The principal varieties of flour above mentioned, and particularly fine wheat meal, can be made to serve as very useful foods by preparation into a dough with the addition of water, salt, and a small quantity of potato, preferably as potato flour. The so-called “flour foods” so much used in Austria-Hungary, and often especially well prepared in private houses and the best hotels, are made from this dough. They are of great nutritive value because of their high carbohydrate content, which is still further increased by the addition of butter and other fats. To be sure, these “flour foods” are sometimes rendered quite indigestible by the additions referred to, particularly if the potatoes have not been properly prepared beforehand. The further addition of poppy seeds, nuts, pre-serves, etc., may make them still more indigestible. The most easily digested of them are noodles, which are made from such dough rolled into thin sheets and dried. They are also well absorbed in the intestine, and their assimilation is improved when the yolks of a few eggs are added to the dough. Macaroni, which is rich in gluten, is also well assimilated. Rubner found that when macaroni or noodles contained only a limited quantity of albumin 17 per cent. thereof remained unused, but that in those rich in gluten only 11 per cent. was lost. Macaroni is a very valuable article of diet, chiefly because it is very nutritious ; it is especially so when eggs have been added, which is very rarely the case in the varieties offered for sale. The commercial noodles, poor in eggs, the so-called “water noodles,” contain, according to König, îo.88 per cent. nitrogen, 0.62 per cent. fat, 1.36 per cent. sugar, 2.10 per cent. dextrin, 72 per cent. starch, 0.42 per cent. cellulose, and 0.64 per cent. ash, together with 0.261 per cent. total phosphoric acid and 0.0228 per cent. lecithin-phosphoric acid. The nutritive quality of egg-noodles prepared at home is much greater. In these, when at least 4 eggs have been used to the kilo of flour, König states that there is contained nearly 4 per cent. more of albumin, which thus amounts altogether to 15.16 per cent. ; more total phosphoric acid, 0.392 per cent., and above all more lecithin, 0.1212 per cent.
We have every reason, therefore, to accord a first place to macaroni as a nourishing food, for even the ordinary commercial varieties represent per kilo the very respectable total of 3360 to 3600 calories, so that if an adult should eat 3/4kilo of macaroni per day he would fare very well. Nor would his nourishment be very one-sided, for it would contain albumin and carbohydrates; it would only be somewhat lacking in fat. Combination with it of some grated cheese, such as Parmesan, would furnish some albumin and fat, and would also aid in its assimilation. We can thus understand how it is possible for the poorer classes among the Neapolitans to live chiefly upon such a diet, just as the Eastern Asiatics live upon rice. Even though they may, as I have myself seen, share their living room with a chicken, turkey, or even a pig, the meat of this much-beloved family companion is only eaten at Christmas, and during the rest of the time they are enforced macaroni-eaters and vegetarians. We can learn much, however, from their frugal way of living, and would do well to imitate them in eating macaroni. The Italian macaroni is, to be sure, of the very finest when made in the best factories, but a very good quality is also made in this country. I frequently recommend macaroni as a healthful addition to the midday and evening meals of my patients in Carlsbad, as it is nutritious and easily digested, and does not impose any hard work upon the stomach and intestines. It is well tolerated and assimilated. Nor does macaroni contain any injurious substances, either for the liver or the blood-vessels, and it thus forms an ideal food for liver and kidney patients, as well as for arteriosclerotics and gouty persons, since it does not lead to the formation of any uric acid, being free of purin bases. It should also be added that macaroni when taken in considerable quantities antagonizes intestinal putrefaction, like foods rich in carbohydrates in general, as has been shown by Combe. As a component part of a vegetable diet macaroni is thus a most valuable addition; it is really to be wondered at that such valuable vegetable foodstuffs as thesemacaroni, tapioca, sago, etc.are scarcely ever to be found on the bill of fare of most vegetarian restaurants, in which the cheapness of the foods is a chief consideration.
As a breakfast food, another variety of the healthful “flour foods,” which are much used in America, would be advantageous. “Grape-nuts,” for instance, in which the floury substance has been dextrinized by roasting and thus rendered digestible and easy of assimilation, is eaten with cream and would be a useful addition to our usual very sparing breakfast. In the United States, this or some other product of wheat or corn meal, such as cream of wheat or hominy, is regularly taken at breakfast. Much more palatable, however, are the almost universally used flat pancakes, or “hot cakes.” They are made of corn meal or buckwheat flour, and are piled up one over the other, spread with butter and maple syrup. The corn cakes are preferable, since they are much more nutritious, and also more digestible, than the buckwheat cakes. With us these cakes would be even more digestive, since our butter is fresher and of a finer quality, while in America the butter is salted and does not come to the table fresh each day. With the addition of butter and syrup, which would be replaced by us with pure honey, or honey mixed with fruit syrups, these corn cakes would furnish a very complete article of diet, since they would contain albumin, fat, and sugar. Such a breakfast would be especially advisable when a strictly vegetarian diet is being followed, since, with that kind of diet, albumin-containing foods and those yielding many calories are a necessity. A very light breakfast of coffee and rolls constitutes a serious mistake for those following a strictly vegetarian diet.
It is obvious that these additions to the breakfast, which are quite suitable in the diseases mentioned when speaking of macaroni, would not be indicated in obesity or diabetes, and should in the latter affection be strictly forbidden. In very light cases of diabetes, buckwheat cakes-with the addition of plenty of butter and a little fruit syrupmight be indulged in, since the assimilation and absorption of the carbohydrates by the intestines is interfered with owing to the high content of cellulose.