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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

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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