These are examples of the opinions of scientific medical dietists of different nationalities, representative of the view held by the great bulk of the medical profession on the vegetarian question. It is only in recent times, however, that such a favourable attitude has been adopted, and despite these statements a large section of scientific opinion is still uncompromisingly hostile, probably because of an obstinate disinclination to reconsider the matter in the light of modern knowledge. It must be admitted that in its early days no effort was made by its adherents to make the diet attractive, and the crude attempts of untutored cooks created aversion and militated against an increase of its supporters; but the application of scientific principles has changed all this, and much of the reproach of the fleshless system has been taken away by Dr. Kellogg, whose glory it is that at Battle Creek Sanitarium he has removed the method from the realm of the haphazard and raised it to the dignity of an exact science.

Vegetarian enthusiasts, both in the medical profession, and amongst irresponsible supporters outside of it, in their efforts to bolster up their practice by scientific evidence, have repeatedly shifted their ground. They originally relied upon the humanitarian argument, and doubtless in most instances this gives the clue to the origin of their practice and theory. The discovery of the hypothetical baneful effects of uric acid on the body was at first a veritable godsend to them, and Dr. Haig was hailed as the saviour of the situation, but when he announced that the vegetables most relied upon contained apparently more purins than flesh foods, his theory was scouted as not being able to hold water, and his practice, whilst being condemned, was gradually absorbed.

More recently Professor Chittenden's low-protein theory, which, whilst advocating the value of great moderation in protein foods of all kinds, by no means rejects those containing flesh, has been greeted with acclamations by every follower of Pythagoras as a perfect explanation of his practice.

All three theories are used to support the vegetable pro-pagandism, the favourable points of each being extracted in support, and the detracting points being calmly ignored or quietly pushed on one side. It is instructive to note how the vegetarians rely upon the statement that flesh foods are full of uric acid, which is an objection to their use, and yet continue to swallow tea, coffee, peas, beans, and lentils.

At the outset one must realise that there are two main divisions in the vegetarian camp. First, those who subsist on fruits, nuts, cereals, and who, for reasons which will presently become apparent, are now in a strong minority; secondly, those who countenance the use of milk and eggs.

Major Mccay's Investigations

The most recent study of the subject and the most vivid description alike of the dangers and inherent possibilities of pure vegetarianism is that presented by Major McCay in his contrast between the physical condition of the natives of the plains of Lower Bengal and the hill tribes of the same department of India. It is of exceptional value as being the outcome of the most accurate experimentation and the most careful observation, confirmed by residence amongst the people themselves. He himself had no interest either in the condemnation of vegetarianism or in the exploitation of a mixed diet. His sole objective was the recommendation of a system of feeding calculated to improve the nutrition of the prison population; but as a result of his inquiry he was unable to resist the conclusion that pure vegetarianism as practised by the Bengalis and Beharis was totally unsuited to their nutritive requirements, detrimental to their health, annihilated every spark of ambitious desire, and degraded huge masses of the people almost to the level of the brutes.

The important factor militating against the health of these two races of people was the bulkiness of their diet, which was potent enough to make a complete alteration in the coefficient of absorption of all the four principles. He found, indeed, that the absorbability of each of the food-stuffs varied with the degree of bulkiness, and that this was dependent upon the extent of the distension of the stomach and consequent delay of the expulsion of its contents. This, coupled with increased peristalsis of the intestines, produced evacuation of their contents before the full proportion of nutriment had been extracted.

On a diet of cereals, pulses, fruits, and vegetables only 85 per cent. of the contained protein is capable of absorption, even when the organs of digestion are in a healthy state, free from the oppression incident to an excess of indigestible material; and so long as these conditions exist the absorption is good, whether in confirmed vegetarians or in those who are recent converts to the system. Up to a certain point, depending upon individual characteristics, addition may be made to the quantity of food without interfering with the efficiency of absorption, but sooner or later a definite point is reached where the actual bulk prevents effective absorption, and further additions to the quantity intensify the difficulty till, as in the case of the Bengalese, not more than 55 per cent. of the protein is absorbed.

Diminution of absorbability may be compensated for by increase of food up to a certain point, beyond which there is a notable reduction in the quantity metabolised. There is, therefore, for each food an optimum amount, which is the most economical quantity capable of being dealt with by the individual.

As the bulkiness is due almost entirely to carbohydrate foods of a low protein value, there emerges another factor of importance which complicates the situation. The presence of excessive quantities of carbohydrates induces intestinal fermentation, with the production of various acids, such as carbonic acid, lactic and acetic acids. These not only reduce the potential energy of the food, but set up irritation in the bowel and inflammation of the mucous membrane. The value of the ingested food is thus seriously reduced, and so, in spite of the immense amount of carbohydrate material consumed, there is a complete absence of body fat and an attenuation of the physical frame suggestive of utilisation of the bodily tissues to supply the necessary energy. Such a parlous situation should give pause to one obsessed by the desire to become a pure vegetarian, and such authoritative testimony should finally dispose of any arguments in favour of the utility of a dietetic system little removed from herbivorism.

Most of the disastrous breakdowns reported amongst the young and enthusiastic converts to vegetarianism in this country are to be found amongst the ranks of those who from ignorance or bigotry have persisted in using a diet so bulky that the stomach and intestinal tract could not deal with it effectively, and who were, therefore, insufficiently nourished. It is from this point of view that the use of a pure vegetarian dietary is so reprehensible and risky, and Major McCay freely acknowledges that by a reduction in the bulk and the addition of more concentrated foods with a larger proportion of protein, such as wheat, a fairly healthy existence is perfectly possible. It should, however, be recognised once and for all that such a diet is seldom capable, especially amongst those who have been accustomed to highly nitrogenous foods, of producing a powerful and vigorous race of people, and one might assert with a fair degree of assurance that only where vegetarian foods are specially prepared is it possible for any one on such a system to attain to his fullest point of physiological activity. This is the diet which has been the subject of so many severe strictures and been almost unanimously condemned by medical scientists.

Although the vast majority of those who live on such a system are destined to exist on a much lower plane of physiological activity than the mixed feeder, from actual observation I am not disinclined to believe that where the food is carefully selected and prepared the fruitarian - as he is designated in this country - may attain to a degree of health and vigour quite up to the average. But what is exceptional in such circumstances is quite a common occurrence for those who do not object to the addition of animal protein in eggs and milk, a system which is distinguished by the cumbrous appellation ovo-lacto-vegetarian - shortened for convenience to lacto-vegetarian - and throughout this discussion my remarks will have special reference to it. It is important to recognise its distinctive features, as the arguments in favour of and the unfavourable criticism levelled at vegetarianism originally applied to fruitarianism. There are still many strict vegetarians who deplore the admission into the diet of anything but what they term the fruits of the earth, and are ready to maintain its suitability and defend its tenets against all comers, but we have already exposed its weak points and need not return to them. All the statements about to be made concerning lacto-vegetarianism will apply with all the greater force to the more restricted system, although it must be admitted that the flesh-abstainer has enormously strengthened his position by the addition of animal proteins.