The Middle Op The Day





Information regarding the mid-day meal will be of value to the

physician in many cases. In cities, luncheon, likely to be rather an

apology for a meal, is taken rapidly, and immediately there is a

return to work. As a medical student in Vienna, I was much interested

in the mid-day meal of the bankers and merchants of the old Austrian

capital. At that time--I hope they have not changed the good custom

since--the banks closed at 12 o'clock and did not open again until 3

o'clock. This gave time for taking the mid-day meal in comfort, and

for a proper interval for digestion. In all the southern countries of

Europe, for seven or eight months in the year at least, little is done

during the two or three hours in the middle of the day. The people get

up earlier and rest at mid-day as a break between the afternoon and

morning. It is quite beyond expectation that anything like this will

ever again be possible in the great commercial cities. The fact that

this was the custom of our European forefathers, however, shows how

business has obtruded itself on the habits that man would naturally

form for himself. Business men hurry to luncheon, or if they take any

time over it, it is because they have invited some one to lunch with

them with whom they wish to talk over important matters. This means of

saving time recalls the well-known expression of James Jeffrey Roche:

"Time is money. Every second saved from your dinner now is a sequin in

your doctor's pocket later on in life!"





Hurried Lunch.--The seeds of our frequent American dyspepsia are sown

partly at the hurried breakfast and then at the hurried mid-day lunch.

When a physician finds this to be the case, then the patient's habits

must be reformed. Otherwise there is little prospect of relief from

neurotic digestive symptoms, or from those uncomfortable feelings so

often supposed to refer to the heart, or other important organ, when

digestion is interfered with. There should be pleasant company at

luncheon if possible; it should be preceded by fifteen or twenty

minutes in the open air, with, as far as possible, complete seclusion

from business thoughts so as to allow the stomach to secure its share

of blood, and it should be followed by at least half an hour of

pleasant occupation that does not call for serious mental work. This

may not be possible for every one, and many will complain that this is

asking too much in our busy time. We physicians are not here to make

the nice customs of medicine courtesy to great kings of finance or to

the busy tyrants of the professions, but to tell them what we think

should be done in order that nature may not be abused. Men

should be advised to take their luncheon in some building different

from that in which their offices are located, or, if they eat in the

same building, to go out on the street for a while before the meal. In

the old days men used to call on one another in order to transact

business, and these little trips were often made just before or after

luncheons.



Now the telephone and the messenger boy have done away with this, with

a great saving of time, but with an increase of intensity of labor

that makes for nervous exhaustion. Luncheon clubs are excellent things

when men do not talk shop, but they have one fatal defect. Almost

invariably they lack simplicity of menu, and, because of the variety

supplied and the example of others, there is a tendency to eat to

excess. A game of billiards after eating is often excellent, because,

when standing, digestion is accomplished with more comfort than when

seated. A walk after the lighter midday meal is a good thing, though

the old saw said "after dinner sit a while," but that was in reference

to the largest meal of the day, and may still hold good for the

evening meal, which is likely to be the heaviest one.





Women's Lunch.--Women are very likely to take their mid-day meal, when

it is their luncheon, very irregularly. If they have to get it for

themselves they are likely to be satisfied with almost anything. If

they get it outside the house they are likely to take it rather late,

so that if they have breakfast before eight o'clock, this putting off

of the next meal causes some disturbance of the economy. When the

stomach gets to be empty, either there is a tendency to swallow air,

or there is a rumbling sense of fullness that disturbs the appetite,

or the appetite itself is capricious, and a headache develops. How

many headaches are due to missed meals it would be hard to say, but

this is one of the most fruitful causes of the ordinary passing

headache. Delicate women, and especially those who work, are likely

not to eat enough luncheon. All the details with regard to this meal

must be known or the physician will find it hard to get rid of many

neurotic symptoms, particularly in working women. The same thing is

true for the so-called society woman, since she is likely to have a

late breakfast and then skip her mid-day meal. This is permissible if

she is so stout as to be able to spare it, but it is all wrong if she

is thin and needs every ounce of weight.





Nature of the Noon Meal.--During the last two generations fashion,

custom and the increasing demands of business have pushed the hour of

taking the principal meal farther and farther away from mid-day. There

are, however, cases in which it seems better that the principal meal

should be taken in accordance with the old custom, about noon time.

For tuberculous patients this is especially important. They often have

fever in the afternoon that seriously disturbs appetite. They may eat

with comfort and relish a couple of hours before the fever is due. For

delicate persons, especially those who have not much appetite for

breakfast and who can not be persuaded to eat a sufficient amount

early in the morning, a hearty meal at noon is almost a necessity.

They should be shown how low their nutrition is during working hours.

Their principal meal of the day before was taken between six and seven

o'clock. They have had a light breakfast, a meager lunch, and

naturally have little reserve force during the afternoon hours. As a

consequence they become overtired, this lessens the appetite, they do

not eat properly, and, above all, they do not digest as well as

they would if their last good meal were not so far away. They are

suffering from inanition, and, as is well known, starving people

cannot be allowed to eat heartily, because their stomachs have not

enough vitality to digest well.



It is often difficult to change the hour of taking the principal meal,

but in special cases this can be done with decided advantage. I have

seen such a change make all the difference between slow recuperation

from bad colds, and have seen it of the greatest possible importance



in tuberculosis. The very changing of the hour will sometimes

suggestively react to make the patient eat more heartily than usual,

the day is broken up better, the reaction against the morning

discouragement comes earlier, and the patient's general condition

improves. Many people rest better at night if their principal meal is

taken at the middle of the day.





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