Grape Therapy

GRAPE THERAPY, one of the types of dietotherapy, applied as a rule in connection with resort therapy. G. t. consists in that, besides the usual diet, the patient receives a significant amount of sweet grapes, while at the same time taking advantage of special climatic conditions. Already in the second half of the 19th century, the beneficial effect of G. t. was explained by its special, almost legendary properties; at the present time there are sufficiently precise data that allow explaining the action of grapes from the point of view of dietetics. For G. t. one should choose sweet varieties of ripe grapes, with thin skin, juicy pulp and easily detachable seeds. Particularly aromatic varieties are not recommended, as they quickly become tiresome. On the coast of the Black Sea (in the Crimea and in the Caucasus) about 300 varieties of grapes are cultivated, of which the most widespread are chasselas (white, pink, muscat), chaush and isabella. Therapeutic grapes, on average, contain: 17.5% sugar, 0.5% nitrogen-containing substances, 0.6% titratable acids (mainly tartaric), 0.4% mineral substances; thus, 2 kg of grapes (average daily portion) contain, after deducting approximately 10% waste (skin, seeds, etc.), 315 g of sugar, 9 g of nitrogen-containing substances, 9 g of tartaric acid and 7 g of mineral salts, which in total amounts to 1,350 calories. In G. t., the patient is prescribed a light diet consisting of white bread, butter, eggs, cheese, meat soups, light varieties of meat and fish, boiled potatoes, rice or other cereals. Homemade cookies, tea, coffee, cocoa are allowed; mineral waters are not recommended; milk, cream, milk dishes, as well as raw vegetables are poorly tolerated. Since patients beginning treatment usually do not have the habit of eating raw fruits, it is necessary to gradually accustom their intestines and their flora to grapes; otherwise, a feeling of pressure, bloating, rumbling and diarrhea quickly appear. In former times, they tried during the usual 3-week course of G. t., starting with 0.75 kg, to gradually reach 3.5-4 kg; now it is not recommended to exceed 2.5 kg per day. The grape intakes are distributed as follows: at 11 a.m. - 1,000 g, at lunch for dessert - 500 g, at 10 p.m. - 500 g, or on an empty stomach - 500 g, at 11 a.m. - 1,000 g and by lunch or dinner - 500 g. Since in many patients, when consuming large quantities of grapes, due to irritation by acids and acid salts, stomatitis, glossitis and gingivitis easily develop, it is recommended to give at least part of the grapes in the form of freshly pressed juice. When using whole grapes, it is necessary to chew the grapes well, and spit out the skin and seeds. Before starting treatment, it is necessary to put the teeth in order, and during treatment to watch the oral cavity. Among the complications during treatment, complaints from patients about meteorism (abdominal bloating) deserve special attention. Early bloating during the meal itself depends on the bad habit of patients swallowing air together with grapes, which can be eliminated by drawing the patients' attention to this. Late bloating is the result of the entry of significant amounts of fermentable material into the lower parts of the intestine, due to rapid peristalsis or due to insufficient chewing, which leads to the so-called "fermentative dyspepsia". In these cases, it is necessary to stop further grape treatment. - Indications for treatment: 1. All cases where it is desired to increase the patient's weight (e.g., initial stages of tuberculosis of the lungs). In addition to the nutritional diet, up to 2 kg of grapes per day are prescribed. 2. Chronic constipation, accompanied by hemorrhoids and stagnant phenomena in the liver. 3. Diseases of the liver, especially, with liver insufficiency and jaundice (in jaundice - in the form of juice). 4. Gout (it is advisable to give half of the daily calories to the patient in the form of purine-free grapes). 5. Kidney diseases (high caloricity, little protein and table salt). - G. t. is contraindicated in all forms of diarrhea, in heart diseases with beginning decompensation (large volume, gases), in diseases of the urinary tract with alkaline urine. - The important nutritional, dietetic significance of grapes is found almost exclusively in southern seaside climatic resorts. This should be explained by the fact that the assimilation of the nutritional elements of grapes is enhanced by the influence of the climate; some physicians compare the effect of grape juice on metabolism to the effect of mineral waters, the effect of which is also maintained by climatic factors. It should be borne in mind that tender southern varieties of grapes do not tolerate transportation and therefore attract patients to the south. In the USSR, grape therapy is carried out in the Crimea and on the Black Sea coast of the Caucasus, from the last days of August to the middle of November; the best time is September and the beginning of October.

The important nutritional, dietetic significance of grapes is found almost exclusively in southern seaside climatic resorts. This should be explained by the fact that the assimilation of the nutritional elements of grapes is enhanced by the influence of the climate; some physicians compare the effect of grape juice on metabolism to the effect of mineral waters, the effect of which is also maintained by climatic factors. It should be borne in mind that tender southern varieties of grapes do not tolerate transportation and therefore attract patients to the south. In the USSR, grape therapy is carried out in the Crimea and on the Black Sea coast of the Caucasus, from the last days of August to the middle of November; the best time is September and the beginning of October.