition of fruits gives us some idea of the com- 

 bination best suited to a fruit diet. In the first place fruits are rich in acids 

 and contain no starch. Acid destroys the ptyaline of the saliva, and delays the 

 digestion of starch, or in fact prevents the continuation of starch digestion 

 in the stomach, hence if acid fruits and a rich carbohydrate diet for starch 

 foods are to be eaten at the same meal the fruits should be eaten at the close 

 of the meal, thus interfering with the digestion of starch as little as possible. 

 Second, fruits contain but little of the nitrogenous food elements, and experience- 

 shows that as a rule acid fruits combine poorly with nitrogenous foods, such as- 

 flesh foods, eggs, cheese, etc. Fruits that contain a digestive ferment, such as. 

 the pineapple, pawpaw and cranberry, seem to be an exception to this rule. 

 Third, fruits, with the exception of the olive, contain very little fat. Acids and 

 fats are .iust as incompatible as oil and water. The conclusion to be drawn 

 from these facts is that fruits should be eaten largely alone, and that they 

 are most digestible and cause practically no disturbance when taken on an 

 empty stomach. Hence the meal at which fruit is eaten should be made up 

 largely of fruit. Careful observation and the study for several years convinces 

 me that this i.s correct, and I believe I am supported by the experience of those 

 who have investigated this mtaer carefully. 



The fact that fruit disagrees with so many people is due largely to eating 

 it at the end of a long meal of several courses, and then to loading it with 

 sugar, fane sugar is not digested at all in the stomach, and in the presence 

 of fruit .iuices it is a prolific source of fermentation. Even in the small intestines 

 the digestion of cane sugar is slow, while that of fruit sugar is rapid, and hence 

 delays the absorption of the latter. The old adage that fruits are "golden for 

 breakfast, silver for dinner and lead for supper," is an error. If combined 

 properly, fruits are golden at any meal. If after eating there is any disturbance, 

 it is due to the combination and not to the fruit. As a rule fruits and vege- 

 tables are a poor combination. In fact, an important dietic rule is that foods 

 that are slowly digested should not be combined with those that are quickly 

 digested and different in character. If eaten alone fruits are digested in less^ 

 than an hour. 



WHEN FRUIT DISAGREES WITH SOME. 



When a patient tells me that he cannot eat fruit, after inquiring into his 

 diet, in nine cases out of ten, I can tell him why. Canned fruits heavily 

 sweetened with cane sugar are a prolific source of gastric and intestinal dis- 

 orders, and should not be used in fevers. Fruits and fruit juices canned 

 without sugar are very serviceable, but the unsweetened fresh fruits and juices 

 are the best. 



The laxative fruits are apples, oranges, prunes, figs, mulberries, dates, nec- 

 tarines, tamarinds, plums and strawberries. 



The astringent fruits are blackberries, cranberries, whortleberries, black 

 raspberries, prickly pears and black currants. This is more true with the fruit 

 juices than the fruit itself. 



All fruit juices are diuretic, or act favoi-alily on the kidneys, especially 

 lemons, oranges and melons. 



The best stomachics or apetizers are oranges, apples, lemons, limes and 

 grape-fruit, and should be eaten one-half hour before meals. 



In the dietetic treatment of disease fruits deserve a much larger consid- 

 eration than they have hitherto been given. While the United States is the 

 greatest fruit country in the world, the American profession is behind its 

 European brothers in prescribing fruits in disease. 



It is quite a general notion that fruits are a common cause of stomach and 

 intestinal trouble. 



It is important to emphasize that over-ripe or under-ripe fruits should 



