How greatly man depends upon his daily bread can only be appreciated by a Carlsbad physician who, like the author, is often obliged to restrict his patients in the use of bread. There is hardly any other article of food which man finds so hard to give up, and many persons would much rather give up meat than bread. Since the most remote times man has been accustomed to this food, which he eats daily from early childhood. Recently I saw at the British Museum remnants of bread in the coffins of the old Egyptian mummies, which proved that already thousands of years ago this food was greatly prized by man.
No other foodstuff used by man is more satisfying than bread when taken in combination with other articles of diet, and many of the latter gain thereby in nutritive value and power of assimilation, as, for instance, milk. The feeling of satiety is more particularly felt when dark bread is eaten; the latter also seems to have more taste. Most people find a fine white bread less to their taste. When we ask for bread, we do not care for a “flour food,” but want a true bread, that is to say, a dark bread. In the shape of rolls, white bread may be satisfactory, since these at least have a good hard crust already dextrinized, and consequently more digestible, and real bread lovers greatly prefer the crust to the soft, white crumb. It is better for the teeth, too, to eat the hard crust and crumb of a not quite fresh black bread, and it is very probable that, for the development of the teeth of a growing child, daily gymnastic exercises, so to speak, with his teeth in nibbling at such hard bread are preferable to swallowing some soft bread almost without masticating it. Even the dog looks instinctively for a hard bite when his master inadvertently provides him with nothing but soft food, and such dogs sometimes try to bite wood, or even hard stones, as I have myself seen. Dark bread has another advantage, namely, that it contains the outer portions of the grain, the glutinous substance, which is more rich in albumin. When the flour of white bread is too finely ground it doubtless contains more starch, but this is not such an important consideration, for we have plenty of starch-containing foods in the vegetables at our disposal. We need rather plenty of albumin in our bread, for the albumin-containing foods are more rare among the vegetables. Potatoes can be accepted as a substitute for the starch content of bread, but cereals do not in this sense form a bread substitute. When bread containing less starch is taken, we can, as is usually done by dia, betics, make up the deficiency by eating potatoes, but this can-not be so well done with cereals. White bread made from the finest flour product of the rolling mills has another great defect, that of furnishing too little phosphorus, lime, and iron. Balland states that fine white Parisian bread contains a mini-mum of 0.06 per cent. phosphorus and o.15 per cent. of phosphoric acid, and a maximum of 0.18 per cent., while the coarser bread furnished to the soldiers contains almost twice this amount of phosphorus.
We see by the above how much more albumin is contained in the coarser wheat flour, but it nevertheless has the drawback that such a gluten-containing bread is more poorly assimilated. Rubneri states that o,f the finest wheat flour 21.8 per cent. is lost, and of the coarsely ground shelled grain about 7 per cent. more. In flour of a medium quality only about 3 per cent. more are lost. It is consequently advisable for us to use bread of a medium quality, as otherwise we must allow for 7 per cent. more; but even though the nutrient salts are more poorly assimilated, we can make up for this. It would be advantageous to mix fine rye flour and wheat flour for making bread. Such bread would be preferable to white bread, because it would stimulate the bowels to a much greater extent than bread entirely free from bran. Bread made entirely from coarse rye flour would, nevertheless, not prove healthful, as according to Rubner much of the albumin is lost, reaching when baked with yeast the enormous amount of 46.6 per cent., and 14 per cent. of carbohydrate ; with a “sour dough,” or leaven, 32 per cent. o,f albumin and 10 per cent. of carbohydrates. For a healthy person, however, such food would not be so bad, and in case the digestion were to suffer, bread made from shelled, coarsely ground wheat could be substituted. In countries where the people eat large quantities of rye bread we find them to be in such a perfect condition of health that we must conclude that this coarse bread diet is not a disadvantage, but rather the contrary. The chief objection to these coarse breads is that the quantity of feces is greatly increased, which tends also to interfere with the assimilation of the other foods. That most to be recommended from the standpoint of health would be the Graham bread made from shelled whole, milled grain. The leavened pumpernickel is less desirable, as 43 per cent. is lost in the intestine. According to Rubner, 26 per cent. of nitrogen and 7.5 per cent. of carbohydrates are not assimilated in the Graham bread.
A healthy person can, however, eat pumpernickel, and it is really an excellent breakfast food, which should be more widely used. The above-named breads may also do good service for diabetics, since owing to the considerable cellulose content the sugar is slowly and with difficulty carried into, the blood, so that the elimination of sugar is very little influenced. I consequently prefer to order small amounts of such bread for my diabetic patients, in preference to the less tasty diabetic breads. For people with delicate stomachs and intestines the easily digested white bread is to be recommended, and particularly zwieback, in which the starch has been converted into a more soluble and digestible form. By simply drying or broiling the slices of bread, thus making the never-failing “toast” of the English and American breakfast tables, bread can be more readily digested. It is also, more easily masticated, and for this reason a somewhat stale bread is to be preferred to that freshly baked.
The most healthful bread of all would be that made in the old-fashioned way by grinding wheat between two stones, in which manner all of the nutrient substances and salts are preserved. When we consider that the poor get almost all of their daily amounts of nutrient salts from bread, we must consider it as a crime against the public welfare when, through greed for gain, or for technical reasons, as is the case in the rolling mills, the flour is largely robbed of its nutritive salts and other substances. The building up of the bony structure, the chest expansion, the development of the lungs, and, consequently, the general health of the population at large stand in intimate relation to the above. Fine white breads are, at all events, to be condemned.