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NATIONAL LIBRARY OF MEDICINE
        National

Library  of  Medicine
         FOUNDED 1836

        Bethesda, Md.
U. S. Department of  Health,

  Education, and Welfare

   PUBLIC HEALTH SERVICE
NLM051649028 
 
 
\
HOW  TO  FEED  THE  SICK
HAND-BOOK
DIET  IN  DISEASE
            CH. GATCHELL,  M. D.
                '//
FORMERLY PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE, UNIVERSITY
   OF MICHIGAN, AND PHYSICIAN TO UNIVERSITY HOSPITAL; ATTENDING
       PHYSICIAN AND CLINICAL LECTURER TO COOK COUNTY
         HOSPITAL, CHICAGO ; AUTHOR OF " KEY NOTES
            OF MEDICAL PRACTICE " ; "TREAT-
                MENT OF CHOLERA."
   To give food and stimulants in the way, at the time, of the
kind, with the cooking and preparing, that will best enable the
poor enfeebled digestion to assimilate it, is one  of the great
arts of nursing.
-Florence Nightingale.
THIRD EDITION.
       CHICAGO
GROSS &  DELBRIDGE
         1885. 
3
  Copyright, Gross <fe Delbridge, 18*5.
       All rights reserved*


         WBD

          QAsSd.

          ins





NATIONAl LIBRARY OF  MEDICK^
   •  BETHESDA  14, MB.  ^ 
            TO THE
      TRAINED NURSES
              OF
           AMERICA,
          WHO IN THE
       PRACTICE OF THEIR
     NOBLE  PROFESSION
   CARRY PEACE AND COMFORT
  TO SO MANY WHITE COUCHES,
AND TO WHOSE INTELLIGENT AID
     HIS OWN PROFESSION IS
     SO DEEPLY INDEBTED,
       THIS  BOOK  IS
         GRATEFULLY
          INSCRIBED
              BY
        THE AUTHOR. 
u 
PREFACE.
   When entering upon the practice of my profession,
I well remember that one of the first questions which
greeted me was,  " Doctor, what shall  I eat ?"  I also
recollect that in the college lecture-room I received no
special instruction which would aid me in making a
reply, and therefore,  from necessity, I early began
searching for such information as would enable me to
answer intelligently this question,  which was almost
daily repeated.
   While it is  expected  that the profession may find
this  book of value when called upon to answer the
frequently recurring question  which  suggested  its
writing, yet, as the introduction indicates, the object
has been to adapt it more particularly to the wants of
the people, and to provide for them  a practical work on
the suject of diet in disease—one which they may take
into the sick-room and into the kitchen.
   Great  care  has  been taken to select only such
recipes  as  have been obtained from reliable sources,
and many of them have stood the  test of trial in my
own practice.
   Free use has been  made  of all  works on kindred
subjects, and Chamber's " Manual  of Diet" has been 
PREFACE.
consulted, while  Niemeyer's, Aitken's and Ruddock's
works on Practice, and Ziemssen's Cyclopaedia,  have
contributed valuable  hints.   Acknowledgment is also
due Florence Nightingale's  "Notes on Nursing," and
the chapter on "The Sick-Room," by Marion Harland.
   With this introduction the book is sent on its mis-
sion  in the hope that it  may  answer the important
question for others, as it has for me.

                              CH. GATCHELL.
  University of Michigan,
      Ann Arbor, 1879. 
PREFACE TO  THIRD EDITION.
  The early exhaustion of the previous editions of this
work has led me to hope that another may be received
with like favor.
  Miss M. E. Hemple, Superintendent of the Illinois
Training-School  for  Nurses,  has favored  me with
very many of the recipes which have been  added to
the present edition,  and their value  is thus assured,
since they have been in  practical use in the wards of
Cook County Hospital.
  The chapter on the Dietetics  of Infancy  has also
received careful attention, while many other important
changes have been made, with a view to adding to the
usefulness of the book.
  Hoping that it may be the means of  aiding in the
restoration to health of  many  sick ones, it is again
consigned to the profession and the people.

                               CH. GATCHELL.
Chicago, Oct., 1885. 
 
TABLE  OF  CONTENTS.
Introduction.......................................      11.
Chapter L—How to Feed the Baby.—The Use of Goat's Milk
   — Condensed Milk — Cow's Milk — Fat — Caseine-Sugar —
   Salts—Gelatine —Lime-water-Substitute for Mother's Milk
   —Food  for Infants Under Four Months  and Over Four
   Months—Oatmeal-water—Barley-water...........      21.
Chapter II. — The Care of the Milk. — Testing with Litmus
   Paper—Milk of One Cow—Preparing Milk for the Baby-
   Care of the  Bottle — Kind  of Nipple to Use—Method of
   Feeding — How to Nurse the Baby — How to Choose a Wet
   Nurse...........................................     31.
Chapter III. —Diet  in  Cholera-Infantmn. —Rules — Avoid
   Starchy Food-Give Only Animal Food—Milk—Beef-tea-
   Wine Whey—Change of Diet—Flour-ball—Bread..      40.
Chapter IV.—How to Feed Fever-Patients.—Rules to Observe
   —Milk Diet—Beef-tea—Wine Whey—Egg  Nogg—Broths—
   Diet for Typhoid  Fever — Typhus Fever—Scarlet Fever.
   ................................................      47.
Chapter V.—Diet in  Dyspepsia. —Rules for the Dyspeptic to
   Observe—What to Avoid—Dishes Allowable—Toast—Dys-
   pepsia Crackers—Clabbered Milk—Brown Bread—Wafers-
   Aids to Digestion.—Pepsin—Digestive Fluid......      55.
Chapter VI.—Diet in Constipation.—What to Avoid—What to
   Eat  Oat-meal—Tamarinds—Dishes.- Rectal Alimentation.
   —When Necessary—Rules to Observe—Beef-tea—Defibrin-
   ated Blood—Cod-liver Oil........................      66. 
CONTENTS.
Chapter VII.—Diet  in Consumption.—Stimulants Harmful-
   Meats—Eggs—Milk—Koumiss—Cod-liver  Oil—When Indi-
   cated—How to  Select —Malt Extract — Hypophosphites.
   ..............................................      75.

Chapter VIII.—Diet in Diabetes. —Vegetables  Prohibited—
   Fruits Prohibited—Vegetables and Fruits Allowable—Ani-
   mal Food Allowable—Rules  to Observe—Gluten Bread —
   Milk Cure.—Rules- Quantity.—Diet in Bright's Disease.—
   Milk  Diet.—Diet in Gravel. — Must be Strictly Vegetable.
   .................................................      83.
Chapter IX—Diet for Travelers.—Light Eating—Vegetables.
   Diet in Seasickness..............................      93.
Chapter X.—Diet for the Corpulent. - What to Avoid—What
   May be Eaten—Dietary  for  Breakfast, Dinner, Supper.—
   Diet in Scrofula.—Diet in Rickets.—Diet  in Scurvy.—Diet
   in Chlorosis —Diet in Collapse....................      97.
Chapter XI—Diet in Rheumatism.—Meat  to Be  Avoided—
   Alkaline Drink.—Diet in Asthma.—Dietary for  Breakfast,
   Dinner, Supper.—Diet in Heart Disease.—Diet in Alcohol-
   ism .............................................      104.
Chapter XII.—Diet in Diarrhoea. - Light Diet—Gruels—Rice.
   Diet in Dysentery.—Diet in Cholera.—During the Attack-
   After the Attack—Diet in Diphtheria.—Keep the Patient
   Well Nourished—Milk Punch—Egg Coffee.—Diet in Inflam-
   mation of the Stomach —The Use of Ice.—Diet in Bilious-
   ness.............................................      110.
Chapter XIII,—Diet for Convalescents.—Little  Appetite till
   Tongue Cleans—Recipes—Mutton—Game—Chicken—Vege-
   tables—Cottage Cheese...........................      117.
Chapter XIV — Recipes: — Beverages — Meats — Oysters —
   Broths and Soups —Vegetables — Breads — Gruels — Blanc
   Manges and  Custards............................      123.
Chapter  XV.—Soups and Broths.—Bouillon—Stock—Beef
   Tea—Mutton Broth—Seasonings —White Soup—Bisque—
   Sago Broth—Clam Soup—Cream of Celery.—Miscellaneous
   —Cream Lemonade—Slippery Elm Tea—Unleavened Wafers
   —Cough Syrup................................,      147. 
INTRODUCTION.
   The human body is composed of a great variety of
substances, and  yet they are capable of classification
into  a few simple groups.  These  substances,  which
we know  under the general name of foods, become
component parts of our bodies and  enter into the
composition of living tissues.  It is important  to the
health of  our bodies that we receive a due supply of
each of these different classes of foods.  If we should
be entirely deprived of any one class our health would
seriously suffer,  and sooner or later  the  body would
succumb to the disease which would inevitably result.
   These elements are so generally distributed through-
out the animal and vegetable kingdoms, among those
substances upon which man relies for his sustenance,
that  it requires little calculation on his part to supply
his body with the needed variety.  The penalty of a
violation of this is seen in scurvy, a disease which
follows a diet deficient in potash combined with vege-
table acids, and all that is  necessary to its cure is to
supply the system with food containing those elements
of which it has been deprived.
   But in  disease, on the other hand, the system loses
an undue amount of certain elements, and these must 
12
introduction.
 be supplied in increased quantity in order to make up
 for the  rapid loss.  Thus in fevers we  supply those
 elements which make muscular and other tissue, which
 waste very rapidly;  in consumption  we supply the
 same, together with fats; in rickets we supply salts of
 lime, in which the body is deficient.
   Accordingly,  the regulation  of the  diet in disease
 consists in supplying those  foods containing the ele-
 ments which  are lacking in  the system,* and offering
 them also in a form to be readily digested and assimi-
 lated.
   Hence, if we can learn the wants of the system, and
 if  we know in what state to introduce  the required
 aliment, we are prepared to intelligently feed the sick.
   To teach this is the design of this work.
   As already indicated, foods may be  conveniently
 divided into three different classes,  which are  named
 as follows:
           Organic  -i Nitr°genized,
             fo      (Non-Nitrogenized.
           Inorganic.

              I.   NlTEOGENIZED FOODS.

   As the name denotes these  all contain  nitrogen.
 They have for  their  bases  certain principles  called

   * This, of course, does not apply to diabetes and diseases
 treated on a similar plan, as the result of experiment; but, as a
general rule, it will  hold good.  I once had a diabetic patient to
whom no instructions regarding diet were given, as I wished for
 a short time to  try the effect of medicine uninfluenced by the
 former.  To my surprise the amount of sugar in the urine began
 to increase rapidly.  Inquiry elicited the fact that  of his own
accord he had begun taking large quantities of sugar in order to
supply the loss,  which he learned was  taking place.  He was
immediately dieted. 
introduction.
13
fibrin,* albumen and caseine.  The chief foods of this
class are of animal origin, and eggs, milk, cheese, and
all meats contain them in abundance.  In small  pro-
portion,  similar principles  exist in some vegetables,
as gluten and legumine in wheat and peas respectively.
   Foods of this class contain a large proportion of
nutrient matter, and of a kind which has to go through
but  few changes before being  converted  into living
tissue.  Their chief function is to act as tissue-builders.
They enter largely into the composition  of  muscular
and other tissue, and hence we give them in fevers, in
which there is great and rapid loss of flesh and waste
of tissue, in consumption  and wasting-diseases gener-
ally.
   These  foods  are all digested in the stomach,  and
hence  should  not  be given  in conditions in which this
organ requires rest.
   Beef is the chief food of this class, and is invalua-
ble  in the dietetic treatment of the sick.  " One of the
most important articles of diet for the sick is beef, and
it should be of good quality;  the bone should not ex-
ceed 20 per cent.,  the  fat should be firm,  not yellow,
and free from blood, and should  not  be  in  too great
proportion relatively;  the muscle should be firm with-
out being tough, not  too pale nor dark-colored,  and
and should not present  any marbling or lividity on
cross-section."—(Bartholow.)
   Mutton is  more easily digested than  beef and in
this respect to be preferred to the latter.   It is,  how-
ever,of less nutritive value.  The broth of mutton has a
delicate and peculiar flavor which renders it especially
agreeable to the sick.   It should be well freed  from
fat______________________________________________________■_
   * This  term is meant to include muscle-fibrin, called by
Flint musculine. 
14
introduction.
    Veal is less  nutritious than  beef, abounding  in
 gelatine.   It is also more difficult of digestion than the
 latter, and has a very limited use in the invalid's die-
 tary.
    Venison is more easily and  quickly digested than
 beef, but does not possess the same nutritive value.
    Chicken is an important article of diet for the sick
 and convalescent.  It is agreeable to the taste and easy
 of mastication and digestion.  It is  not, however,  so
 nourishing as  beef, but probably enough  so for all
 ordinary purposes.
   Pork, containing as it does much fat, is difficult  of
 digestion and finds no place, either fresh or cured,  in
 the invalid's dietary.
   Salted meats are not very easy of  digestion.   They
 are deficient in nutritive value and should not be taken
 by the sick.
   Fish is a nutritious food,  but  not adapted to the
 wants of the invalid.
   Salted fish is difficult of digestion and should never
 be used by the sick.
   Cheese is a rich food and cannot be taken by those
with dyspepsia  or weak stomachs.  In nutritive value
one pound of cheese is equal to three and a half pounds
of lean beef.
   Oysters are highly nutritious,  easy of digestion, and
usually well borne by a delicate stomach.  Simply pre-
pared they form  a valuable addition  to the invalid's
dietary.
   Eggs are rich  in albumen.  They are highly nutri-
tious, generally easy of digestion, and form a  very
important  part of the invalid's food.  They should
never be cooked more than three  minutes.   The yolk
is more digestible than the white, if hard-boiled.  Raw 
introduction.
15
 or whipped eggs are among the most digestible of ali-
 mentary substances.
    Milk is one of the most important articles of food
 for the sick, and life may be sustained for weeks on
 this alone.  It  is highly nutritious, contains all the
 elements which enter into the composition of the tis-
 sues, and can be served up in many different forms
 and be introduced into a great variety of other foods.
 Some diseases can be cured by simply adopting a diet
 consisting exclusively of milk.
  .  There are some with whom milk disagrees either in
 health  or  sickness.  This  cannot be accounted  for,
 being  due  to some  idiosyncrasy.  When  this  is the
 case it can sometimes  be remedied by adding a little
 salt to each glass of milk—not enough to make it taste
 salty.   The addition of lime-water to the milk will
 correct it for others.
    Clabbered milk, sour milk and butter milk are equally
 as nutritious as fresh milk and will be borne by many
 stomachs which cannot tolerate  the former.   These
 are valuable articles of diet which are too much neg-
 lected.
    Gelatine belongs to this class.   It possesses scarcely
 any nutritive value, and must not be relied  upon as
 food.   On it alone any animal will starve.  It may be
 used as a  vehicle for  the introduction  of other sub-
 stances, or for its soothing properties alone.

           II.  Non-Nitrogenized Foods.

    The foods belonging to this class are sugars, starches
 and fats, the first two  being exclusively of vegetable
 origin (liver-sugar being left out of account), while the
last-named  is produced by both animals and vege-
tables. 
16                 introduction.
   While the nitrogenized  foods  in the main go to
build up tissue, these find their chief use in keeping up
the heat of the body.*  Hence when the athlete wishes
to develop his muscles, he eats beef:  when the Esqui-
maux wishes to fortify himself against cold, he eats
blubber.
   All the principles  of this  class are fat-formers.
Mr. Banting  found sugar to be the most active agent
of this kind that he used.
   Sugar has a very limited range in the invalid's die-
tary, being used chiefly for seasoning.  It is especially
harmful in diabetes.  It should never be taken by the
corpulent if they desire to decrease their weight.
   Sugar-of-Milk is to be  preferred to cane-sugar in
the preparation of dishes for infants.
   Starches  form a large  and important part of our
food.  As food for the sick they occupy a prominent
place.   After the salivary glands become active, starch
forms an important part of the infant's diet.
   Corn-starch has but a limited  use  in the invalid's
dietary.  It can be made into blanc-manges for the
convalescent.   It  is  too  heavy for most  stomachs.
   Sago is an excellent form  of  starch of  which to
make dishes  for the sick, as well as for infants.  It is
to be  preferred to tapioca, a similar product, because
the grains are finer and it can be rendered smoother,
and hence is  easier of digestion.
   Arrowroot is another starchy food much used in the
preparation of dishes for the sick and for infants.   It
is excellent of the kind, but it must  be remembered
that a child will starve if fed on starch alone.  Do not
    * Although the doctrine on this subject has been modified,
yet since each class finds its chief use in the direction indicated,
the statement, as made, will stand. 
introduction.
17
 depend too much upon the arrow-root gruel, to the ex-
 clusion of other foods.
    Wheat.  Preparations of this grain form many of
 the most useful  foods known to man.  It contains all
 the elements which enter into the composition of the
 body.  Wheat flour, however, as ordinarily prepared,
 has been deprived of the most valuable consituents of
 the grain, the salts and  nitrogenous portions.  The
 flour which is made by the so-called "patent process"
 is not open to this objection.  Brown flour, or Graham
 flour, also retains these elements.
    This is a very valuable food and can be prepared in
 a great variety of forms.
    Corn, in the form of meal, hominy and samp, forms
 an important food, but it finds no place in the invalid's
 dietary.   It contains more oil than  the  other grains,
 and it is hard to digest.
    Oatmeal has  come to be a favorite article of diet
 with many, but  it must be remembered that it is a
 very hearty food—almost as much so as meat, and it
 requires a strong stomach  to digest it.  It  is not a
 proper  food for invalids or dyspeptics.  It  will not
 hurt horses.
    Potatoes.  These form a valuable  food, but are not
 well adapted to a diet for the sick.   They are rich in
 the starchy elements.  The  best potatoes  are  mealy
 and powdery when  boiled.   Young potatoes, and old
 waxy potatoes  are  indigestible and  should never be
 taken by those with weak stomachs.
   Rice is said to be the chief food of nearly one-third
 of the human race.  It contains a greater proportion
 of starch than any other vegetable.  It is easy of diges-
tion, leaves very little residue, and is a useful food in
 sickness,  finding its chief  place in  bowel diseases. 
18                 introduction.
Care must be taken to have it well cooked, or it will
defeat the very object for which it is given.
   Gums,  such as gum-Arabic and that which adheres
to flax-seed,  have the same composition  as  starch.
They possess  no nutritive value whatever, but pass
through the alimentary canal unchanged, and flax-
seed tea and similar preparations are useless as foods.
   Fats—including oils—cannot be taken by those
with weak digestive powers.  They are unfit foods for
fever-patients and those who suffer from  indigestion.
In consumption fats are very useful, not only in sup-
plying  the element which is deficient in the system,
but also  in aiding the nutritive process through  the
influence which they exert over cell-growth.
   Inunctions of oils serve a valuable purpose when it
is impossible to take them by the stomach and yet it is
desired to keep up nutrition.
   Cream  is too rich  for most invalids.  It  should
never be used in febrile  conditions, but is of value in
consumption and wasting diseases.
   Butter may be placed in the same  category with
cream.  Consumptives should use it liberally.
   Cod-liver  oil has a deservedly high  reputation in
the treatment of a certain class of diseases, especially
in consumption.  While  the oil undoubtedly is the im-
portant agent, some ascribe to the iodine which all
cod-liver  oil  contains, its peculiar  virtue in this  dis-
ease.  It  holds  an important  place also in the treat-
ment of scrofula and marasmus.
   Olive oil may be substituted for the cod-liver oil if
the latter disagree.  It is equally as good as an inunc-
tion. 
INTRODUCTION.
19
               III.   Inorganic  Foods.

    While the principles belonging to this class cannot
of themselves support life, yet, since they are as neces-
sary to the  proper  constitution of the body  as any
other,  they occupy the position of a food and must be
considered as belonging to the class of alimentary sub-
stances.  While some of these  go  to the formation of
solid tissue, as lime in the bones, their general purpose
would  seem to  be to exert some sort of control over the
processes of nutrition.
    Water is the most important of the inorganic princi-
ples.   It enters into the  composition of all the tissues
of the body.  Some diseases are much benefited simply
by drinking large quantities of "soft" water.  The im-
portant point to be observed in the use of this princi-
ple is to obtain it in as pure a state as possible.
   Salt enters  into the composition of almost all our
food, but in insufficient quantities to satisfy the de-
mands of the system.  It exerts a favorable influence
over the processes of nutrition, and if entirely deprived
of it disease will surely follow.
   Iron exists in our food, both  animal and vegetable,
in sufficient quantity to satisfy the wants of the  system
in health.  In those diseased conditions in which it is
deficient it must be supplied in increased quantities.
   Phosphate-of-Lime is  supplied in combination with
animal  and vegetable  foods.   When it is deficient in
the system, as in rickets, it should be artificially intro-
duced. 
 
CHAPTER I
            How to Feed  the Baby,

   It is a fact, well known to medical men, that one-
third of the children brought  into the world die before
they  complete their fifth year of existence.  While
there are various causes which combine  to  produce
this fearful rate of mortality, probably there is none
which is so directly responsible  as improper food and
improper feeding.  It was his knowledge of this which
led Sir C. Clark, an eminent London physician, to say—
"The ignorance of mothers in feeding children is worth
a thousand pounds a year to me."  And this signifi-
cant statement has  been made in  various terms  by
many physicians.
   Since the health of the  child is directly dependent
on the nature of the food  which it receives,  this be-
comes a question of vital importance,  to which too
much attention cannot be paid,  and it is designed, in
this  chapter, to convey to mothers and nurses  such
information as will enable them to avoid those errors
of feeding which  are responsible for much of the ill-
health of infancy and childhood.
   And first, it cannot be insisted upon with sufficient
emphasis, that there is no reliable  substitute for the
mother's milk, and, until the proper period for weaning
has arrived, in sickness or in  health, the child will 
22
DIET IN DISEASE.
thrive best on that food which was designed for it by
nature.   Mother's milk is  made  for babies—cow's
milk is  made for calves.  Human milk  has another
immeasurable advantage over cow's milk, in that  it is
ahvays fresh.
   But the time arrives when a change becomes neces-
sary, and then it is that we must seek for  something
to replace that food which is now no longer the child's
natural  aliment,  or of which circumstances deprive it.
   There  are two periods in the infant's  life when
especial care is called for in the management of its
diet—at the time of weaning, whether this be premature
or at the usual age, and in its "second summer," when it
is so liable to disturbances of  the stomach and bowels.
   Until the  child is old enough to live on a mixed
diet, milk is its  natural aliment;  and the important
object to be kept  in view is to give it a preparation as
nearly as possible resembling the mother's milk,  and
to give this before any change has taken place in it—
that is, before it has in the least degree "turned." While
it is true,  as already stated,  that mother's milk is the
child's natural aliment during its nursing life, yet, when
the period of weaning has arrived, we are compelled to
resort to the milk of the lower animals for its newly-
adopted food.

                   Goat's Milk.

    If  the  child be deprived of its  mother's milk,  the
best substitute  is goat's milk, if this can be obtained
fresh  and pure.   As compared to cow's milk, it  con-
tains more sugar-of-milk than the former, and it is less
liable to become  acid.  As a substitute  for mother's
milk I would recommend this above anything else  that
it is possible to obtain. 
HOW TO FEED THE BABY.            23
   But it is so scarce an article in  this country that
we must seek  for something which it is not so difficult
to procure.
                  Condensed Milk.
   This must  sometimes be relied upon for feeding the
baby, and it is to be preferred to ordinary milk, unless
you  are  certain  that the latter is  fresh and  pure.
Often, when traveling, we are compelled to rely upon
its use, and then it is the  best substitute that can be
obtained.  If  it be used at all,  the American brands
will  be found to be better  than the  Swiss, as the
former are more apt to be freshly prepared.  Be care-
ful not to prepare it too strong.
                    Cow's  Milk.

   After all,  our  main dependence  must be placed
upon that milk which  all  can obtain in such abun-
dance—cow's  milk.  But in its natural state it cannot
be fed  to a young child, and it requires some modifica-
tion  in order  to fit it for the infant  organism.   Both
cow's milk and human  milk contain, in addition to a
large per centage of water,  which is greater in the
latter than in  the former, the following elements :
   Fat. — This, in the form of minute globules,  is dis-
tributed throughout the mass of fresh milk.  After the
milk has stood for several  hours it rises to the top as
cream,  and, when churned, becomes butter.  It is an im-
portant element of nutrition, but when given in too
great quantity is a source of harm, becoming converted
into fatty acids and setting up indigestion.  The pro-
portion of butter in cow's milk is greater than in human
milk.                   ,
   Caseine— This is the cheesy part ot the milk, which
coagulates and forms the curd.  It contains very im- 
24
diet in disease.
 portant elements of nutrition,  but requires strong and
 healthy powers  of digestion to  render  it capable of
 assimilation.  Cow's milk contains a greater propor-
 tion of caseine than does human milk.
   Sugar.—There is  a peculiar form of  sugar, known
 as sugar-of-milk,  in all  milks.  This is much easier of
 digestion than the common cane sugar,  which we use
 on our table.  There is a less  proportion of sugar-of-
 milk in cow's milk than in human milk.
   Salts.—There are numerous salts in  milk, among
 the more  prominent of which are the phosphates of
 lime, soda, and potassa, all of which perform very im-
 portant  parts  in the processes of nutrition.   These
 exist in cow's milk in greater proportion than in human.
 There is also common salt,  or chloride of sodium,
 which is of equal importance to those already named.
 There is, relatively,  less common  salt in cow's milk
 than in  human milk.  There is, relatively, a smaller
 amount  of free  alkali in cow's milk  than  in human
milk, and hence the former is more apt to become acid
than is the latter.
   A review of what has been given concerning the
relative amounts of the different  constituents of these
two kinds of milk, teaches that in order to  so modify
cow's milk  as to  make it  more  suitable for the baby's
use, it is necessary to

   Decrease the proportion of
                  Caseine
                  and Butter,
and at the same  time increase the proportion of
                  Water,
                  Sugar,
                  Common Salt,
                  and Free Alkali. 
               HOW TO FEED THE BABY.            25

   Now, if cow's  milk be diluted  by simply adding
water to it, the first of these is accomplished, and the
proportion of the solids is correspondingly decreased.
But this is not enough.  There is still another object to
accomplish.
   "The important difference between  woman's  and
cow's milk is  that  the  caseine  of  woman's milk
curdles   in the stomach  into  small,   light   flakes,
forming a  very  loose jelly, while  that  of cow's milk
coagulates  into large compact lumps.  The loose flakes
of the woman's milk are easily digested and  assimi-
lated: the firm lumps  of  caseine of  the cow's milk,
the infantile gastric juices are incapable of dissolving.
They are thrown  up  again, or wander through the
whole  intestinal  tract  as large,  sour, undigested
masses.u—(Vogel).
   Therefore, in order to render the cow's milk diges-
tible for the infant's  stomach,  we must prepare  it
in such a way as to obviate this tendency on the part
of the caseine to coagulate into large, compact masses.
This we can in a great measure accomplish by diluting
the milk with some mucilaginous  liquid, which shall
hold the caseine in suspension,  so that it shall be
slowly and gradually attacked by  the  gastric juice,
thus producing  a  looser clot, on which the digestive
fluids and the peristaltic motions of the stomach have
a better opportunity to act.
   There are several articles which may be used for
this purpose.  For very young infants  the most appro-
priate are preparations of gelatine, isinglass, or gum
Arabic. 
26
DIET IN DISEASE.
                      Recipe 1.

                     Gelatine.

           Cox's gelatine, one half ounce;
           The white of one egg;
           Pure soft water, boiling hot, one pint.
   Soak the gelatine for about ten minutes in a tea-
cupful of cold water;  then pour on to it the  boiling
water, and stir until the gelatine dissolves.  Beat well
the white of one egg, and stir  it briskly into the gela-
tine solution; put it on a slow fire, and stir gently till
it  boils;  take off as soon as it boils; let it stand a
minute, then  strain well through a jelly-bag.   When
cool it will form  into a stiff  jelly.  Keep .this  well
covered and in a cool place.
   One-third of a one-shilling  package of Cox's gela-
tine  is one-half ounce.   Russian isinglass or Cooper's
gelatine may be substituted by those  who are  accus-
tomed to their use.

                      Recipe 2.

                Gum Arabic Water.

   Dissolve enough  pure gum Arabic  in two ounces of
water to make a thick syrup-like mucilage.  Keep this
in a wide-mouthed bottle, well corked.
   After diluting the  cow's milk with  water—which
process accomplishes the first  step indicated as being
necessary, viz., decreasing  the proportion of caseine
and butter, as well as  that part of the second which
requires the proportion  of  water to be increased—it
only remains to add those elements which exist in too
small a quantity. 
HOW TO FEED THE BABY.
27
    And before going  further let  me  give a word o
 advice concerning the purity of the  different articles to
 be added to the milk.

    Water.—Let this be a pure, soft water.  Above all
 things is this caution necessary here in Chicago, where,
 at some seasons of the  year, our lake water is so con-
 taminated by the city  sewage as to be the cause of
 much sickness among both children and adults.  Use
 for the baby Waukesha, or some  other pure spring-
 water.  That  from the Douglas Park artesian well is
 excellent.  If spring-water cannot be obtained,  do not
 use the lake water  until it has  been first boiled and
filtered.

    A very good filter can be made out of a common
 earthen flower-pot.  Get a new flower pot, with a hole
 in the bottom; line it with a piece of new canton-flan-
 nel ;  put into the bottom of this, to the depth of two
 inches, some  clean  sand;  over  this  put a layer  of
 pounded charcoal, and  fill up with fine gravel.  This
 domestic filter will  answer the purpose of the most
 elaborate,  and is very easily made.   After several
weeks' use it should be renewed.

   Sugar-of-milk.—Do  not   use  the ordinary  cane
sugar, but  get of some  reliable druggist a half pound
or a pound of sugar-of-milk.   This is the kind of sugar
which naturally exists in milk, and it is much  more
easily digested than the former.

   Lime-water must  also be added,  in order to supply
the free alkali which, it has been said, is deficient in
cow's milk, the absence of which renders it so much
more  liable to become acid.   Or, common baking-soda
may be used instead  of the  lime-water. 
28
DIET IN DISEASE.
                     Recipe 3.
                   Lime-Water.
   Get a piece of unslacked lime the size of an egg,
break it up,  put  into a clean quart bottle, and fill  up
the bottle with rain-water.  Let this stand over night;
the next  morning it is  ready for use.  There will still
be a heavy sediment of lime in the bottom of the bottle,
but the water will have taken up all that it  can dis-
solve.  When you have used all the water in the bottle,
fill up again with water  on the lime which remains,
and repeat this  again  and again as long as the lime
lasts.   Do not shake the bottle, but use the clear lime-
water off the top.
   Common  salt  must  also be added, for it performs
an important part in assisting in the digestion and
assimilation of other food elements,  and,  as compared
to the other mineral ingredients, it  is  contained in
cow's  milk in insufficient quantity.


  Food for  Infants Under Four Months of Age.

   With  the knowledge which we  have gained, we are
now prepared to compound a  food which is recom-
mended as being an  excellent  substitute for mother's
milk.
                     Recipe 4.
          Substitute for Mother's Milk.
   Fresh milk,   -    -    -   1  teacupful;
   Hot  water,      -          1      "
    Soda (bicarb.),               \ teaspoonful;
    Sugar of milk,   -          1       "
    Salt,                   -   A  little;
    Gelatine,   -               1 tablespoonful. 
HOW TO FEED THE BABY.
29
  First dissolve the  sugar, the soda, the salt, and the
gelatine in the hot water, and then add the milk.
  Make it fresh at  each  feeding.  This is about the
right proportion for a baby of four months; under that
age decrease the proportion of milk slightly; over that
age, increase it.   In place of  the gelatine, oatmeal-
water, barley-water, or gum-Arabic water  may also be
used, substituting a cupful of either for the pure water
which is  used  when gelatine is employed. The addi-
tion of some gelatinous fluid seems to favor the digest-
ion of the milk.
   Food for Infants Over Four Months of Age.

   In preparing food for infants  over four months  of
age, the proportion of milk should be increased and
also we may add some  preparation possessing nutri-
tive value.  This will be found in oatmeal-water and
barley-water.

                     Recipe 5.
                  Oatmeal-Water.

    Oatmeal,   -              one teacupful;
    Cold water    -            one pint;
    Salt,   -                   one saltspoonful.
   Stir the oatmeal and the salt into the water and
let it soak over night, or all day.  Strain thoroughly
through a thick napkin.   It is very important that this
be well strained, so as  to leave  no solid particles  of
oatmeal, as their  presence in the child's food would
irritate the bowels, and set up trouble which did not
previously exist. 
30
diet in disease.
                     Recipe G.
                  Barley-Water.

    Pearl-barley,  -         two tablespoonfuls;
    Water,               -  one pint;
    Salt     -              one saltspoonful.
   Wash the barley and soak it half an hour in a little
luke-warm water previously  salted.  Pour it into a
pint of boiling water,  letting it simmer one-half  hour.
When done, strain into a pitcher.
   Now the baby's food may be prepared by adding to
the milk oatmeal-water, or barley-water.  For a single
feeding, take of
                     Recipe 7.
    Milk,  -    -„   -   -     one teacupful;
    Barley-water,  -          -  one teacupful;
    Sugar-of-milk,    -   -     one teaspoonful;
    Lime-water,   -          -  two teaspoonfuls;
   Heat this by setting  the vessel  in which they are
mixed in a pan of  hot water.   When warm it is ready
for the bottle.
   These  preparations  of oatmeal and   barley  are
nutritive, and at  the  same time,  from their  bland,
mucilaginous character,  they aid the digestion  of the
milk by preventing the  formation  of hard lumps of
caseine.
   Use the oatmeal-water if the bowels be  inclined to
constipation; the barley-water if the bowels be loose. 
HOW TO FEED THE BABY.
31
                   CHAPTER II.

             The Care of the Milk.

   The following directions, though they may seem to
be unnecessarily minute in detail, are of  the utmost
importance, and Florence  Nightingale, than whom
there is no higher authority on the subject, would con-
sider that the  half had not been told.  Although  it
involves some trouble (if it be so considered), yet it  is
much less trouble than it  is to care for a sick baby,
and too much attention cannot be paid to this subject.
   Have  the milk brought to the house twice a day,
and  let the  morning's supply be  brought  as early as
possible.   Be  sure that  this is  not the milk of the
previous night.  As soon as the milk arrives, test it to
see if it is sweet.   Keep on hand  at all  times some
blue litmus paper.  This can be obtained  at any drug
store.  Take a piece of this blue paper,  about the size
of the  large blade of  a  penknife, and dip it into the
milk.  If the paper turns from blue to red in color, it
indicates that the milk is acid,—it  has begun to sour,
and is unfit for the baby's use.  Throw it away, or use
it for some other purpose, and get some sweet milk for
the baby.
   By dipping a piece of litmus paper into vinegar, or
any  other  acid,  you can  see  the character of the
change which will  take place if it be dipped into sour
milk.  If the change in color be but slight, it  is enough
to condemn  the milk. 
32
DIET IN DISEASE.
   Test the  milk with  litmus,  not only when first
brought to the house,  but at intervals during the day,
when you are about  to  prepare each  fresh mess of
food.  If at any time the litmus shows it to be "turned,"
get some fresh milk for the baby.
   If possible, let it be the milk of but one cow.   If the
milk of but a single cow cannot be obtained, that from
a number of cows, mixed—as ordinarily contained in a
dairyman's milk can—will be more uniform in  quality
than if frequent changes be made.
   Do not let the milk-man  bring you  skim-milk.  If
the milk has already  been robbed of its cream, then
this deficiency must be supplied by the addition of a
little cream obtained from some other source.
   In hot weather the milk intended for the baby's
use may be scalded as soon as  received.   Do not let it
boil, but just scald it.   If it should boil, throw it away
and get a new supply.  If scalded it will keep better.
Keep the baby's milk  separate from that intended for
general  use.
  As soon as the milk is received add baking-soda in
the proportion of one teaspoonful to a quart of milk.
   All pans and other utensils which may contain the
milk, should be well scalded  and scoured, washed with
soda, rinsed with clean, cold water, and dried.
   The  best vessel  in which  to keep the milk is a
crock, which should be kept for the purpose, amd should
be well  scalded, scoured,  rinsed and dried as soon as
emptied.  Keep two such crocks, and let one be drying
while the other is in use.  Cover the crock with a clean,
folded napkin, or folded towel (this excludes  the air
more effectually than  can be  done  by a  dish or hard
cover) and set it  in the coolest  place to be found, going 
HOW TO FEED THE BABY.
33
to it as often as necessary to dip  out—with  a  clean
cup—the small quantity wanted for the baby.
  If  the air of the  refrigerator is not laden with the
odor of cooked meat  and vegetables,  this will be the
best  place for it.  Otherwise  set the  crock in a pan,
surround it with ice  or cold water, and set it in the
cellar.
   Remember that milk has a remarkable property of
absorbing odors and deleterious matters, and it should
be kept in  the purest  atmosphere that can  be found.
The germs  of disease,  absorbed from  the atmosphere,
have been known to be conveyed in milk.

       To Prepare the Milk for the Baby.

   Take from the crock enough  for one feeding, and
prepare it as already  directed.  If the milk-man has
already anticipated you,  do not add so much water.
   Put the milk into  the nursing-bottle, and use im-
mediately.  After the  child has had  sufficient, throw
the rest away—it is the best economy in the world!
   If allowed to stand in a warm place, it soon becomes
unfit for use.  Prepare it fresh, according to the above
directions, every time  the child needs feeding.  Do not
use the same bottle  of milk throughout the night—
prepare it fresh at each feeding, as you would during
the day.
   Never put a second supply of milk into a  bottle con-
taining the remains of  a former—use  a  fresh and  clean
bottle,  even though no more than an hour  has elapsed
since the last one has been used.
  In Maternite hospital, Paris, all infants are fed with
cup and spoon, on account of the difficulty of keeping
bottles sufficiently clean. Try this if the baby does not
thrive. 
34
DIET IN DISEASE.
             The Care of the Bottle.

   At least three bottles should be kept for the baby,
that two may be going through the cleansing  process
while one is in use.
   Select a stout bottle, having no lettering on it, and
with no sharp angles.  If there be a sharp angle in the
bottle,  or any lettering blown into it, such an out-of-
the-way corner can  harbor a speck of old milk, which
is  sufficient to set  up fermentation in any amount of
new.
   As  soon as  the child has taken enough for one
feeding,  empty  from the bottle what remains and
without delay scald and wash the bottle with hot water
and soap.  After scalding, put the bottle into a  basin
of clean  cold water, in which a little soda has  been
dissolved.  Let it remain  in the soda-bath for half an
hour, then take it out, rinse it in clean water, and let it
dry by hanging it inverted on a peg.
   It is  important  that this  process should be  gone
through  with after every feeding.   A nursing-bottle
which contains but a mere trace  of old milk—so  small
a quantity that it can scarcely be seen—is sufficient to
spoil all that is afterwards put into it, and thus derange
the child's stomach and bowels.
   Use a simple, thimble-shaped, black rubber nipple.
Black rubber is  purer than the white—the latter con-
tains injurious  ingredients.  But above all things I
would caution you  against the use of the style of nip-
ple consisting of a little rubber bulb  for a mouthpiece,
a rubber tube leading to the bottle, where it passes to
the cork, terminating in a glass tube reaching to the
bottom of the bottle.  They are the invention of some
Herod, intended for lazy folks,  and could not  have 
HOW TO FEED THE BABY.
35
been better devised if they had been calculated for the
purpose of slaughtering every innocent who grasped
them in their mouths.  They are pernicious in the ex-
treme,  and the cause of much sickness.  They contain
so many obscure crevices that it is absolutely impossi-
ble to  keep them clean.   I have cut open the tubes
belonging to several of these, which had been in use
for some time, and found every one inhabited  by a
fungous growth, which would contaminate every ounce
of milk passing through them.
   The plain thimble-shaped, rubber cap is the only
suitable nipple to use for the baby's bottle.

               Feeding the Baby0

   The quantity to be given at each feeding will vary
with the constitution and temperament of the child.
A little experience will  teach how much the child cares
for, and afterwards the amount prepared can be regu-
lated accordingly.  About four ounces at a feeding  is
sufficient.
  Do not over-feed the baby.  Children often suffer
from too much feeding.  Instead of giving the breast
or the bottle every time the child cries, give it occasion-
ally a  drink of cool water, and it will express satis-
faction and become quiet.   Children often suffer from
thirst,  and only take the milk which is offered because
you do not give them water.  Try this. 
36
DIET IN DISEASE.
   Do not  feed the child while  on its back, or lying
down.  Do not bounce the baby about after feeding,
lest it throw up what it has taken.  Let it lie  quietly
for at least half an hour.

             How to Nurse the Baby.
   If both mother  and child  are in good health,  no
directions on this subject are necessary more than the
dictates of nature afford.  Young mothers, however,
commit a few errors  which, with a  little instruction,
they may be spared.
   And first, do not ruin a child's health by putting it
to the breast every time it cries.  This  is the only
means it  has of expressing  its  emotions.  "  If it is
hungry, it cries ;  if it is overfed it cries ;  if it suffers
from the prick of a pin, it cries;   if it  lies  too  long in
one  position,  so as to receive undue pressure  on any
one part, it cries;  if it is exposed to cold,  or any part
of its dress is too tight,  or it is  held  in an awkward
position, or is exposed to too bright a light or too loud
a sound, it can indicate its discomfort only by its cries.
And yet the one remedy of ignorant nurses for so many
different evils is, not to find out and remove the true
cause of offense, but to offer the child the breast."
   If you have regular intervals for nursing, the child
will  be less apt to fret for the breast  than it will if it is
given whenever it cries or becomes uneasy.
   As a rule,  during the first month of life the child
should receive the breast about every two hours during
the day, and about three times during the night.
   After  the first  month  the  intervals may  be
lengthened, and  it may then be fed about every three
hours during the day, and only twice during the night.
   The infant should be  fed in  this way until after
the  appearance of the first teeth, or  until it  is eight 
HOW TO FEED THE BABY.
37
or nine months old.  Prolonged nursing is injurious
to both mother and child.
   A mother who is consumptive or scrofulous should
not nurse her children.
   A mother who is very excitable, or subject to fits of
violent passion, should not nurse her babe.  Do not
put the child to the breast after hearing  any depress-
ing news, or suffering from fright.  Convulsions and
death of the child have been known to follow  a viola-
tion of this rule.
   Great attention should  be given to the care of the
nipples, for soreness of these may cause a similar con-
dition of the child's mouth.  Before each nursing wash
the nipples  thoroughly with a weak solution of baking
soda (bicarbonate of soda).
   If the nipples have already become  sore, wash them
with a little warm  water and  soda before  and after
each nursing, dry thoroughly and gently,  apply a little
olive oil to the surface and cover with a  nicely-fitting
India-rubber shield while suckling.

           How to Choose a Wet-Nurse.

   Almost all that can be said on this important sub-
ject is poetically expressed in the following lines from
Saint Marthe in Psedotrophia:
    "Choose one of middle age, nor old nor  young,
     Nor plump nor slim her make, but firm and strong ;
     Upon her cheek let health refulgent glow
     In vivid colors, that good humor show.
     Long be her arms, and broad her ample chest,
     Her neck be finely turned, and full her breast;
     Let the twin hills be white as mountain snow,
     Their swelling veins with circling juices flow ;
     Each in a well-projecting nipple end,
     And milk in copious streams from these descend.
     Remember, too, the whitest milk you meet,
     Of grateful flavor, pleasing taste, and sweet,
     Is always best." 
38
DIET IN DISEASE.
   The  nurse should, of course, be in perfect health.
Reject those who are cachectic, or who have any taint
of scrofula, consumption, tubercular affection, specific
disease,  or  other  communicable  malady.   There
should be no return of her catamenia.
   As these points  should in all cases be referred to
the family physician, it is not necessary to give specific
instructions in a work of this character.
   Her age  should  be but  little, if any,  greater than
that of the mother.
   Her breasts should be full, plump and well formed,
and  she should be able to suckle with  both breasts.
   There is danger of  the child becoming  deformed,
or squinting, if it nurse on but one side.
   The nipples should be prominent, so as to be easily
grasped by the child, and be free from cracks or sores.
   The milk should flow freely, and  when dropped in
water produce a cloudy appearance, and not sink to
the bottom  in thick drops.  The nurse's milk should
not  be  older than  the child which is to  be nursed.
There is less objection  to giving " young milk " to an
older child.  Milk that  is  over  twelve months old
should not be depended upon to nourish a young babe.
   If for any reason a mother  is unable to nurse her
babe, then it is wise to provide a good wet nurse.  But
let me caution physicians and mothers against getting
a wet-nurse for a sick baby.  With intelligent care it is
possible to administer to the child any desired variety
of food, and the physician has the matter of nutrition
entirely within  his  own  control,  but if a wet-nurse
enter into the problem, you have all  the annoyances
of sore nipples,  mental emotions and caked breasts to
contend against, and you have no more control of the
child's diet than you have of the clouds in the heavens. 
HOW TO FEED THE BABY.
39
             How to Wean the Baby.

   If there be nothing of special importance to demand
the  weaning of the child at an earlier period,  this
should be begun when it is about nine months old, by
which time it will generally have cut several teeth. In
fact, the weaning should not be begun  until two or
more teeth have made their appearance.
   Begin  the weaning when the child is strong  and
well. If  it has  become  reduced by  disease, or is
suffering  from an acute attack,  postpone the ordeal
until it is again in good health.
   Do not wean during the summer season.   Select a
season of  the  year when the  weather  is moderate.
March, April or May are favorable months, as are  also
October and November.
   Prepare the child for the weaning process by getting
it  gradually  accustomed to other food besides its
mother's milk.   Give milk from a bottle, or feed it soft
spoon-victuals, such as arrow-root, sago, cracker soaked
in milk, or any of the numerous articles recommended
in the next section.
   At the same time give the breast at longer intervals,
so as to accustom the child not  to expect it.
   When you once begin the weaning process,  be  firm
and  unrelenting; take no back-steps.
   The process should occupy about twelve or fourteen
days, so that at the end of two weeks, at the most, the
breast can be entirely dispensed with.
   It is  better to excite an aversion to the breast than
to have the child fretting for it.  This can be done by
touching the  nipples with some bitter substance,  such
as a  little salt or soap. 
40
DIET IN DISEASE.
   After weaning, it is  important that the  child's
stomach should not be overtaxed.  Often at this time
the foundation of a weak stomach is laid.
                   CHAPTER HI.


          Diet  in Cholera-Infantum.


   Many of the directions already  given will  also ap-
ply to the feeding of the baby in cholera-infantum, or
" summer complaint."   It is even more important at
this time that the strictest attention should be given to
the care of the milk and nursing bottle.  Keeping this
in mind, the proper care of the infant during the sum-
mer months may be summed up in these three

                      rules:
   Keep the baby cool;
   Let it have plenty of fresh air;
   Let it have no food in which the process of fermenta-
tion has begun.
   If these instructions be rigidly observed, the child
need not see a sick day.
   The first and most important thing to learn in the
dietetic treatment of cholera-infantum, is to
   Give no starchy foods whatever!
   Flour, arrow-root, sago, and the like will do absolute
harm, for they will ferment and aggravate  the disease.
In fact,  the use of starchy food, or  food  containing 
               HOW TO FEED THE BABY.             41

starch, is in many instances the direct  cause  of sum-
mer diarrhoea and cholera-infantum.
   In order to digest starch it requires an active secre-
tion of  the  juices  of  certain  glands—the  salivary
glands and the pancreas—which in young children are
still undeveloped.   This,  and the further  fact that
milk, the food which mother  Nature has prepared for
infants, contains no  starch whatever, is sufficient indica-
tion that it should not form a part of their diet.  Nor
is this deduction necessary, for practical experience
teaches the same lesson.
   Hence, bread, crackers,  rice, arrow-root, sago and
other food containing starch, should be carefully ex-
cluded from the infant's dietary.
   Dr. C. H. F. Routh, of  London, says: " I cannot
conceive of anything more  injurious than this popular
arrow-root feeding.  I believe it is a cause of the death
of many infants."
   In the Foundlings Hospital, in Paris, M. Guillot
noticed one season that the mortality rate was unusu-
ally great.  On investigation he found that the passages
from the bowels of almost all  the children had a jelly-
like  appearance.   He  applied iodine  to it, with the
result of changing its color to a deep blue, thus showing
that the starchy  food was  passed entirely undigested.
   This is an experiment that any mother can repeat.
Get  at  the  drug store half  an ounce of tincture of
iodine.   If  there be a suspicion  that  there may be
undigested starch in  the stools, drop a little of the iodine
into it.   If it turns  blue where the iodine touches, it is
positive evidence of  the presence of starch.
   Hence, all food given at this time should be of ani-
mal  origin. 
42
DIET IN DISEASE.
                   SCALDED MILK
may be given, if retained on the stomach.   Prepare it
with lime-water and sugar-of-milk, with a small pinch of
pepsin in it.  Condensed milk may be used if perfectly
pure and fresh milk cannot be obtained.

                     BEEF-TEA.
   When  the child is in a weak and  low condition,
beef-tea (page 51) is to be preferred to all other foods.
Give a good article of beef-tea, as much as the child
can  take  and retain, repeated at frequent intervals.
Remember that in that low  and prostrate condition
into which children with this disease so rapidly run,
beef-tea is the most important dietetic article that can
be given.   It is stimulating,  and rouses the  waning
strength.   After getting up a reaction  by its use, give
again condensed milk, fresh milk, or infant's food.

                      Recipe S.
                     RAW MEAT.

    Scraped beef has been successfully used in the die-
tetic treatment of cholera-infantum.  Take a  piece of
fresh beef with one surface cut across the grain; scrape
this surface with a spoon until as much of the pulp is
scraped off as possible.  Now, with a sharp knife, take
off a thin  slice and make a  fresh surface and scrape
as before, repeating this until it has all been  reduced
to a soft puree.  By this method the indigestible fibrous
part of the meat is rejected.   Feed this puree to  the
baby,  after adding a little fine salt to it.  A little pep-
sin will aid its  digestion.
    Many sick children have been brought up from very
low conditions on this diet alone. 
HOW TO FEED THE BABY.
43
                      Recipe 9.
                  Albumen Water.
     Cold water,  -              one half pint;
     Whites of two eggs;
     Sugar-of-milk, -            one teaspoonful.
    Drop the whites of the eggs into  the water and stir
gently,  without  beating,  until they are well mixed.
Sweeten. Give cold or frozen.
    This will sometimes be found to  be a valuable aid
in nourishing a child when sick with diarrhocea.

                     Recipe 10.
                    Wine  Whey.
     Fresh milk, -              one pint;
     Sugar-of-milk, -            one teaspoonful;
     Sherry  wine,     -    -    one teacupful.
    Heat the milk to the boiling point, and add the wine.
Let it simmer gently  until the curd forms.  Strain
through a cloth and sweeten with the sugar.
    This will sometimes agree with the sick child  when
other foods fail.
    Sometimes,  when the  child  is  very low,  a little
brandy added to its food helps to stimulate and get up
a reaction.
    Koumiss (page 78), will be eagerly  taken by  some
sick children when all other foods are rejected, and many
sick babies have been brought up from very low condi-
tions on this alone.
   The preparations of milk, with gelatine, gum arabic,
or barley water, may be tried if  other foods disagree.
Sometimes what agrees in one case will fail in another,
and we must change until  a food is found which will
suit the given case.  It is thought that  it will not often 
44
DIET IN DISEASE.
be necessary to search outside of those here recom-
mended.
    The natural reaction of the contents of the bowels
is  alkaline.   In Cholera infantum, or the bowel com-
plaints of infancy, they often become acid in reaction,
and  then the stools  become green in color, for acid,
acting on the bile, with which all healthy passages are
colored, changes it from a yellow, the natural color, to
green.  Hence, a change in color from green to yellow
is favorable, for it shows that the secretions are losing
their acid character.
                 Change of Diet.

   Milk should form the child's food  for the first six
months.   No starchy food  is needed, nor can it be
digested until the teeth  appear, and the "dribbling"
shows that the glands are  secreting  an abundance of
saliva.  Before this the child can starve on arrow-root
and other starches.   Even after this  period the  diet
should still consist principally of milk, to which may
be gradually added  simple articles  of food after the
child is a year old.
   At this time the best thing with which to thicken the
child's milk, in order to add to its nutritive value, is
the flour ball.

                     Recipe 11.
                   Flouh  Ball.
                              one pound;
                              one teaspoonful;
                              one teaspoonful;
                              four tablespoonfuls.
Flour,    -
Salt,    -    -
Sugar-of-milk,  -
Cold water,   - 
HOW TO FEED THE BABY.
45
    Mix these well together; tie the mass up tightly in
 a stout muslin cloth, or a pudding-bag, so as to form
 a firm ball.  Boil this in  a  kettle of water from early
 morning until bedtime.   Take it out and hang it up to
 drain and dry.  The next day open it and peel off from
 the surface the layer  of  dough which will be found.
 There will remain a hard, solid ball.  Dry this in the
 sun or in the open oven.  Keep it in a dry, cool place,
 and,  as  it is needed, shave off from one  side two or
 three teaspoonfuls, make this  into a paste, free from
 lumps, with  a little  water, stir this into a pint of milk
 and scald it, being careful not to let it boil.
   In  the flour-ball the starch of the flour is changed
 into  dextrine,  which  makes  a highly digestible and
 nutritious food for infants.  You need not seek further
 or ask for greater variety—the child will thrive well on
 the milk and dextrine.
    If the sugar-of-milk be not at hand, it may be made
 with this omitted.

                     Recipe 12.
                   Bread Jelly.
    A  quantity of  the soft  part of a loaf is broken up,
 and boiling water being poured over it,  it is covered
 and allowed to steep for some time; the water is then
 drained off completely and fresh water added, and the
 whole placed on the fire and allowed to boil slowly for
 some  time until it becomes smooth; the water is then
 pressed out  and the  bread, on cooling, forms  a thick
jelly,  a portion  of which is to be mixed with milk or
water, as wanted.
   This bread jelly,  recommended by Dr. Churchill, is
very nourishing, and can  often be taken when other
things disagree. 
46
DIET IN DISEASE.
    But milk should form the  chief part of the child's
 diet until it has passed the period of dentition, or until
 it has as many as  twelve teeth.  With some children
 this will not be until  they are two years old, while it
 will occur earlier with others.
    "Well-made broths of chicken, mutton or beef are
 valuable at this time  as a change.  One small meal of
 a finely-cut,  rare mutton-chop, slightly seasoned, with
 the soft part of a slice  of milk-toast, or a soft-boiled
 egg, may be  given  at first, very sparingly, at midday
 meal; or, better  still, the wing-bone of a well-boiled
 chicken, with all of the gristle cut  off, will  pave the
 way.  A small quantity of the well-chopped white meat
 of a thoroughly boiled chicken, not more than a tea-
 spoonful, may be tested, and this can be followed by a
 mealy, well-roasted potato, seasoned with butter and
 salt,  and well mashed.  Some well-boiled  rice, with
 gravy of beef-juice, will do well for some. Beware of
 other food; a taste of this or that which happens to be
 on the table, will only spoil the child and give  you great
 anxiety by the subsequent disturbance of the bowels
 which it will cause."
   And above all,  avoid the pernicious practice  to
 which so many are addicted,  of feeding the  child  on
 candy. It destroys the appetite for wholesome food and
 injures the teeth.  In moderate  quantity, fresh, ripe
fruit will do  no  harm, unless the bowels be already
too loose. 
HOW TO FEED FEVER-PATIENTS.          47
                   CHAPTER IV.

           How to Feed Fever-Patients.

   There  is good reason to think that in times past
many fever-patients were literally starved to death for
want of food to nourish them, as well as famished for
want of water to  liquefy the blood and cool  their
parched and bleeding lips.  But this practice is now
abandoned, the old notion that we  should  " stuff  a
cold and  starve a fever," has long since given way to
the modified doctrine that both the cold and the  fever
should be well fed.
   It was the great Dr.  Graves, of Dublin, who said
that he desired no greater epitaph on his tombstone
than simply the three words,  " He fed fevers." To the
reform which he thus initiated we owe many lives, for,
no doubt,  under the old and erroneous method of keep-
ing the patient on a low diet  for fear of adding " fuel
to the flames," many poor victims were actually starved
to death when recovery would have followed had they
been properly nourished.
   But care and judgment in  the  management of the
dietetics is as important  as  the medicinal treatment
itself, and a certain plan must be observed.  The in-
structions which follow will apply to almost  all the
acute fevers.  It is well to keep in mind a few  general
                      RULES.
   1.  Give no solid food to a  fever-patient.
   2.  Let the food be simple but nutritious.
   3   Give food at frequent intervals  and in small
quantities. 
48
DIET IN DISEASE.
   4.  Let a fever-patient have all the cold water that
he wants to drink.
   5.  Solid food given during convalescence will often
cause a relapse.
   6.  If the patient  be  properly nourished from the
outset there will be little need of alcoholic stimulants.
   Remember also that those fever-patients who have
been properly nourished will make the best recoveries.
   If the  patient's  mouth be  foul,  the lips,  teeth
and  tongue covered with " sordes," before giving food
cleanse the mouth with cold water containing a little
lemon-juice,  using a swab  or the corner of  a  napkin.
A little of the liquor-permanganate-of-potash may also
be used for this purpose.
   When a patient is  weak and lying on his  back, it is
exceedingly tiresome for  him to take food or drink a
spoonful at a time;  even  this slight effort wearies him.
At such a time none but liquid  food should be given,
and this through  a bent glass tube.
   Food for fever-patients should  be fluid in form,
easy  of digestion and highly nutritious.
                      Milk.
   No better form of  food  than this can be chosen, if
it agree with the patient.
   Give to the patient regularly every two hours a tea-
cupful of milk.  This may be fresh from the cow, or
scalded, or ice-cold, to suit the fancy of the sick one.
When but httle food can be taken it is a good plan to
have a pitcher of  iced-milk, and when the patient com-
plains of thirst give  this instead of water.  Typhoid-
fever patients who are fed on nothing but milk through-
out the course of  the disease make excellent recoveries.
The  best way of administering it is to let the patient
draw it through a bent tube. 
HOW TO FEED FEVER-PATIENTS.
49
    If the milk disagree or be  thrown up curdled, a
table spoonful of lime-water  to a cup  of milk may
prevent this.
                    Buttermilk
may be given instead of sweet milk.  It is both refresh-
ing and nutritious.  It should be fresh, and, like the
milk, given in  small  quantities frequently repeated.
Its tendency is to allay fever.
    To some patients milk is repugnant.  To others its
continued use will  render  it so.  Its use may then be
varied by giving gruel.
    The perfection  of gruels should be, according to
Miss Austen, " thin, but not  too thin ;  thick, but not
too thick."
    For the first three days of the fever,  if the patient
receive oatmeal gruel the waste  of tissue which occurs
during that time will be fully met.  The oatmeal, how-
ever, should be thoroughly  well boiled.  If it be under-
done more harm than good will  follow.

                     Recipe  13.
                  Oatmeal Gruel.

    To two  tablespoonfuls  of  oatmeal add two  table-
spoonfuls of water, and make a smooth paste.  Stir this
into a pint of boiling water, and boil for half an hour,
stirring well.   Add a  little salt,  and strain through
muslin.  If too thick, thin  with  a little milk.
   Later in the course of the fever the patient requires
food which is  stimulating as well as nourishing.  But
unless the patient is in an asthenic, i. e., a weak and low
condition, preparations  containing alcohol should not
be given.  If,  however, there is  great prostration with
weak and feeble circulation, alcohol is indicated. 
50
diet in disease.
                    Beef-Tea.
    This much-abused  article will find its chief use in
those weak conditions in which  the patient needs
stimulating.   There is very little  nourishment in  it,
but it seems to have a remarkable power of sustaining
life out of all proportion to tfye amount of solid matter
which it contains.
   If a patient has a continued fever and it is known
that beef-tea will be wanted from day to day, too much
pains cannot be taken in its preparation.   It is well to
observe the following
                      rules:
   1.  Never let beef-tea boil.
   2.  Always begin with  cold water.
   3.  The finer the beef is cut the better.
   4.  There  should be no fat, gristle or bones ad-
hering to the meat.
   5.  The proper proportion of beef and  water  is a
pound to a pint.
   6.  Beef-tea that " jellies" when cold has not been
properly made.
   7.  After being made,  carefully remove from the
surface all traces of fat.
   8.  To "warm up" beef-tea, put it in a cup and set
the cup in a vessel of boiling water.
   To get all the virtue  of the meat the following recipe
is the best:
                    Recipe 14.
                    Beef-Tea.
   Take one pound of fresh meat,  cut very fine, soak
in one-third of a quart of cold water  over  night.  In
the morning remove the  meat, saving the water  in
which it has soaked.  Put  the meat into two-thirds of 
HOW TO FEED FEVER-PATIENTS.
51
 a  quart  of water  and let  it simmer for two hours,
 keeping the water up to its original level by replacing
 what is lost by evaporation.  Now pour the beef-broth
 into the  cold liquor in which the meat was soaked,
 squeezing the meat as dry as possible.
    The meat  which remains should be spread on a tin
 plate and slowly dried  id an open oven.  When per-
 fectly dry it can be easily reduced to a powder in a
 mortar.  Mix this meat-powder in the liquor and you
 have all the elements  of  the meat in  a fluid form.
 Salt to taste  and add twenty drops  of muriatic acid
 and three grains of pepsin.
    This is the only preparation of beef-tea which con-
 tains all the virtue of the meat.   Other  beef-teas are
 stimulating, but they have no nutritive value whatever.
    A simpler  method, and  one which will answer for
 ordinary purposes, is the following:
                     Recipe 15.
                     Beef-Tea.
    Prepare a pound of beef in the usual manner and
 soak it in a pint of cold water for two  hours.   Now
 place the vessel containing the meat into a sauce-pan
 of water,  and  let the water in the latter boil  for three
 hours (putting the meat  and water into a stone bottle
 and this into a kettle  of boiling water  answers the
 same purpose).  Replace water that is lost by evapora-
 tion.  When done strain and salt to taste.  The last
 vestige  of fat  may be removed by skimming  the  sur-
face with a piece of white blotting-paper.
                    Recipe 16.
                   Wine Whey.
    Fresh Milk,     -    -    one pint;
    Sour wine,   -           one wineglassful;
    Sugar,     -              one teaspoonful. 
5-2
MET IN DISEASE.
    Put the milk into a shallow saucepan and  let it
 come to a boil;  as soon as it reaches  this point, add
 the wine, slowly, skimming off  the curd which  rises,
 for about fifteen minutes.  Add a tablespoonful  more
 of the  wine, skim off what  curd remains, and it is
 ready for use.  Sweeten to taste and season with nut-
 meg, if allowable.
   Whey is not very nourishing, but prepared in this
 way it is refreshing and  stimulating.

                     Recipe 17.
                    Egg-Nogg.
            One egg;
            One tumbler of milk;
            One desertspoonful  brandy;
            One desertspoonful sugar.
   Carefully  scald  the  milk and  let  it  afterwards
become cold.   Beat the sugar and egg up together to a
froth, put into a tumbler, add the brandy and fill up
with the milk.  If wanted in a hurry the milk may be
used without scalding.
   This is stimulating and nutritious.
   After the stage of depression has passed the stimu-
lating  food  may be dropped and a return made to
simple,  nourishing, easily-digested articles.   Food
should  be  given yet with great care, especially in
typhoid, and nothing solid should  be swallowed by the
patient.  Give again meat broths, milk, and the like.

                    Recipe IS.
                  Mutton Broth.
    Fresh mutton,    -    -     one pound;
    Cold water,    -            one quart;
    Salt,   -                    one teaspoonful. 
HOW TO FEED FEVER-PATIENTS.
53
    Take a pound of fresh mutton,  free from fat; cut
 into thin slices with a sharp knife; put into a suitable
 dish, salt, pour over it a quart of cold water  and let it
 simmer over a slow fire for an hour, then let it boil for
 an hour longer.  Strain off the broth through a sieve
 refusing the meat fibre.   Season with salt.
                      Recipe 19.
                    Beef Broth
 may be made according to the same recipe, taking a
 pound of beef free from fat.   A piece of the neck or
 shoulder is best.   These broths may be thickened with
 sago if desired.
                      Recipe 20.
                  Chicken Broth.
    Take a tender chicken;  remove the skin and all fat.
 Cut it in  two longitudinally and  remove the lungs,
 which will be found attached to the  back.  Now cut
 these halves into small pieces, cutting through bones
 and flesh.  Put these  pieces into a suitable dish, salt,
 pour on a quart of cold water and let it simmer for an
 hour and a. half, then set it on a hearth or  back of the
 stove  and keep up the heat for half  an hour longer.
 Strain through a sieve or coarse towel to separate the
 broth from  the  bones and fibre.   Season  to taste.
 Thicken with a little flour or sago if desired.
   The yolk of an egg beaten up in any of these broths
 adds greatly  to their nutritive value.
   This dietary is intended to apply to  any of  the
 essential as well  as  to the  symptomatic fevers.   But
 some of them require special mention.
                 Typhoid Fever.
   This fever is generally protracted  and exhausting,
and the diet  needs careful attention,  especially when 
54
DIET IN DISEASE.
 convalescence  approaches  and  the  appetite returns.
 Relapses are often brought on by some error In diet or
 over-indulgence.  No solid food should be taken until
 health is fully restored.  It  must be remembered  that
 the lining-membrane of the intestines has been ulcera-
 ted, and for some time after the patient is up it is in a
 very sensitive state, and extreme care must be observed
 lest the inflammation  be again aroused.  So simple a
 thing as eating  too much boiled  rice has brought  on a
 fatal relapse.   A diet consisting exclusively of milk  may
 be depended  upon  in this fever.  Let the milk  be
 scalded.  Give this throughout the entire course of the
 disease,  and  until  convalescence  is  far  advanced.
 There is no better diet in typhoid fever.
                  Typhus Fever.
   In this fever there is great and rapid  destruction
 of tissue,  and it is highly important that this  loss
 should be met,  from the first, by very nutritious  food
 given regularly and persistently.   If the prostration be
 great,  give beef-tea  and  egg-nogg.   If  swallowing
 becomes impossible, life may still be supported by
 nutrient enemata.
                  Scarlet Fever.
   While the general dietary already given will apply
 to this fever, yet,  since there is usually some inflam-
 mation of the stomach attending  it,  the food must be
 especially bland and unirritating.  Only a small quan-
 tity should be  given at  a time,  and it will be better
 borne if it be cold.  Iced  milk,  iced barley-water,  and
 the like,  will agree better than warm  food.  A milk
 diet fulfills all indications in this fever, and is especially
useful in that its tendency is to act as a diuretic,  and
thus keep the kidneys freely acting. 
DIET IN DYSPEPSIA.
55
                    CHAPTER V.


                Diet in Dyspepsia.

    Since this disease is generally produced by errors
 in diet, no plan of treatment which does not involve a
 careful regulation of this important matter can ever be
 successful in effecting a  cure.  While it is true that
 "what is one man's meat is another man's poison,"
 yet a strict observance of the dietary here given cannot
 fail to benefit every case, and it will cure in many.  It
 is important to the success of the treatment that, once
 begun, it be faithfully carried out, and the instructions
 given  be rigidly observed.  If this be done, it is not
 too much to say that every sufferer  from this  very
 common  complaint  may be  restored  to  a  state of
 health.
   Dyspeptics should adhere to the following

                      rules:

   1.  Eat slowly.
   2.  Masticate thoroughly.
   3.  Never eat when tired.
   4.  Avoid exercise immediately after a meal.
   5.  Do not eat " between meals," or be constantly
"nibbling,"
   6.  Never overload the stomach, or eat until you
feel oppressed.
   7.  Do not drink  large quantities during or after a
meal— a moderate quantity will do no harm. 
56
DIET IN DISEASE.
What Dyspeptics Should Not Eat.
Peas,	Herring,
Beans,	Sausage,
Hash,	Sardines,
Ham,	Mackeral,
Fish,	Salt-meats,
Cakes,	Fresh bread,
Cheese,	Griddle-cakes,
Cabbage,	Raw vegetables,
Cucumbers,	Young potatoes,
Confections,	Old, waxy potatoes
Pastries.	
   Drink no tea or coffee.
   Never eat meat that has been twice-cooked.
   Fats and pastries are especially to be avoided.
   Eat no sweet  puddings,  sauces, or the like, at the
end of a meal.
   Flatulence is more apt to follow the use of vegeta-
ble than of animal food.
   Some can eat with impunity what disagrees with
others;  avoid everything which disagrees with you.
   The use of  alcoholic beverages will  produce dys-
pepsia, and aggravate one already existing.
   Eat no fresh bread.  All bread should be stale or
toasted, and the crust is to be preferred  to the crumb.
And in his connection I  take pleasure in giving the
remarks of a lady who is performing a  very praise-
worthy work in liberating the people from the thrall-
doin of bad cookery.  It is called

               A Talk About  Toast.
   " Mrs.  E. P. Ewing,  in  a lecture on cookery, at
Dearborn   Seminary, said  that toasting  effectually 
DIET IN DYSPEPSIA.
57
destroyed yeast germs  in  bread, and converted the
insoluble starch into a  soluble substance resembling
gum, and  which  chemists called  dextrine,  so that
toasted bread was incapable of  fermenting  and pro-
ducing flatulence,  or becoming sour on the stomach.
Bread toasted very dry agreed  better with a  weak
stomach than any other bread.  Indeed, a sensitive
stomach would frequently digest toast when it  would
digest no other article  of  food.  Hence toast,  which
was  in general use  as  a diet for invalids, could be
safely and judiciously recommended  for them  at  all
times; and the loose talk indulged in by some self-
styled teachers of  physiology about the extreme un-
healthfulness of toast, especially when buttered, only
gave emphasis to the fact that toasting bad bread and
melting bad butter  did  not improve the  quality of
either, or render them less indigestible or unwholesome
than  when in their original unregenerate condition.
Melting or boiling inferior  butter would not make it
proper food for a human stomach, and the most skilful
manipulation  would not  convert  sour, half-baked
bread into nutritious, palatable toast.   The latter held
so important  a place among foods  that  every one
should know how to make it properly.  Yet one of the
best  American authorities on  culinary  matters  has
said  that only about one in 10,000 knew how to make
toast, and  the lecturer indorsed the statement, so far
as to assert that bad toast was the rule, and good toast
the exception.
   In making toast three directions should be observed:
Cut the bread, which should be somewhat stale, in even
slices, about half an inch in thickness.  If the bread
is fresh,  slightly dry them.  Hold each  slice a  suffi-
cient distance  from the fire, which should be of clear,
bright coals, to keep it from burning, and let it brown 
58
DIET IN DISEASE.
evenly.   For this purpose a wire broiler or a toasting
fork can be used.   When the surface of one  side be-
comes a rich, golden color, turn and heat the other
side in  a similar manner, until the slice is perfectly
toasted.  Serve the moment it is done in a warm plate,
dry or buttered, and it will tempt the appetite of either
invalid or epicure.  And the average individual, said
Mrs. Ewing, might indulge occasionally with impunity
in a broiled quail or a Boston stew, served on toast
after this  method, without the least fear of future
regret or discomfort."
   The  dyspeptic  should never eat raw fruit at  the
end of a meal.   Between meals  a little ripe fruit will
do no harm.
   Take nothing into the stomach at a meal that will
lower its temperature, for this interferes with digestion
and produces dyspepsia. Therefore take no ice-water,
ices, or  ice-cream.
   If the dyspeptic be troubled with eructations of gas
from the stomach, this may be corrected by eating
only vegetable food at one meal and animal food at
another.  Taking both  kinds  at one  meal will aggra-
vate this trouble.
   An interval of five hours should eiapse between any
two  meals.  It  requires this  length  of time for  the
stomach to dispose of its contents after one meal, and
to overtax it  by forcing more food into it before it has
had an  interval of repose is a fruitful  cause of indiges-
tion.
   Rest after a meal aids digestion.   Those who are
in good health should do no kind of mental or  bodily
labor immediately following  a  meal,  and  still less
should a dyspeptic.  It will aid recovery if the sufferer
from dyspepsia will rest for  one or  two hours after a
meal. 
DIET IN DYSPEPSIA.
59
    Many dyspeptics  can entirely recover if they will
 observe the instructions  already given, and  confine
 themselves to a diet of dyspepsia-crackers,  cod-fish
 and clabbered-milk, prepared according to the recipes
 which follow.
                     Recipe 21.
                 Dyspepsia-Crackers.

    Take of wheat-meal one quart;  butter,  one table-
 spoonful ;  water, enough  to make a very stiff dough.
 Beat this dough with a potato-masher or rolling-pin
 for half an hour, laying it on a bread-board  for the
 purpose; roll it into a ball and beat it out over  and
 over again.  Now roll it out very thin, cut into round
 shapes, prick with a fork and bake in a quick oven.
    The wheat-meal should be especially prepared for
 these  crackers.  If  no other is to  be had use good
 brown flour.  But too often this is made up  of poor
 flour, middlings and  bran. To secure  a good  article,
 buy some good wheat, take it to the mill and  have it
 ground.  Let the bran be sifted out,  but leave the
 middlings  and flour  together, and you have  a good
 wheat-meal.
                     Recipe 22.
                     Cod-Fish.
   With a sharp knife cut thin pieces of the  cod-fish
cross-ways of the grain of the fibres;  soak this over
night to extract the  salt;  the next morning pour off
the water in which  it has soaked, put the fish into
some fresh water and cook it  for half  an hour, then
add a teacupful of milk and a tablespoonful of flour;
just  before dishing for the table beat up an egg and
stir this in. 
60
DIET IN DISEASE.
   This is a very nutritious dish,  and it is also very
easy of digestion.  Eaten with some of the dyspepsia-
crackers,  it makes as nice a meal as anyone need
desire.
   If milk should disagree, then it must be omitted
and the cooking done with water only.
   If the  fish be soaked in sour milk instead of water
the salt will be better extracted and  the  fish made
fresher.

                    Recipe 23.
                 Clabbered-Milk.
   This is simply thick sour milk.  It is also called
loppered milk and bonny-clabber.
   Set a quantity of skimmed-milk away in a covered
glass  or china  dish.  When it  turns,  i. e.,  becomes
smooth, firm and jelly-like, it is ready to serve.  Do
not let it  stand  until  the whey separates  from the
curd, or it will become acid and tough.
   Set it on the ice for one hour  before it  is wanted
for use.  Serve from the dish in which it has turned.
Cut out carefully with  a large spoon,  put in saucers
and eat with cream  and nutmeg.
   This is one of the most wholesome of dishes, and
those to whom it is new soon acquire a taste for, and
grow fond of it.
   Marion Harland, in her excellent book,  " Common
Sense in the Household," says of bonny-clabber:
   " Few people know how delicious this healthful and
cheap dessert can be made if eaten  before it becomes
tart and tough, with a liberal allowance of cream and
sugar.  There  are  not  many  jellies and creams
superior to it." 
DIET IN DYSPEPSIA.               61
   To be relished the clabber must be new and fresh.
If allowed to become stale and tough it will pall on the
taste.
   In health it may be eaten sweetened, but it should
not be eaten with sugar by dyspeptics.   Nutmeg must
then be relied upon to give it flavor.
   In case the clabbered-milk is not agreeable at first,
begin with a  small  quantity—a  tablespoonful at a
time—and gradually a taste for this very useful food
can be  acquired.   Some  prefer taking  it as a drink,
beating it up until it becomes creamy.

                     Recipe 24.
                   Schmier-Kase.
   This is made by tying clabbered-milk in a cloth to
let the whey drain out.   Hang it in a cool place over
night.  It may be eaten like the bonny-clabber. It is
an excellent food for the dyspeptic, and may be taken
in almost  any quantity.   It is light, nutritious, and
easy of digestion.  It is called by some cottage-cheese.
   By observing the rules already laid down  and
adopting this dietary, many cases of dyspepsia may be
cured.  The greatest  obstacle to a complete recovery
seems to be that as improvement takes  place and  the
appetite returns the patient is tempted to over-eat, and
this  being  yielded  to  almost  invariably  causes a
relapse.  The " word  to the wise " is not always suffi-
cient, and each one must  learn by sad experience.   It
is better to eat moderately until the  stomach fully
recovers its powers, than to transgress these rules and
suffer a relapse.
   The  dietary already given should be adopted and
strictly followed by all who suffer from dyspepsia in
its worst forms.   Those  who suffer from the  milder 
62
DIET IN DISEASE.
 forms of this disease should  live  on simple  food.
 Dishes prepared  according to the following  recipes
 will be found to be well  adapted to the wants of the
 dyspeptic, and also to afford ample variety.
    White bread disagrees with  many dyspeptics, and
 its use should be avoided.  The following recipe makes
 an excellent article of brown bread.

                      Recipe 25.
                   Brown Bread.
    Prepare  a good sponge, as for white  bread.
    Put into the bread-pan  two parts brown-flour (do
 not sift  brown-flour), one-third  white  flour, and to
 every quart  of this mixture allow a handful of Indian-
 meal, with a teaspoonful of salt.
    Wet this with the sponge, and when it is  mixed,
 add, for a loaf of fair size, half a teacupful of molasses.
 The dough should be very soft.   If there be not enough
 sponge to reduce it to the  desired consistency, add a
 little luke-warm water.
    Knead this long and thoroughly, and set it to rise,
 which  will require a longer time  than for white bread.
 Give it plenty of time.  Knead again, make into loaves
 and set for a second rising.  When light bake steadily,
 giving it a longer time than white bread requires.  Be
 careful that  it does not burn.  Do not cut while hot.

                     Recipe 26.
               Unleavened Wafers.
   Mix good, dry flour, with a little salt  in it, to a stiff
dough  with  milk.  Roll  out thin.   Cut  into  round
cakes,  and roll these again  almost as  thin  as letter
paper.  Bake very quickly.   They may  also be mixed
with water. 
DIET in dyspepsia.
63
    These wafers are easily digested, very delicate  and
 fill an important  place  in the  dyspeptic's  dietary.
 They can be used  as crackers,  eaten  with  soups  and
 broths, and in a great variety of other ways.

                     Recipe 27.
                Unfermented Bread.
    Take one  ounce  of bicarbonate  of  soda  (baking
 soda)  and one  quarter ounce of  salt; mix with four
 pounds of flour.  Mix this with a quart of  cold water
 containing half a  fluid-ounce of  muriatic  acid,  and
 make  a thin dough with as little kneading as possible;
 put it  in the oven without delay.   It requires a longer
 time for baking  than*it takes for fermented bread.
    This is better for the dyspeptic than  the ordinary
 fermented bread.
    Some  of  the preparations of  gluten,  for which
 recipes are given in Chapter VIII., will be found to be
 good food for dyspeptics.
    Many recoveries from dyspepsia have  been  known
 to  follow the free use of koumiss, and  I would recom-
 mend  this in every  case in which it is possible to give
 it a trial.
    Besides the  articles here mentioned,  there are of
 course others which the dyspeptic can eat, but there is
 such a difference in their stomachs that no general list
 can be given which  will apply to all cases, unless it be
 the simple dietary recommended at the opening of this
 Chapter, which will agree with all.  If complete recovery
 be aimed at, it must be adopted and rigidly adhered to
until a cure is effected.  As the stomach becomes more
tolerant the return  to a mixed diet must be carefully
made.   Even after health is fully restored care  in  the
selection of  the  food must be observed, for it must be 
64
DIET in disease.
 borne in mind that that which will once produce dys-
 pepsia will also be the most efficient agent in bringing
 about a return of the same trouble, and probably the
 most important general rule yet laid down is: — Avoid
 everything which disagrees with you.


                 Aids to Digestion.

                      Recipe 28.
                      Pepsin.
    To prepare: "Take a perfectly fresh pig's-stomach.
 Carefully dissect  the mucous membrane from the mus-
 cular coat, and place the membrane on a flat board.
 Clean off  all  remains  of  food  and  mucus with  a
 sponge and a little water.   With the back of a knife,
 or with an ivory paper-knife, scrape the surface very
 hard and  squeeze out the contents  of the glands.
 Spread the viscid mucus thus obtained on a piece of
 glass, so as to form a very thin layer, and dry it at  a
 temperature of 100° over hot water, (or in vacuo over
 sulphuric acid).  When  dry scrape it  from the  glass,
 powder it, and keep  in a well-stoppered bott\e." —
 (Beale.)
   This powder  may  be kept  in  a glass-stoppered
 bottle for years without losing  any of its virtue.  It
 is a valuable aid to digestion in dyspepsia.
   When it is desired to use it to aid digestion, two or
 three grains  may be taken just before a meal, or it
 may be taken with the food, sprinkling  it on as  you
 would salt, as it is tasteless  and inodorous.
   Or, it may be prepared in & fluid form, and a table-
 spoonful of this fluid mixed with any of  the dishes of
animal food recommended in this work. 
DIET IN DYSPEPSIA.
65
                      Recipe 29.
                  Digestive Fluid.
    Copy the following recipe and take it to your drug-
gist:

          Pepsin
          Acid mur. dil..................iia  3ii
          Glycerinae,
          Aqua cinnamonii,..............aa  3ii
        M.
    Take a teaspoonful in lime-water after each meal.
    This will be found to be a great aid to digestion.
    Good preparations of pepsin can always be had at
the druggists.  It is a good plan to keep some on hand
at all times, for in sickness it is a great aid to diges-
tion.  It should be used in the preparation of  animal
foods alone, as it is useless in the digestion of  the
starches.
                      Recipe 30.
                  Malt-Infusion.
     Crushed malt,    -            three ounces;
     Cold water,   -                one-half pint.
   Mix these in a vessel and allow it  to remain for
from twelve to fifteen hours.  Then run it through
filtering-paper until it becomes perfectly clear.
   This is rich in diastase, and contains maltose in
considerable quantities.   It is liable to fermentation,
and hence must be  prepared fresh daily.  It may be
preserved, however, by adding a few drops  of chloro-
form to the infusion, and keeping  it in a bottle, well
corked.
   The malt-infusion is to be used  to aid in the diges-
tion of farinaceous (starchy)  foods.   It may be used
by the dyspeptic, or may be added to the infant's food. 
66
DIET IN DISEASE.
It is best taken mixed with the food.  Add a table-
spoonful to half  a pint of gruel.   It  promotes the
digestion of bread, oat-meal,  sago, tapioca, rice, and
articles of this class.
   The preparations of extract of malt to be had of any
druggist, may take the place of  the above domestic
preparation.   These  extracts contain in  an easily
digestible form many elements which go to make bone
and  muscle.  They are especially valuable in those
cases of indigestion in  which the starchy foods are
hard to dispose of, when the patient is troubled with
eructations of gas and flatulent colic.   It also aids in
the digestion of fats, and may be  taken when these
disagree.  This makes it especially useful, combined
with cod-liver oil, in those diseases in which the latter
is indicated.
                   CHAPTER VI.

             Diet in Constipation.

   The  condition of the  bowels is so directly depend-
ent on the nature of one's food, that either an unnat-
ural looseness, or  a condition  of costiveness, may be
made to follow a radical change in the diet.  So true
is this that those who travel over the western prairies,
living on crackers, beans, rice, coffee and large quanti-
ties of buffalo meat, will  sometimes go for as great a
period as two weeks without a  passage of the bowels,
while, on the other hand, we all know how frequently 
DIET IN CONSTIPATION.             67
a diarrhoea follows the use of green corn, squash, or
other summer vegetables.
   Putting, then, what we learn from tnese facts into
practice, and the dietetic treatment of costiveness be-
comes a simple matter.  The indications for treatment
are to avoid eating much meat and dry food, but to
drink freely of water and let the diet consist largely of
coarse meals, succulent vegetables and juicy fruits.
   Accordingly we may lay out the  following dietary:
	WHAT TO AVOID,	
Tea,	Salt meats,	Biscuit,
Coffee,	Cheese,	Muffins,
Wine,	Beans,	Fresh bread,
Beer,	Cake,	Griddle-cakes,
Pork,	Pastry,	
Veal,	Pickles, WHAT TO EAT.	
Mush,	Turnips,	Peaches,
Hominy,	Spinach,	Apples,
Oat-meal,	Cabbage,	Oranges,
Wheaten-grits,	Tomatoes,	Melons,
Corn-bread,	Asparagus,	Grapes,
Brown-bread,	Cauliflower,	Cherries,
Greens,	Figs,	Raspberries,
Cresses,	Pears,	Blackberries,
Squash,	Prunes,	Strawberries.
   A menu somewhat after the following order may be
adopted:—
   Breakfast:  Begin the  meal by eating an orange;
take a dish of oat-meal porridge, some brown bread,
tomatoes,  a goblet of  milk with a pinch of salt in it. 
68
DIET IN DISEASE.
   The meal  may be varied by adding occasionally
some fried mush, farina or hominy, wheaten-grits,  a
mealy, baked potato, and in  season  substitute musk-
melon, raspberries or strawberries for the orange.  A
little salt in milk is said to overcome the constipating
effect which it is supposed to  possess.
   Dinner:  Vegetable soup;  a moderate quantity of
beef or  mutton;  brown  bread;  such vegetables  as
squash, corn,  tomatoes, asparagus and the like;  for
dessert, Indian pudding and  peaches, melons, apples,
grapes, or other fruits.
   Supper:  Cold meat;  corn-meal  mush with  milk,
brown bread;  milk:  baked apples or stewed prunes.
   Wheaten-grits may be  substituted for the mush.
Graham crackers will make  an excellent addition to
this diet.  Other fruits may be taken ad libitum.
   Do not overload the stomach.
   Drink as much soft water as you can dispose of.
   It is a good plan to drink a goblet of oat-meal water
every morning while dressing.
   It is an error to suppose that a person is constipated
unless  there is a daily passage of the bowels, for one
who  has  an evacuation regularly  every  forty-eight
hours may consider himself in a condition of perfect
health  as regards this function.
   The following drinks and dishes are all adapted to
the relief of the condition under discussion.

                     Recipe 31.
                 Oat-meal Water.
    Oat-meal,    -           one tablespoonful;
    Cold water,    -    -    one gobletful.
   Stir the oat-meal into the water and let it stand for
about an hour.  Strain through a sieve and drink cold. 
DIET IN CONSTIPATION.
69
 This is a refreshing drink, and one adapted to those of
 costive habit.
                      Recipe 32.
                  Tamarind' Water.
     Tamarinds,    -    -     one tablespoonful;
     Ice-water,  -             one gobletful:
     Sugar,  -                one teaspoonful.
    Stir the tamarinds in the water until they are  as
 nearly dissolved as possible; strain into a goblet and
 sweeten.   Drink cold.
                      Recipe 33.
                    x\pple Water.
              Two large, juicy apples ;
              Boiling water, one quart.
    Slice the apples into a pitcher and pour the boiling
 water over them.   Cover close until cold, then  strain
 and sweeten to taste.
    This is an excellent drink for those who are inclined
 to constipation.
                     Recipe 31.
                     Porridge.
     Oat-meal,     -     -    two tablespoonfuls;
     Boiling water,   -    -  one pint.
    Mix the coarsely ground oat-meal with  a small
teacupful of cold water till it is of uniform consistence.
Then pour onto this, in a sauce-pan, the boiling water
and keep  boiling and stirring for forty minutes.  It is
now fit to serve, but may be kept simmering till wanted
if a little  more water  be added as the  other steams
away. Serve hot in a soup  plate, and add cold milk to
reduce it to a proper temperature. 
70
diet in disease.
                     Recipe 35.
                   Boiled Mush.
    Indian meal,    -               one cupful;
    Cold water,   -                 two quarts.
   Stir the Indian meal into the cold water, bring it to
a boil for two  hours,  stirring  often with a wooden
spoon.  Eat hot with milk.

                     Recipe 36.
                 Oat-meal Gruel.
   Boil two  ounces of oat-meal for an hour in two
quarts of water.  Salt  to taste.

                     Recipe 37.
                Oat-meal  Porridge.
   Put into a farina-kettle—i.  e., one kettle set within
another—two quarts of boiling  water, some salt, and
six ounces of oat-meal.  Keep the water in the outer
kettle boiling for one  hour.  Keep the inner kettle
covered, and do not stir the porridge until it is ready
to serve.   Eat hot, with milk or cream.
                     Recipe 38.
                Oat-meal Pudding.
   Take some of the porridge made by the last recipe,
add the yolks of some eggs,  some sugar, salt and lemon
and the whites of the eggs,  well beaten.   Bake for one
hour.   Serve with cream and sugar.
                    Recipe 39.
                 Wheaten-Grits.
    Cracked wheat,
    Boiling water,
one cupful;
one quart. 
                diet in constipation.             71

   Soak the  cracked wheat in a little cold water for
one hour, stir this into the boiling water and boil for
one hour, stirring often.  Add a little salt.
   This may be eaten with cream or milk, with either
salt or sugar, some preferring one, some the other.
                     Recipe 40.
                   Graham Mush.
    Graham flour,         -   -     one cup;
    Boiling water,  -                 one quart.
   Wet the flour with a little cold water and stir this
into the boiling water, previously salted.   Boil half an
hour, stirring constantly.
                     Recipe 11.
                      Hominy.
    Hominy,   -                   one cupful;
    Cold water,    -                three  pints.
   Put the hominy into the water, salt,  bring  it to  a
boil, and boil for one hour,  stirring often.  Eat with
milk.
                     Recipe 12.
                   Bread  Sauce.
   Crumb up several slices of brown bread, cover with
water; boil till smooth, pepper and salt to taste, stir
in one-half the quantity of stewed  tomatoes.  This
makes an excellent sauce to be  eaten with meat.
                     Recipe 43.
                   Baked Apples.
   Cut out the blossom end of the apples with a sharp
pen-knife and pull out the stems; wash, and pack them
in a pudding dish, putting a little sugar on top of each 
72
DIET IN DISEASE.
 apple.   Pour a cupful of water in the bottom of the
 dish, and cover the dish  containing the apples closely
 with another dish or pan;  set in a moderate oven and
 let them steam until tender all through.
    When done pour the  liquor over while hot, and
 repeat this as they cool.  Set on the ice several hours
 before tea.  Transfer to a glass dish, pouring the juice
 over them again.
    This is the  only proper  way to bake apples.  They
 are more tender and better flavored than when baked
 in an open dish.
    Besides these articles the dyspepsia-crackers (R.20.),
 brown  bread  (R.  24.) and  unleavened-wafers (R. 25.),
 recommended in the chapter of Dyspepsia, will make
 valuable additions to this dietary.
    Stewed prunes, baked apples and other fruits should
 be freely indulged in, and may form part of each meal.


               Rectal Alimentation.

   In some diseases, when food cannot be  taken by
 the mouth,  it  becomes  necessary  to  resort to rectal
 alimentation.   Life in this  way may be supported for
 many weeks, no  food whatever being  taken into the
 stomach.
   The most common conditions in which this becomes
 necessary are —
   Ulcer of the stomach;
   Stricture of  the oesophagus;
   Inflammation of the stomach;
   Diphtheria,  when the patient is  no  longer able to
swallow;
   Debility or exhaustion, the patient being  too weak
to take food; 
RECTAL ALIMENTATION.
73
    Finally, any condition in which the stomach rejects
 all that is taken into it.
    The following are the
               RULES  TO BE OBSERVED:
    Preparatory to administering an enema, empty and
 wash the rectum by giving an injection of clean, warm
 water.
    1.  Force the enema in slowly.
    2.  Throw it as high up as possible.
    3.  Inject at intervals of two hours.
    4.  Inject no more than half a teacupful at a time.
    5.  Let  the enema  have a temperature of about
 that of the body—say 98° or 100° Fah.
                     Recipe 44.
                   Milk Enema.
    Warm milk, with a little salt added, makes a simple
 and readily-absorbed enema.   Heat  the milk to the
 proper temperature, inject half a teacupful every two
 hours, and the patient is getting considerable nourish-
 ment.
                     Recipe 45.
                 Beef-Tea Enema.
    Beef-tea,    -              one pint,
    Raw beef,     -            three ounces;
    Dilute  muriatic acid,   -    twenty drops;
    Pepsin,  -                two grains.
   Take  of beef-tea one pint.  Take  three ounces of
raw beef, free  from fat, scrape it with  a  spoon, and
chop it until  reduced  to a pulp;  stir  this into  the
beef-tea,  heated to the  proper  temperature, add  the
acid and pepsin, and it is ready to inject, according
to the rules given. 
74
DIET IN DISEASE.
   Also, a simple  enema of  beef-tea is sometimes
given,  without the addition of scraped beef, but it is
not so  valuable an aliment as that prepared as in this
recipe.

                    Recipe 46.

            Defibrinated Blood Enema.

   Fresh blood is the  most valuable of tissue foods,
and, when from disease the system is no longer able to
keep up its usual  supply, we are but imitating nature
when we introduce  this pabulum into the shrunken
veins.  Blood may be looked upon as meat in solution,
and in a far better  state to be  appropriated by the
system than any that the arts of man can provide.
The blood  must necessarily be deprived of its fibrin,
but so  small a  quantity of nitrogenous elements is lost
by defibrinization, that its value as  a nutrient is not
materially lessened.
   Defibrinated  blood,  then,  is  the  most valuable
nutrient enema that can be used to  sustain patients
demanding this kind of nourishment.
   Go  to the slaughter-house and take from the large
pan the blood of  a  recently-killed beef.  It must  be
taken fresh, as soon  as it has flowed from the neck of
the animal, and before it has had time to coagulate or
form a clot. At this time, or even while it  is flowing,
it must be whipped with a bunch of straw or a handful
of twigs, to remove the fibrin.  Secure the blood-serum
which  remains in a wide-mouthed jar.  When wanted
for use this may be brought to  the proper temperature
by setting the jar  in a vessel of warm water. Inject as
you would milk or other enemata. 
DIET IN CONSUMPTION.              75
                     Recipe 47.
               Cod-Liver Oil Enema.

   Chop fine a half  pound of fresh beef-pancreas,
cover this with water and allow it to stand for an hour
in a warm place.   Strain through a cloth.
   Mix an ounce of this pancreas-solution with a half
ounce of cod-liver oil and use as an injection in those
cases in which it is desired to supply the system with
fat.
   Cod-liver  oil is a valuable injection in many wast-
ing diseases,  especially for young children.  It  should
also be used as an inunction and rubbed into the skin,
over the bowels of  infants who can no longer take food
by the stomach. In this manner considerable nourish-
ment will be afforded.
                   CHAPTER VII.

             Diet in Consumption.

   The object to be aimed  at in  the dietetics of this
disease is to give a liberal allowance  of the most
nutritious food that the patient is able to digest.  If
you can keep up nutrition you are doing much toward
arresting the course of the disease.
   The diet should consist chiefly of animal food, such
as beef, mutton, chicken, and other fresh meats, milk,
eggs, oysters and animal fats and oils, the object being
to provide such food as will be most easily assimilated. 
76
diet in disease.
   By this it is not meant, of course, that no vegetable
food should  be  taken.   Good, mealy potatoes, bread-
pudding, plain preparations of rice, sago and tapioca,
and  all sound and fresh vegetables which are easily
digested, may form part  of the dietary.  Use plenty of
milk in the preparation of all  dishes into which it can
be made to enter.
   The consumptive should  avoid the  use  of  salt-
meats, fish, pork,  rich gravies, pastry, and everything
which will disturb digestion.
   Above all must everything be avoided which will
loosen the bowels.
   Use no alcoholic stimulants whatever!
   Alcohol is not only useless in this disease, but may
do positive  harm.  On this subject Dr. Chambers says :
   " As to the use of alcohol in threatened cases, and
in the early stages of tubercle, I  have no hesitation in
pronouncing an  opinion adverse to it."
   When the disease is far-advanced and it is desired
to stimulate the waning strength,  there is less objection
to its use.
                      Meats.
   Beef. — The consumptive should take an abundance
of fresh  meat.   Every morning  for  breakfast, if  the
appetite be strong enough, a  tender  beef-steak,  rare-
done, should be  eaten. It should be broiled quickly on
a grid-iron, over a clear, hot fire, or on the coals.   Do
not prick it with a fork, as it will let the juices escape.
Dress with butter  and season with salt  and  pepper.
Serve hot.
   At  dinner take a  liberal  slice  of rare roast-beef,
together with some of the juice  of the meat.   Take
also,  if it  does  not disagree,  a little  of  the  suet  cut
from the hot roast. 
DIET IN CONSUMPTION.
77
   Mutton is very digestible, and may be used to give
variety to the meat diet. For breakfast a mutton-chop
may  occasionally  be  substituted for the beef-steak.
The only proper way to cook the chop is to broil it.
   Select a nice chop, sprinkle with  salt and pepper,
and place it on a grid-iron over a clear, hot fire for six
or seven minutes, turning  it occasionally to cook both
sides equally.  Do not prick it  with the fork.
   Chicken may be added  for variety, but as a steady
article of diet is not so well borne as beef.
   Soups and meat-broths  form a valuable addition to
the consumptive's dietary.
   Veal  is, compared with other meats, indigestible,
and should not be taken.
   Raw meat is sometimes recommended for the con-
sumptive, but really it possesses no virtue which does
not belong to the rare-done beef in  an equal  degree.
If taken, it should  be minced very fine, seasoned with
salt  and  pepper, and spread on a thin slice of bread.
                       Eggs.
   Let eggs form a prominent  part  of the diet.   An
egg should never be cooked more than  three minutes.
They are best soft-boiled or soft-poached.  If the eggs
be hard-boiled the white, which is less digestible than
the  yolk,  should be  removed,  and the  yolk alone
mashed up with a little butter and salt, and eaten with
toast, or an unleavened wafer  (R. 14.)   This  is very
palatable and nutritious.
                       Milk.
   Milk may be used by the consumptive in unlimited
quantities, if there be no idiosyncrasy which prevents.
It fulfils all the indications of  a nutritious and easily
assimilable food,  so important in this  disease.   It 
78
DIET IN DISEASE.
should be used in the preparation of as many dishes
as it can properly enter  into.  Let the patient take
occasionally a tumbler of milk with an egg beaten  up
in it.   Some like it warm from the cow, and if the
patient does the milking,  so much the better.
   Clabbered-milk,  as is already  prescribed for the
dyspeptic, is also an excellent food for the consump-
tive, and it  cannot be  too  highly  commended.  It
contains  all the elements of  fresh milk in  a form
requiring  less  effort on  the  part of the  system to
assimilate them, thus making it both very nutritious
and digestible.  The patient should learn to use this,
and let it form a prominent part  of the dietary.  It
makes a nice dessert, and may be used in this way, or
it may form the principal part of the meal at breakfast
or tea.  With cream and  sugar, and fresh unleavened
wafers a nice meal can be made.
   Cottage-cheese is another agreeable food  of  this
same class, and for  variety may sometimes be used.
Buttermilk,  also, should be freely indulged in.

                     Koumiss.

   Another  form of milk, the use of which has been
attended by great benefit in many cases of consump-
tion, is koumiss, or Arabian  milk  wine.  It is said to
have been thus used by the Arabs for many centuries,
and 'is now very extensively used by the tribes living
on the steppes of Russia, and it is only comparatively
recently that it has  been  known to the civilized world,
having been introduced  by Dr. Jarotzki, a  Russian
physician.   The Arabs make  it of mare's milk, but an
excellent article can be  made  from the  milk of the
cow.  It  contains some alcohol, and is contraindicated
in those cases in which the latter should not be used. 
DIET IN CONSUMPTION.
79
    There are  many different  methods  of making
 koumiss, almost as many as  there are people who
 make it. No  better article,  however,  can be made
 than that supplied by the following

                     Recipe 48.
     Champagne bottles -    -    six one-quart;
     Compressed yeast     -     one square cake;
     Granulated sugar    six even tablespoonfuls;
     Fresh milk   -                 one gallon.
   The bottles must be warm, and perfectly clean.  Put
 into each bottle—
     Yeast   -              one-sixth of a cake;
     Sugar               -   one tablespoonful;
     Hot water     -     -    two  tablespoonfuls.
   Shake the bottle till the yeast is dissolved, then add
 1£ pints of warm milk.   Stir the milk constantly while
 it is being brought  to  blood-heat, so that it may be
 evenly warmed throughout,
   Cork  the bottles very tightly, and tie or wire the
 corks.   Shake  the bottles well, and lay them on their
 sides, keeping  them  at  a temperature of not less than
 75° or 80° F.   Leave them four or five days, turning
 them over gently once each day.
  When the milk looks thick and smooth, like bonny-
 clabber,  the  bottles  should  be put on ice and left
twenty-four hours.   This stops  further fermentation.
  Only  the stoutest  bottles should be used—ordinary
ones are apt to  burst.  Care must be taken in opening
a bottle  of Koumiss, as it is highly effervescent.   It is
best to use a champagne tap. 
80
DIET IN DISEASE.
   When wanted for use, shake the bottle before draw*
 ing the Koumiss.
   If these instructions are observed, success is certain.
 Failure will follow  only from  a want  of the proper
 regulation of the temperature, either of the milk, when
 warming it, or of the place where the bottles are kept
 while fermentation is going on.
   The process is simple and it makes a most delicious
 and refreshing drink.
   As already said,  the use  of koumiss  has been
 followed by great  benefit in many  cases of consump-
 tion.   A bottleful a day may be taken, in addition to
 the ordinary diet.  Drink a glassful before each meal.

                  Cod-liver Oil.

   Of  all articles used in the treatment of  consump-
 tion, cod-liver oil  remains the most important.  The
 giving of the oil is not  merely to  supply fat, but its
 action is to improve nutrition, since fat is the basis of
 all molecular, or cell-growth.
   Dr. Chambers says:  " Cod-liver oil is a typical ali-
 ment,  representing what is the  fittest of all  known
 substances to supply the  deficiency that constitutes the
 disease---Oleaginous substance is what is furnished
 by nature for the primary growth and nutrition of all
 the higher tissues of  animal bodies; so that in admin-
 istering it we are wisely imitating the wisest teacher of
 medicine, mother Nature."
   Instructions regarding  the choice  and  mode  of
 administration of the oil will be useful here.
   The oil should be as fresh as possible.
   It should have no color, but be pale  and clear.
   The brown-colored oils are impure, and made from
livers that have partially decomposed. 
DIET in consumption.
81
    The oil should be kept well corked, and in a cool
 place.
    If exposed to  the  air the oil becomes  strong and
 rancid—keep well corked and do not open oftener than
 necessary.
    There  are many  preparations of  cod-liver  oil in
 emulsion—combined with malt, with pancreatin, hypo-
 phosphites, and other articles.   These are all useful,
 and are to be recommended in different cases.
    A dose of a teaspoonful is sufficient to begin with.
 Increase this quantity gradually until  a tablespoonful
 is taken three times a day.
    Do not take it  on an empty stomach—it will cause
 disagreeable eructations.
    The best time to take the oil is about  half an hour
 after a meal.  If  taken  at this  time the oil has but a
 short time to remain in the  stomach, as the already
 partially-digested meal is fast passing into the intes-
 tines.
    While taking the oil avoid the use of all  pastry,
 pork,  fat  meat, rich  dressings and the  like.   There
 seems to be less danger of disturbing digestion if  all
 other fats and oils be avoided while taking this one.
    To some the taste  of the  oil is  very  disagreeable
 and they find it difficult to take,  while others meet with
 no difficulty whatever.   But even in the latter class its
 long-continued use will cause it to pall on the taste, so
 it is best to disguise it  as much as possible. There are
 various ways of accomplishing this;  what will suit one
 may not suit another.
  . Before taking the  oil chew something of a sharp
nature,  to  engage  the nerves of  taste.  For this
purpose chew a clove, a peppermint  lonzenge, or take
a pinch of  salt. 
82
DIET IN DISEASE.
   The  spoon  should be  introduced  well  into  the
mouth, the oil deposited well back on the tongue and
taken down at one swallow.
   After swallowing the oil the taste which remains in
the mouth may  be removed  by drinking some well-
sweetened coffee, or  by  immediately eating a fresh
cracker.
   The use of the oil should be persisted in for months
and years.
                  Malt Extract.
   This offers a useful food for the consumptive, as it
assists in  the digestion of the starches and fats, and
hence, combined with cod-liver oil, the latter can often
be taken and disposed of by the system when in  its
pure state it would disagree.   The same can be said
for cod-liver oil in emulsion with maltine and pancrea-
tin.

                 Hypophosphites.
   The hypophosphites of lime and soda, as introduced
by Dr. Churchill,  of  Paris,  are beneficial  in many
cases.  It will not do to substitute the hypophosphites
for the oil, but  some  patients who have been taking
the latter for a long time  cease  to  make further
improvement; in such cases the hypophosphites may
be given together with the oil, and improvement will
go on.
   The hypophosphites in solution  are  kept by  all
druggists.  Ask for the syrup of hypophosphites of lime
and soda. 
DIET IN DIABETES.
                   CHAPTER VIII.

                Diet in Diabetes.

   Diabetes is marked by the appearance of sugar in
the urine.  The  dietetic treatment is based on the fact
that sugar and  starch (which latter in the system is
converted into sugar), when taken into the system,
cause an increase in the amount of sugar passed off in
the urine, and aggravate the disease.  The indication
then is to supply  a diet  containing  neither sugar  nor
starch.
   The following tables will aid in the selection of a
dietary for the diabetic:

           Vegetable Food Prohibited:
Arrow-root,	Carrots,	Sago,
Asparagus,	Maccaroni,	Sugar,
Bread,	Oat-meal,	Turnips,
Biscuit,	Pastry,	Tapioca,
Beans,	Potatoes,	Vermicella
Beets,	Peas,	
Crackers,
Rice,
Fruits Prohibited :
Apples,	Peaches,	Blackberries,
Grapes,	Plums,	and
Pears,	Pineapples,	Other sweet fruits,
Bananas,	Raspberries,	
 
84
diet in disease.
              Beverages Prohibited:

   All alcoholic drinks, as wine,  beer, brandy,  ale,
cider, etc.
   All sweet drinks—i. e., those containing any form
of sugar.
   Honey may be mentioned in this connection.

           Vegetable Food  Allowable :
Artichokes, Cabbage, Celery, Cresses,	Cucumbers, French-beans, Olives, Greens,	Lettuce, Pickles, Spinach,1' Mushrooms.
	Fruits Allowable :	
Lemons, Cherries, Currants,	Gooseberries, Strawberries, Acid fruits generally.	
             'Animal  Food Allowable :
   All meats,  poultry,  game, fish,  oysters, cheese,
milk, and eggs may be freely indulged in.
   Liver alone, on  theoretical grounds, is prohibited.

           Dishes  That May Be Taken:
   All preparations of gluten;
   Oysters, stewed,  or fried with gluten or bran-flour;
   jellies, if  there be  no sugar in them;
   Lettuce, with hard-boiled eggs and salad-dressing;
   Soups of various kinds, if  they contain no flour;
   Tea and coffee should not be sweetened with sugar;
glycerine may be substituted,  if agreeable.
   It is better to put cream into tea and coffee instead
of milk. 
DIET in diabetis.
85
    Custards and puddings  should be sweetened with
 glycerine.
    If the diabetic be compelled to take ordinary bread,
 it should be cut thin and well toasted.
    In changing the diet, observe the following
                       rules:
    1.  Do not adopt a rigid diet too abruptly.
    2.  First reduce the supply of bread and increase
 at the same time the supply of meat.
    3.  Next substitute brown-bread for wheaten-bread.
    4.  Then some bran-bread or gluten-bread may be
 substituted for the wheaten-bread.
    5.  Now gradually come to a diet regulated accord-
 ing to the tables already given.
    The diabetic patient should
      Chew slowly and eat moderately;
      Drink as much water as the thirst demands;
      Wear warm flannels next the skin;
      Take a great deal of open-air exercise.
    Of  all  articles  of  food of which the diabetic is
 deprived it seems to be harder for  him to deny himself
 bread than any other one.  For this reason physicians
 have  taxed their  ingenuity to provide a  substitute
 which shall be free from starch.  One of the earliest
 substitutes devised was bran-bread. But few will care to
 go  to the trouble of preparing this when gluten-floar
 can be obtained, and besides it is deficient in nutritive
value.
                  Gluten Flour.
   Fortunately we have in gluten flour a substitute for
ordinary wheat flour which makes an excellent  article
of bread that can be freely eaten by the diabetic.  It is
agreeable to the palate, very  nutritious,  and almost 
86
DIET IN DISEASE.
entirely free from the starchy elements, so injurious in
this disease.  The amount of starch which it contains
is  so  small  that  it need not be taken into account.
Gluten flour is  made from that part of the grain of
wheat which underlies the bran-scales and  surrounds
the starch-area.  It is now manufactured in various
parts of the country.  It can be made up into a great
variety of agreeable dishes, and the following recipes
will enable the diabetic to provide  himself with a diet
as liberal as those enjoy who are under no restrictions
in this respect.
                    Recipe 49.
                  Gluten Bread.
    Milk,  -              -  one pint;
    Warm water, -    -    one pint;
    Butter,     -         -  one heaping teaspoonful;
    Yeast,  -              one-half cake;
                    Two eggs.
   Mix the milk and water;  soak  the yeast-cake in a
little warm water, beat the eggs well and add these to
the milk and water; stir in gluten flour until a soft
dough is made, work in the butter, kneading as you
would ordinary bread-dough.  Mould, put  in pans to
rise, and when light bake in a hot oven.
   Gluten bread requires  less yeast  than ordinary
bread, and less time in rising.  The  dough should be
made  softer than for white-flour bread.
                    Recipe 50.
                  Gluten Gems
      One egg;
      One pint water;
      One tablespoonful butter;
      One tablespoonful baking powder;
      Gluten flour to make a thin dough. 
DIET IN DIABETES.
87
   Beat the egg up, add it to the water, put in a little
salt; mix the baking powder with the dry flour, then
stir this into the water to make a thin dough, and stir
in the butter.  Bake in hot, well-buttered gem-pans
in a quick oven.   These take a longer time to bake
than other gems require.

                     Recipe 51.
                   Gluten Mush.
   Stir the gluten into boiling water to make a thick
mush.  Cover the vessel containing the mush, set it in
another vessel of boiling water, and keep the water in
the outer vessel at a boil for half an hour or longer.
If there are any lumps, stir in a little boiling water
and they will break down.  Eat with cream.

                     Recipe 52.
                   Fried Mush.
   Stir one pound of  gluten flour into  a  quart  of
boiling water, add a little salt and boil for ten minutes;
pour into a shallow dish and allow it to cool.  The next
morning cut into slices and fry.   Eat with butter.
   This is  a very nice dish for breakfast.

                     Recipe 53.
                   Gluten Cakes.
       One cupful gluten;
       Two tablespoonfuls butter;
       Three tablespoonfuls grated cheese;
       Two tablespoonfuls cream;
       Yolks of two eggs;
       One-half teaspoonful salt;
       A little nutmeg. 
88
DIET IN DISEASE.
   Mix all of these ingredients thoroughly together in
a dish; roll out thin the dough thus made;  bake in a
quick oven.
   This is a very agreeable cake and helps  greatly to
give variety to the diabetic's diet.
                     Recipe 54.
                  Gluten Pudding.
   Soak two thick slices of gluten bread, broken up,
in half a pint of milk; add one beaten egg; sweeten
with glycerine and bake in a small basin.
   This makes a tolerably good pudding  for the dia-
betic—enough for one person.
                     Recipe 55.
                  Gluten Wafers.
   Stir some gluten flour, with a little salt, into cream
to make a dough  which  can be rolled out  very thin.
Cut into forms and bake in a quick oven.
   Gluten  flour can also be used  for making gruels,
for thickening soups and gravies, and in frying oysters.
                     Recipe 56.
                   Bran Water.
    Wheat bran,   -              two quarts;
    Cold water,   -                three quarts.
   Mix the two in a large dish, and let the bran soak
over night.   The next morning rub and  squeeze the
bran with the hands until all  the meal which adheres
to it is washed off; strain through a fine sieve, press-
ing and squeezing until the bran is almost dry.
   This makes a nutritious and pleasant drink for the
diabetic, and, as it contains no starch, it can be taken
with impunity. 
DIET IN DIABETIS.
89
                    Milk Cure.
   Cures  of  diabetes have  been effected  by an ex-
clusive  milk diet, as recommended by Dr.  Donkin.
This is  well worth a trial, especially in recent cases.
   In order to obtain the full benefit of this  treatment,
the patient must adopt and rigidly adhere to  the
following

                      RULES:

   Use fresh milk.
   Carefully remove all  cream.
   The  milk may be taken cold  or warm, but it must
not be boiled in the warming.
   The  first day take from four to  six pints.  (This
would be from  two  to  three glassfuls of milk taken
every two hours  during the day).
   It  is better to divide the day into equal periods and
take  frequent draughts—even  though  a glassful be
taken every hour—than it is to take a large  quantity
on the stomach at once.
   Now the quantity of  milk taken  may be increased
from  day to  day, until  five  or six quarts are taken
daily.
   This quantity, six quarts, need not be exceeded.
   Nothing else must be taken while the milk diet is used.
   If  at the end of a week there is no  improvement,
the treatment may be abandoned.
   If the treatment be of benefit, it will  be denoted by
a diminished amount of urine, less sugar, and improve-
ment in the general health.
   This treatment should be continued from three to
six weeks after  all sugar has  disappeared from the
urine. 
90
DIET IN DISEASE.
   The return to a diet of solid food must be gradual,
and  upon the care taken in this, much of the success
of the treatment will depend.
   Milk should still be taken, but other articles gradu-
ally  added, and  meats, beef-tea, broths, and  the class
of vegetables  recommended  as allowable, .may  now
form part of the dietary.
   The success  of this treatment consists in rigidly
carrying out the strict rules which have been laid down,
and above all care in returning to a mixed diet.
   For variety,  clabbered  milk may be taken along'
with the sweet-milk diet.
   By  following the instructions given in this chapter,
any person suffering from diabetes may live to enjoy a
fair degree of  health for many years, and permanent
cures have sometimes followed  the dietetic treatment,
especially the milk diet, which, of all methods of treat-
ment for diabetes, is by far the most important, and
that  which  has been  followed by the most striking
beneficial results.
            Diet in Bright's Disease.

   In this disease  "the object aimed at by the die-
tician should be  to supply the nutritient organs with
aliment which is the most readily and rapidly conver-
tible into blood and tissue, namely, digestible animal
food in frequent, moderate quantities."— (Chambers.)
   According to  this,  then,  the diet  should consist
largely of dishes composed of milk, soft eggs, oysters,
mutton, rare-beef, chicken, game, and the like.
   Some physicians advise  the observance of a diet
composed  chiefly of vegetables, on the  supposition 
DIET IN BRIGHT'S DISEASE.
91
that a meat diet throws extra work upon the kidneys
in compelling them to remove from the blood an excess
of urea, from the waste of azotized material.  Hence
the diet should be chiefly composed of vegetables, and
bread in all forms; potatoes, rice, hominy, maccaroni,
peas, beans and other vegetable food,  should make up
the principal  part of the diet, while comparatively
little  meat should be taken.  If the  patient does not
do well  under the meat diet first recommended, then
this may be tried,  but the greatest benefit will proba-
bly follow the use of the

                    Milk Diet.

   " In  a series of cases which have been described by
Dr. Schmidt, in his inaugural thesis,  I have obtained
most  brilliant results where all other treatment had
failed, by putting the patients on an  almost exclusive
diet of milk."—(Niemeyer.)
   Having tested  this plan of treatment in my own
practice, I am prepared to recommend it to others.
   The  patient  should  gradually  leave  off  all his
ordinary mixed  diet,  until he reaches an exclusively
milk diet.   Begin by drinking  a quart of milk a day,'
and increase the quantity from day to  day until finally
five or  six quarts of  milk daily are' taken.  The day
may be  divided into equal periods and half a pint or a
pint taken at a time.  This treatment should be kept
up for at least a month.   By that time considerable
improvement will have  been made,  and  the after-
treatment may be regulated by the varying conditions
of the case.
   The instructions given for the milk diet in diabetes,
may be  applied here. 
92
DIET in disease.
   The  subject of Bright's disease should make it a
point to drink large quantities of soft water.  This helps
to "wash out from  the  blood," so to speak, the im-
purities with which it becomes loaded.
   In disease  of  the kidneys  alcohol essentially acts
the part of a poison, and must not  be taken in any
form  or  quantity   whatever.  Therefore drink  no
spirituous or malt liquors.
                 Diet in Gravel.

   Those who are subject to stone in the bladder, and
gravel may do much towards  a cure  by adopting a
systematic dietary.
   The object should be to take a large proportion of
vegetable food, and but little meat.
   Eat no more meat than once a day.
   Avoid especially  rich sauces, cheese, rich soups,
sugar, fats, cream, and everything that will disturb
digestion.
   Take no spirituous or malt liquors of any kind.
   If the attacks of  gravel are frequent, come to a
strictly vegetable diet, eating no meat whatever.
   Drink no " hard " water, or water impregnated with
lime.  Drinking freely of "soft" water,  rain-water, or
that which has been freed from mineral substances, is
very beneficial, and the more "soft" water the patient
drinks, the better.
   A strict observance  of  these rules  will  do  much
towards promoting a cure. 
DIET FOR TRAVELERS.
93
                   CHAPTER IX.

               Diet  for Travelers.

    Many of the  disorders of digestion  with which
 those who are "on the road" a great deal are troubled,
 may be avoided by giving due attention to the nature
 of the food which they take, and by observing a few
 simple rules in the regulation of their diet.
    As a rule, much of the  trouble arises from taking
 too much meat and not enough vegetables.  Dishes of
 meats and  eggs are more  quickly prepared than are
 vegetables, and there is great temptation to rely upon
 the former almost to  the exclusion of the more succu-
 lent food.
    Again, there is a disposition on the part of  some to
 eat too heartily, more than the appetite demands, and
 more than they would if at home.  It will be found
 that if a light diet only be  indulged in it will not be
 followed by the headaches,  constipation and digestive
 disorders that attend  immoderate eating.
   The  hasty swallowing of meals at  railroad eating-
 houses is another prolific source of indigestion on the
 part of travelers, and the dining-cars now to be found
 on all first-class roads are  an inestimable blessing to
 the traveling public.  If  you are compelled to eat at a
 station,  take but a light meal and  eat  slowly and
 deliberately.   " Twenty minutes  for  refreshments "
 afford ample time to dispose of a full meal.  If you
take pains to observe, you will find that you spend  no 
94
DIET IN DISEASE.
greater time than this at the table, when at home,
with nothing to hurry you.
   The traveler who suffers from constipation should
refrain from eating great quantities of meat and white
bread and rolls, and should partake largely of succu-
lent vegetables and fruits.  Cabbage, potatoes; turnips,
cauliflower, tomatoes, squash, beets, onions, corn and
peas should  be freely indulged in,  and brown-bread
and corn-bread in preference to white-bread.
   All kinds of ripe fruits, apples,  peaches, pears,
grapes,  bananas,   strawberries,  raspberries,  black-
berries, oranges, and the many others  to be found in
our markets,  should be freely eaten.
   Veal and  chicken will  be found to be less  binding
to the bowels than pork, beef and cured meats.
   Nuts, confections, cakes  and pastries  should  be
avoided.
   The drinking of so much tea and coffee at hotels
and railroad eating-houses is another cause of indiges-
tion.  Drinking much tea, especially produces indiges-
tion and constipation.
   When possible, drink milk instead of tea or coffee.
A pinch of salt in each glass of milk is said to over-
come its constipating effects.  Butter-milk, when it is
to be had, makes an excellent and wholesome drink.
   Some of  the ailments  from which travelers suffer
are due  to the water which  they are compelled  to
drink.   These may be avoided in a great measure  by
drinking no water which has not been boiled and  then
filtered.  A pocket-filter may be carried for the latter
purpose.
   In some  parts  of  the  country the  dishes  will all
contain too much  grease,  causing acidity, a nauseous
taste in the mouth, flatulence or  diarrhoea.  The best 
DIET IN SEA-SICKNESS.
95
way to correct this is to take  some vinegar or lemon-
juice on the plate, and  eat these with as many dishes
as possible.
   In hot weather the appetite for breakfast of those
who travel  is often  impaired by  passing a restless,
sleepless night.  This may be remedied by wringing a
sheet or some towels out of cold water and spreading
them on the floor, or hanging them where the breeze
from an open window will blow over them. This v/ill
cool and moisten the atmosphere.
   If,  while traveling,  you are taken with diarrhoea
keep perfectly at rest on the back, and suck a lemon,
and you will soon be over it.
   A  careful study of Chapter V., Diet in Dyspepsia,
and Chapter VI., Diet in Constipation, and an observ-
ance of the instructions there given will be of great aid
to those who suffer from the  disturbances to which
traveling-men are especially liable.
               Diet in Sea-Sickness.

   Really the only certain way to avoid this bete noir
of ocean travel, is to take the old Captain's advice and
" never go to sea."  But if once you are called upon to
pay tribute to Neptune, there is nothing for it but to
endure with the best possible grace.
   There is usually almost  complete loss of appetite,
and really but little food of any kind is required.
   It is a good  plan to have the steward bring a bowl
of gruel or porridge to your berth every morning.
After taking this, lie quietly for several  hours and you
are pretty well fortified for the trials of the day. 
96
DIET IN DISEASE.
    Lemons possess no especial virtue in relieving  the
 sickness,  but they are very grateful to the sufferer in
 removing from the mouth  that foul  taste which is an
 inevitable accompaniment, and for this purpose all
 who are about to start on a voyage are advised to pro-
 vide themselves with a supply,  if they are not  to  be
 had on board.
    Lemon-drops, to be had at the  confectioners,  make
 an excellent substitute, and I would advise all who  are
 about  to  make  a sea-voyage to  provide themselves
 with a pound of lemon-candy, or "acid-drops."  They
 are  really better than the lemons  for the purpose
 indicated.
    While the  sickness continues  little else than  the
 porridge or gruel, with perhaps some tea and toast,
 can be taken.  As the appetite returns something more
 is called for, and yet  the stomach will not permit its
 owner  to go to the saloon, much less to indulge in  the
 rich fare with which the table is generally laden.  At
 such times I found it a good plan to remain in  my
 stateroom, or on deck, and before meal-time  get  the
 steward to give  me a sight of the bill-o'-fare.  From
 this 1 could generally select some plain-cooked vegeta-
 bles, oysters (when in season), sago, or rice-pudding,
 or other dish which my feelings would at once tell  me
 could be relished.
   Besides these attentions to diet the sufferer should
 remain in the fresh air as much as possible, and also
 avoid the  upright position.   If  the  weather  permit,
 spread your steamer-rug on the deck  and lie  upon
 that; if compelled to be below, maintain the recumbent
posture.
   It is said that those whose stomach and bowels  are
 in best condition when they go aboard, seem to suffer 
              DIET FOR THE CORPULENT.            97

least.  But I could not discover that this had anything
to do with it.
   It is poor comfort, while one is suffering all the
agonies of  the mal de mer,  to be  told by some wise
individual who has crossed before, "don't you know,"
that you will feel better when you get over it.  Ask
your comforter if he intends  his remark to be taken in
a Pickwickian sense.
   Sea-sickness is usually a  harmless complaint, from
which  there is  soon  complete recovery,  about three
days being its average duration.  But in rare instances
it  is so long continued  that the victim suffers in his
general health  from  want of nourishment,  since  no
food whatever  can  be taken into the stomach, and
sometimes  even life  is  endangered.  In such  cases
nutrition should be kept up by nutrient enemata.
                   CHAPTER  X.

            Diet for the Corpulent.

   Those  who  are unusually corpulent  may reduce
their weight many pounds by observing a strict regimen
in diet, and by taking proper exercise.
   The rule should be to  take with the food  no fat or
sugar, and as little of the starchy foods as it is possible
to get along with.
   Accordingly,  the following  dietary may  be  pre-
sented. 
98
DIET IN DISEASE.
What Should Be Avoided:
Fats,	Bread,	Soups,
Milk,	Biscuit,	Sago,
Cream,	Crackers,	Tapioca,
Butter,	Pastries,	Beets,
Pork,	Pies,	Potatoes,
Sugar,	Puddings,	Arrowroot,
Cake,	Rice,	Corn-starch,
Candies,	Gruels,	Sweet potatoes.
   No sweet fruits should be taken.
   Put no cream or sugar into tea or coffee.
   It is best to avoid  the use of milk altogether;  let
water be the only drink.
   Alcohol, in spirituous or malt liquors, must not be
taken.
               What  May  Be Eaten:
Fish,	Cresses,	Oysters,
Beef,	Cabbage,	■ Spinach,
Veal,	Tomatoes,	Lettuce,
Mutton,	Pigs-feet,	Radish,
Tongue,	Turkey,	Greens,
Celery,	Chicken,	Squash.
Onions,	Game,	
   Other vegetables, containing little or no starch;
   Sour fruits, as cranberries, lemons, sour apples,
and the like.
   Besides adopting this dietary, the object may  be
promoted  by observing certain other rules,  the  most
important of which are the following:
   Do not spend too much time in sleep. Eight hours
should be the utmost limit—seven hours are better.
   Take a cool sponge-bath every morning, and,  if
possible, take one or two Turkish baths a week. 
DIET FOR THE CORPULENT.
99
    Take  a run in the open air, two or three  times
 daily, until perspiration is induced.
    According to these rules, the following daily regi-
 men may be observed:
    Rise at  seven o'clock, take a cool sponge-bath and
 rub the body with a coarse towel or flesh-brush.
    If possible take a short, brisk run in the open air.
    Breakfast at eight on lean meat,  being careful to
 avoid  all fat.  Eat also dry toast, any vegetables in
 the list, and tea or coffee without cream or sugar.
    Dinner at twelve:  Eat plain meat (avoiding fat),
 fresh vegetables, as tomatoes, cabbage, cresses, celery,
 onions, and others  in the list.  Take no potatoes or
 sweet  dishes.  Dessert  may consist  of  a tart  jelly,
 baked  apple, lemon-ice, or the  like.  Do not  take
 soups or pastry.
    Tea should consist of lean meat,  apple  sauce, a
 little toast and tea.
    Eat moderately, and if this regimen be carried out,
 keeping up  the exercise,  it cannot fail of having the
 desired effect.
    After continuing this for two or three weeks the
 measures  need not be so strictly carried out,  but still
 no sugar or fat should be taken in the food.   Sugar is
 the most active of all as a fat-forming food.
   Take the weight of the body every few days, and
do not let  the reduction in weight go on at a greater rate
than half-a-pound a day. 
100
DIET IN DISEASE.
                 Diet in Scrofula.
   While  scrofula is often of hereditary origin, yet it
may be acquired.   Prominent among its causes are,
an  absence of sunlight, breathing a vitiated atmos-
phere, and living on insufficient, unwholesome  food.
Hence, while the matter of general hygiene should not
be neglected, the regulation of the diet  must receive
due attention.  Give to scrofulous subjects an ample
supply of the most nutritious foods. • Let the  child
have  a greater amount of animal  food than  those
children receive who suffer from no taint of this  kind.
Of all foods of this character, cod-liver oil is probably
the most important.
   If a mother be scrofulous she should not nurse her
babe,  but put it immediately to a healthy wet-nurse.
If, on the other hand, the child inherit scrofula  from
the father, and the mother be free from any such taint,
she may nurse her babe.  During lactation, however,
she should take three times a day a teaspoonful of the
hypophosphites of lime and soda.  If the child be put
to a wet-nurse the  latter should likewise take the
hypophosphites.
  . Too  early  weaning  should  be carefully  guarded
against.
   After weaning, the  child should receive  an un-
usually large proportion of animal  food.  It should
have a bountiful supply of milk, adding to each glass-
ful a tablespoonful of lime-water.
   Give to the child a piece of meat  about the size of
your finger, cut lengthwise of the fibre, from the rare
part of the beef-roast or beef-steak.  Let it have this
to chew.
   Take a small piece of beef, broil it very quickly on
hot coals.   Do not cook it too much,  but  let the inside 
DIET IN RICKETS.
101
be  red and juicy.  Mince this very fine with a chop-
ping knife, spread it on a thin slice of bread which has
been lightly buttered, sprinkle with fine salt, and give
to the child to eat.
    This  is more palatable than the raw meat usually
recommended in these cases, and there is not so much
danger of the child's becoming afflicted with worms as
there is when the meat is taken without cooking.
    If the  scrofula be  already established when the
child comes under treatment, cod-liver oil should form
a  prominent part of  its diet.   Give a teaspoonful
three times a day.  This is a most important remedy in
these cases.   Give the oil by inunction if there should
be  difficulty in  getting the child to take it  by the
mouth.
    A scrofulous  child should  enjoy  an abundance of
fresh air and sunshine.

                 Diet in Rickets*
    The condition known as rickets rs caused by faulty
nutrition, and a proper regulation of the diet, supply-
ing those elements in which  the  system is deficient,
will correct the tendency, and restore the child to a
state of health, in almost every case.
    Too early weaning often causes  rickets in otherwise
healthy children.  Bottle-fed children also  sometimes
fall victims to the disease when those who have care
of them  are ignorant of  the proper nature of the food
which they should receive.  An otherwise healthy child
will grow rickety if kept upon a diet consisting  of
starchy food.
   A rickety child should receive a generous meat diet,
as in scrofula.    Give it raw beef, finely minced and
spread on bread.  Let it have plenty of milk, with 
102
DIET IN DISEASE.
lime-water added.  Extract of malt, containing, as it
does, phosphates of lime and other salts, is among the
most important foods which the child can receive, and
its use should not be neglected in any case.
   Preparations of malt, containing, as they do, phos-
phate of lime, are very valuable in the treatment of
rickets.  If not given in this form, some pure phos-
phate of lime should be put  into the milk which the
child drinks.
   Cod-liver  oil  may be  given  in  small  quantities,
beginning with doses of ten drops, and gradually in-
creasing the amount until the child takes a teaspoonful
two or three  times a day.   This  is a highly important
part of the treatment.   If this  course be pursued,
giving  the child  meats, milk, lime-water, extract  of
malt,  and cod-liver oil, in addition to  its other diet,
and the matter of general hygiene receive due atten-
tion, recovery will follow in almost every case.

                 Diet in Scurvy.

   Of all diseases in the catalogue this is pre-eminently
the one which is most amenable  to dietetic treatment.
Since  it is produced by a lack of vegetable food, the
treatment suggests itself:—Supply the system with
that of which it has been deprived.
   Hence all that is necessary  to cure  a scorbutic
patient is to supply him with a vegetable diet.
   Half a pound of potatoes a day will prevent scurvy.
Give to the  patient tomatoes,  saur-kraut,  onions,
greens,  cabbage,  spinach,  and  other vegetables, and
especially limes or lemons.
   The  citrates,  tartrates,  malates  and  lactates  of
potash should be used as drinks. 
          DIET IN CHLOROSIS, AND COLLAPSE.        103

   " Land scurvy," or purpura,  may be treated in a
similar manner as regards dietetics.

        Diet in Chlorosis—Green-Sickness.

   In this disease the food should be of such a character
that it can be readily converted into blood, of which
the system is deficient.  Hence juicy beef should form
a prominent part of the diet, and the  patient should
take as much as she can with  comfort;  more, even,
than the immediate wants of the  system demand.
Fresh milk should be taken in abundance.
   Besides these, other nutritious animal foods should
form a prominent part of the dietary,  and oysters in
all forms, codfish,  soups and broths, should be freely
taken.

                 Diet in Collapse.
   In the collapse following wounds, and the collapse
of " shock," extract  of meat and wine, equal parts, is
the best stimulant that can be  given, and its use has
saved many lives.   It was used with great success in
the Austrian army  in  1859, and  in the American
armies during the late war.
                 Extract of Meat.
   " Cut the lean of fresh-killed meat very small, put
it into eight times its weight of cold water, and heat
it gradually to the boiling point.  When it has boiled
for a  few minutes,  strain  it  through a cloth,  and
evaporate the liquor gently by water-bath to a soft
mass.   Two pounds  of meat yield one ounce of extract.
Fat must be carefully excluded or it will not keep."—
(Liebig.) 
104
DIET IN DISEASE.
   " Equal parts of this extract and good sherry wine
should be freely administered."—(Ruddock.)
                     Recipe 57.
               Hot Milk and  Water.
    Fresh milk,   -    -          one-half pint;
    Boiling water,    -        -  one-half pint.
   Pour  the  water  into  the  milk,  and  give  im-
mediately.
   This is very quickly absorbed;  it soon enters the
circulation, and increases  the  volume of blood,  and
is  an excellent restorative after hsemorrhage or faint-
ing.   It has the advantage of being very quickly pre-
pared.
                    CHAPTER XI.

             Diet in Rheumatism.

    Give  no meat whatever to a patient with rheumatic
fever; it will invariably aggravate the disease.
    If meat in  any form  be taken in rheumatism it
 seems to turn  to acid, and as this is already in excess
 in  the  system,  the  meat  will only aggravate  the
 disease.
    The patient must live on  vegetable food until health
 is fully restored, however hard it may be for him to be
 deprived of his accustomed diet.
    Even after apparent recovery the return to a meat
 diet must be made very cautiously and gradually, for
 if adopted  too early  it will sometimes bring on a
 relapse. 
diet in rheumatism.
105
   The  patient  suffering  from  rheumatism  must,
therefore, have a purely vegetable  diet,  consisting of
such articles as  gruels, boiled rice,  preparations  of
sago,  tapioca, farina, corn starch,  panada and  other
preparations of bread, mashed potatoes  and the like.
   The  patient should receive no  beer,  ale  or  other
malt liquors, or  alcohol in any  shape,  as these will
invariably aggravate, and must in all cases be strictly
prohibited.  No acid drinks  should be taken, and sweets
should be carefully avoided.
                     Recipe 58.
                  Alkaline Drink.
             Peel of  one lemon;
             Tablespoonful of sugar;
             Half a pint of pure  water;
             Half a pint of Vichy water.
    Slice the lemon-peel very thin and  put  it into a
pitcher with the sugar; pour on  enough hot water to
dissolve the sugar; add the other water.  This makes
a pleasant alkaline drink for use  in rheumatism.

           Diet in Chronic Rheumatism.

    " The rheumatics seldom need  lay a patient up if he
will adopt  the simple dietetic expedient of eating a
certain quantity of  fresh  mustard with every meal,
much if he is worse than usual,  a little if he is pretty
comfortable."— (Chambers.)
                      Recipe 59.
                   Celery-Toast.
    Cut up  some sticks of  celery and boil in a little
water until tender;  add some milk,  stew for a  while, 
106
DIET IN DISEASE.
salt and pepper to taste, thicken slightly with flour,
pour this over some soft  toast, and eat as you would
asparagus.
   It  is claimed  by many that  cooked  celery is of
benefit in chronic rheumatism, and there  is sufficient
testimony to this  effect  to make  it worth a trial.  I
offer it on the authority of  a writer  in  the Medical
Record, having had no experience with  it myself.

                  Diet in Asthma.

   Asthmatics are generally dyspeptics, and for such
cases more  is to be done on the side  of  the stomach
than in any other direction.
   The following plan of dietary has proved to be of
great benefit in the treatment of this disease.  It  was
first employed by a prominent English physician.
   First by proper treatment get the bowels to acting
regularly.
   " After baving attended to the general secretions for
about  ten days, the strict dietetic treatment is to be
begun.
   " The diet  is  to  be  regularly weighed  out,  and
adhered to  with the greatest strictness, the hours of
meals  being most rigidly fixed as follows:
   " Breakfast at eight a. m.,  to  consist of half a  pint
of tea or coffee, with a little cream, and two ounces of
dry stale bread.
   " Dinner at one p. m., to  consist of two ounces of
fresh  beef  or  mutton, without fat or skin, and  two
ounces of dry stale bread  or well-boiled rice; three
hours  after dinner (not sooner), satisfy the thirst with
as much milk, toast-water, koumiss, or other beverage,
as is desired. 
DIET IN ASTHMA.
107
   " Supper at seven  p. m., to consist of two ounces of
meat as before, with  two ounces of dry stale bread.
   "The patient is  not  allowed to drink any  fluid
whatever within one  hour before  his dinner or supper,
and not within three  hours after  either of  these meals.
At other times  he is not limited as to drinks, except
that the use of all malt liquors is to  be prohibited.
Soda or seltzer-water  may be indulged in at other times
when thirsty."
   Dr. Pridham says of this method:
   " Under this treatment in a few days the distressing
symptoms may be expected  to subside, and after the
regimen has been strictly persevered in for at least a
month, two  ounces more of meat may be permitted  if
digestion is  found to  be sufficient.  The stomach must
not have more  to do than it  can  accomplish.  The
powers of digestion are known to be recovering when
the stomach craves  for food as  the hour of nourish-
ment arrives.   If flesh is gained, strength improves;
and while the tongue cleans, the  appetite improves
the distention of  the stomach  lessens, and  there is
sufficient evidence that the powers of digestion  are
recovering.   Great  encouragement is  then given to
follow up the line of treatment which is here indicated.
The patient  ought also to be  able to sleep six or seven
hours at a time, and to lie  in bed  all the night.  If
these results follow, the ultimate cure of the case may
be looked for."
   This makes a very spare diet—more so than many
patients are willing to submit to.  For such it may be
modified and rendered more tolerable by Dr. Salter's
dietary in Asthma, which is as follows:
   " Breakfast: —A cup of bread and milk, an egg, or
a mutton-chop,  or some cold chicken or game.  Tea is 
108
DIET IX DISEASE.
 better than  coffee,  and milk  and water better than
 either.  Dinner:— Mutton  ought to be the staple diet;
 beef or lamb rarely, pork  or  veal never.   Succulent
 vegetables or potato may be eaten,  and a little farina-
 ceous pudding or  stewed fruit, or fruit out of a tart,
 should conclude the dinner.  Water is the best fluid to
 drink, and there should be no cheese and no dessert."
 A light tea should be taken.
   The  quantity of food eaten should be small, and
 therefore highly nutritious,  extremely digestible, and of
 the simplest and plainest kind.


              Diet  in Heart Disease.

   In organic  disease of the heart the kind of food
 taken is not of so great importance as the  quantity
 that is taken at one  time, and the relative amount of
 liquids and solids.
   The indications of this disease are to —
   Take but a small quantity of food at a time;
   Let  the  food  contain but  a small proportion of
 liquids to the amount of solids;
  "Drink  but a small quantity of liquid at any one
 time;
   Drink no cold water or cold liquids  of any kind.
   In heart  disease the circulation of the blood is  so
 obstructed that absorption takes place very slowly,
 and hence if a large quantity of liquid  be ingested it
remains a long time in the stomach, thus not  only
interfering with digestion, but, by its  proximity to the
heart, embarrassing  the latter organ in its action.
   Hence, a patient  with heart disease should take a
dry diet.   Do  not  begin a  meal by taking  a dish of
soup.  Take liquids  by the  teaspoonful, or only a sip 
              DIET IN CHRONIC ALCOHOLISM.         109

 at a time, during meals.  At  other times, also, drink
 should be  sipped  only,  and not swallowed  down, a
 gobletful at a time, as is  the habit with many.  Take
 all the water that the thirst demands, only take it in
 the manner directed.
    Whatever solid food is taken should be highly nutri-
 tious  and  largely composed  of meats.   Let  beef,
 mutton, chicken, oysters  and game form a prominent
 part of the diet, with a fair proportion of vegetables.
 In a word, the patient should have a rich, nourishing
 diet.
    No alcohol in any shape should be taken by a person
 with heart disease.  In enforcing this I cannot do bet-
 ter than give the words of Dr. Chambers:
    " Alcohol  is really   the  most  ungenerous   diet
 possible.   Addiction to it impoverishes the blood,  and
 is the surest  road to that degeneration of muscular
 fibres which is so much to be feared.   And in diseases
 of the heart it is especially hurtful, by quickening the
 beat, causing capillary congestion and irregular circu-
 lation, and mechanically  dilating the  cavities."

           Diet in Chronic Alcoholism.
    In  trying  to overcome the  appetite for alcoholic
 beverages much aid may  be derived from  a judicious
 regulation of the diet.  The supply of alcohol should
 be cut off at once.   The  diet  should  then  be  made to
 consist entirely of farinaceous food and fruits.   The
 victim should  eat no meats, chesse, eggs, nuts  or other
foods of this character, but the  diet should be limited
 to the starchy foods alone, bread, oat-meal, potatoes,
and other vegetables.
   He should  also eat freely of fruits.   Let him take
some fruits at every meal,  and  eat all  of  them that he 
110               DIET IN DISEASE.
can  between meals.   He should  indulge  freely in
apples, oranges, bananas, grapes, peaches, pears and
all kinds of berries.  In a word, he should become a
strict vegetarian, for vegetarians do not become hard
drinkers.
                  CHAPTER XII.

     Diet in Diarrhoea and Dysentery.

   A person  suffering  from diarrhoea should take as
little food as is possible to get along with—the less the
better.  That  which  is taken should be light and easy
of digestion, and such as will not irritate the mucous
lining of the bowels.
   But in acute attacks it is best to take no food what-
ever.  The patient will not suffer from  this fasting,
and in many cases recovery will  quickly  follow if he
simply  maintain  the  recumbent posture, and take
nothing but cool water or lemonade.
   But  if the attack be  protracted it is necessary to
judiciously nourish the patient.
   If the  food be  cool the diarrhoea will be  sooner
arrested than if warm food be taken.
                     Recipe 60.
               Milk and  Lime-water.
   Let the patient drink iced-milk containing a table-
spoonful of lime-water to the gobletful of milk.   Take
small quantities at frequent intervals. 
          DIET IN DIARRHC3A AND DYSENTERY.       Ill

   In many cases this is sufficient, and nothing more
need be taken.   It is  refreshing,  nourishing, and at
the same time astringent.

                     Recipe 61.
                    Rice Gruel.
    Boiling milk, -            one pint;
    Ground rice,    -         one tablespoonful.
   Wet the rice with cold milk, making  a smooth
paste, and stir this into the boiling milk.  Boil for ten
or fifteen minutes, stirring well, for it will easily burn.
Salt to taste.

                     Recipe 62.
                    Boiled Rice.
   Boil some rice for one  hour in sufficient water to
cover it.   Season with salt or butter and serve plain or
with milk.
   If properly 'cooked this is an  excellent dish in
bowel diseases.   It should be  cooked long  enough to
completely soften the  grain. If the grain of the rice can
be felt when pressed between the thumb and finger it
is not done. If the grain  be  hard it  will  irritate the
bowels, but if  well softened  it  is  easily digested,
entirely assimilated, and is one of the best foods that
can be used in bowel diseases.

                     Recipe 63.
                  Thickened  Milk.

   Milk, thickened with flour  and seasoned with salt
makes an excellent dish in diarrhoea. 
112
DIET IN DISEASE.
            Diet in Chronic Diarrhoea.
   Chronic Diarrhoea requires a greater variety and
more nutritious food.  Give the most digestible kinds
of meat, mutton and chicken, and soft eggs.  Meat
broths,  thickened with sago or flour, are good.   Rice
with milk may be added.  Avoid the use of vegetables—
except mealy potatoes—and  all food that is relaxing
to the bowels.

                Diet in Dysentery.

   Much that has  been said on  diarrhoea will also
apply to this disease.  But in dysentery fasting is not
of so great importance,  although a light diet only
should be indulged in.
   Cold drinks often aggravate the colic which accom-
panies many cases of dysentery.
   A diet consisting exclusively of milk is  of as great
value in this  disease as in  diarrhoea.    Take it as
recommended on page 91.  It may be taken cold if it
does not aggravate the colic.
                     Recipe 64.
                       Eggs.
   Eggs may be given either raw  or  soft-boiled.  If
cooked,  no other form than boiled eggs should be used.
Raw eggs, beaten up in milk and seasoned with sugar,
make a  palatable and nutritious dish, especially useful
in dysentery.
                     Recipe 65.
                    Raw Meat.
   Raw meat,  finely scraped with a spoon so as to
form a pulp, is an excellent dish.  It may be spread on 
DIET IN CHOLERA.
113
a piece of toast or stale bread,  and salted.  Chew the
bread well so that no hard pieces find their way into
the stomach.  This  is very nourishing and does not
aggravate the disease by irritating the bowels.  It may
be used in either acute or chronic cases.
   Avoid the use  of fruits and succulent vegetables.

                 Diet in Cholera.
   During the prevalence  of  a cholera epidemic all
persons should be very guarded in what they eat.
   Avoid all food which has a tendency to derange the
stomach or  to  relax the  bowels.  Eat  sparingly  of
vegetables : eat no pickles,  cucumbers, squash,  green-
corn, unripe fruit, or other food that is relaxing to the
bowels.
   Drink no ice-water, and avoid the use of alcoholic
stimulants.
                During the Attack
no food whatever is required.  The incessant  thirst
from which the patient suffers it is hard to gratify, for
water taken into the stomach aggravates the vomiting.
And yet the patient  should receive all the water that
he craves if he  can retain  it.   If this is impossible,
much  benefit  may be derived  from holding  small
pieces  of  ice  in  the  mouth  until  they melt away.
Injections of  warm milk may be used with advantage
if nothing can be  taken by  the stomach.
                 After the  Attack
no solid food should be taken until  the stools are  consis-
tent and fcecal.
   Great care must be observed during convalescence.
An attack of indigestion at this time is often followed
by a fatal relapse. 
114
DIET IN DISEASE.
   At first only farinaceous food should be given, and
this in small quantities, frequently repeated.  Rice, thor-
oughly cooked, corn-starch, thickened milk, arrowroot
and the like, may be first taken.
   Milk, however, is to  be preferred even to this, and
if the patient can take it, nothing  else need be sought
for.
   Meats.  When greater variety  is called for, soups
and broths containing no vegetables, may be given, and
after this meats which are simply  prepared and easily
digested.
   Vegetables.   This  should be the last form of food
resumed, and during convalescence the use of all vege-
tables must be strictly prohibited.

               Diet in Diphtheria.
   To keep the patient well  nourished is an important
part of the treatment of diphtheria, for while it  is a
very exhausting disease, at the same time the throat is
often in such a condition that it is almost impossible
to get the patient to swallow any food  whatever.  The
pain on swallowing is so great that even adults will
sometimes suffer  the pangs of hunger  and endure
thirst rather than take food or water.
   It is therefore important to begin to give a diphtheritic
patient an abundance of nourishing food as soon as the
disease has announced itself.
   Begin with  soft eggs and milk.   Let  the patient
drink all the milk that he can be induced to  take.  A
glass of milk with an egg beaten up  in it should be
given at as frequent intervals as it can be taken by the
patient.
   In the stage of  depression, milk, eggs, and wine or
brandy are called for, as the patient then needs  stimu- 
DIET IN DIPHTHERIA.              115
lating, as well as nourishing.  Milk-punch, and similar
preparations, will fulfil the indications.
                     Recipe 6G.
                   Milk Punch.
    Milk,    -    -         One tumblerful;
    Brandy,               - Two dessertspoonfuls.
   Sweeten the milk well and stir in the  brandy thor-
oughly.   Give very cold, with ice.
                     Recipe 67.
                    Egg Nogg.
              Yolks of  two eggs;
              One gobletful rich milk;
              Tablespoonful sugar ;
              Tablespoonful brandy.
   Beat the egg-yolks up well with the sugar; stir this
well into the milk and then add the  brandy.
                     Recipe 68.
                   Egg Coffee.
   Make a cup of  strong coffee—add boiling milk one
half; sweeten a little more than usual; beat the white
and yolk of  an egg together thoroughly.  Boil the
coffee, milk and sugar together and pour this over the
beaten egg, in a cup, as you are  about to  serve it.
   This is nutritious and stimulating, and of as great
value as the preparations containing alcohol.
   If the patient can no longer swallow, he should be
nourished by nutrient enemata.  In this way many
lives may be saved, for otherwise the patient will perish
of exhaustion from want of food.
   Inunctions of oil will also help to keep up nutrition.
Rub the legs and the  abdomen well  with  olive oil,
repeating the process several times a day. 
116               diet in disease.
                Diet in Gastritis.

   In inflammation of the stomach very little food of
any kind can be taken,  and during the height of the
attack, when the  stomach  is much inflamed,  there
must be an abstinence from all food.
   Whatever food is taken must be cold.
   Let the  patient take small pieces of ice in the
mouth, and some bits  of ice may be swallowed.
   Often ice-cream can be taken when all other food is
rejected.   This is soothing,  cooling, and at the same
time nutritious. Iced-milk may in some cases take the
place of ice-cream.
   Lemonade may be drunk if the patient crave and
retain it.
   As improvement progresses, and the patient is able
to take a greater variety, give starchy foods only, such
as barley-water,  rice,  arrow-root and the like, but no
meats.  The meats are digested in the stomach, while
the starchy foods are digested in the canal beyond the
stomach.
   If the attack be  protracted, and nothing can be
retained on the stomach, as is sometimes the case, then
the patient must  be  nourished by nutrient enemata.
   Exceedingly great care must be observed in return-
ing to a solid diet after the attack, as any indiscretion
is liable to be followed by a relapse. Take no meats or
solid food.  If milk agree,  nothing more is required.
When  a  change is made, broths and gruels may be
added.  The first  solid food taken may be oysters, raw
or stewed.  These will often agree when the stomach
will tolerate solid food of no  other kind. 
DIET IN BILIOUSNESS.
117
                Diet in Biliousness.

   In that disturbance  of the liver commonly known
as "biliousness," regulation of the diet will promote
recovery.
   Avoid the use of highly seasoned and  stimulating
food.   Take no spirituous or malt liquors.   Take no
heavy meats, sweet or oily articles of  food.  Let the
diet be light and easy of digestion, consisting mainly
of vegetable food.  Eat moderately, and  avoid  over-
loading the stomach.
   In jaundice the patient should eat an abundance of
green vegetables at every meal, and  drink  freely  of
cold water.
                  CHAPTER XIII.

            Diet for  Convalescents,

   After a long spell of sickness, with the derangement
which  the  digestive organs generally  undergo,  it is
often difficult to tempt the returning appetite.  Nor is
it necessary to urge the matter if the patient is doing
well, and not suffering from want of food.   There is
little desire  for food so long as the  tongue retains its
coating, and it will be found that the returning appe-
tite will keep pace with the cleaning  of the tongue.
   After recovery is so far advanced as to admit of a
more generous diet, the following recipes will help to
settle the much-vexed question — " What shall I eat ?" 
118
DIET IN DISEASE.
                     Recipe 69.
                  Mutton Chops.
   When the patient is prepared to indulge in a meat
diet, mutton chops will be found to be very acceptable.
They should be broiled over a clear fire for six or seven
minutes;  turn frequently, and  do not prick with a
fork.  Serve  hot;  season with  salt  and pepper after
they come from the fire.
                     Recipe 70.
                       Game.
   Pigeon, quail and snipe, are especially acceptable to
the convalescent, and will tempt the returning  appe-
tite.  Broiling is the best mode of cooking.

                     Recipe  71.
                     Chicken.
   Tender spring  chicken may take  the place of the
game when the latter is not to be had.  It is very nice
broiled, or may be stewed or fricasseed.

                     Recipe 72.
                     Omelette.
            Two eggs;
            One cupful buttermilk;
            One-third teaspoonful soda;
            Three tablespoonfuls flour.
   Beat up the eggs, stir them into the buttermilk with
the flour, add the soda, some  salt,  and  stir  all to a
creamy consistence.  Put three tablespoonfuls of this
batter onto a hot, buttered griddle.  When one side is
brown, fold it on itself, turning  one half on the other.
Serve hot and eat with butter or syrup. 
diet for convalescents.
119
   It can also be made with sweet milk and baking
powder.
                     Recipe 73.
                    Milk Toast.
   Pare off the crust from stale, light bread;  slice half
an inch thick and toast quickly.  Dip each slice, as i„,
comes from the toaster, in boiling water.
   Butter thinly, sprinkle a little salt over, and  lay in
a deep, covered dish.
   Have ready in a sauce-pan enough boiling mill to,
cover the toast well.  Thicken  this a very little with
flour, being careful that it is not lumpy.  Salt this jnilk,
melt  in  it a bit  of butter,  and pour over the  toast.
Cover closely  and let it  stand five minutes  before
serving.
                     Recipe  74.
                  Potato Surprise.
   Scoop out the inside of a sound  potato, Uaving the
skin attached on one side of the hole, as a lid.   Mince
up finely the lean of a juicy mutton-chop,  with a little
salt  and pepper, put it in the potato, pin down the lid,
and bake or roast.  Before serving — in the skin — add
a little hot gravy if the mince seems to be  too dry.
                      Recipe 75.
                    Tomato  Soup.
   Peel  six good-sized tomatoes  and cut them into
small pieces; put them into a sauce-pan, with a quart
of water, and boil until tender; season with salt and
pepper.   Now stir into the water half a teaspoonful of •
baking-soda.   Lift  the kettle  from  the  stove when
stirring  in the soda, or the soup  will run over as it
foams.   Boil again, and add a pint of sweet milk. Put 
120
DIET IN DISEASE.
 broken crackers into a  dish, pour the soup over them
 and serve immediately.
    This is an excellent  dish for convalescents, being
 often taken with relish  when nothing else tempts the
 appetite.  It  may  be used in all cases except where
 there is a tendency to looseness of the bowels.

                      Recipe 76.
                    Sago Custard.

             Two eggs;
             One pint milk;
             One tablespoonful sago.

    Boil the sago in a little water till clear; add the
 milk and let  it come to a boil, then add the eggs, well
 beaten, and sugar  to taste.  Put the vessel containing
 the custard into another vessel of boiling water; stir
 till it thickens a little.   When partly cold flavor with
 lemon or vanilla.

                      Recipe 77.
                   Spanish  Cream.

             One quart  milk;
             Yolks of three eggs;
             One-half box gelatine;
             Two tablespoonfuls sugar.

    Soak the gelatine for an hour in the milk, put on
 the fire and stir well as  it warms.   Beat the yolks very
. light with the sugar, add to the scalding milk, and heat
 to boiling point, stirring all the while.
    Flavor with vanilla  or lemon.  When almost  cold,
 put into a mould wet with cold water. 
              DIET for convalescents.           121

                     Recipe 78.
                  Baked Custard.
            Two eggs;
            One pint milk;
            Two tablespoonfuls sugar.
   Scald the milk: beat the yolks up with the sugar,
add  this to the milk, and when  well mixed stir in the
whites, previously beaten light.  Flavor to taste.  Pour
into  cups and bake until firm.  Eat cold from the cups.

                     Recipe 79.
                 Arrowroot Jelly.
    Boiling water,         -   one cup;
    Arrowroot,    -            two teaspoonfuls;
    White  sugar,     -   -    two teaspoonfuls.
   Dissolve the sugar in the cup of water; put this on
the fire and bring it to  a boil.   Wet the arrowroot in
a little cold water, and rub it smooth.   Stir this into
the hot water while it is boiling.  Add one teaspoonful
of lemon-juice and keep  it boiling until it is  clear.
Wet  a cup  in cold water, and pour in the jelly to form.
   Eat when cold, with cream and sugar. This is a
delicate dish and will  tempt many a dainty appetite.

                     Recipe  80.
                 Sago  Blanc-mange.
            One pint milk;
            One-half pound sago.
   Soak the sago in cold water for four hours.  Heat
the milk and stir in the soaked sago. When it has dis- •
solved, sweeten to taste.   Boil slowly fifteen minutes,
stirring all the time;  take from the fire, flavor, beat 
122               DIET IN DISEASE.
until nearly cold,  pour  into  moulds  dipped in cold
water.   Turn out and eat with sweetened cream.
                     Recipe 81.
                 Floating  Island.
          One pint milk;
          Two eggs;
          Two tablespoonfuls white sugar;
          Teaspoonful vanilla extract.
   Beat the yolks well, stir in the sugar, and add the
hot, not boiling, milk, a  little at a time.   Boil until it
begins  to thicken.   When cool add the flavoring, pour
into  a  glass dish, first stirring well.   Heap upon it a
meringue  of the whites beaten to a froth.  This well-
known dish makes a very agreeable one for the sick
or convalescent.
                     Recipe 82.
                 Cottage Cheese.
   Heat sour milk until the whey  rises to  the top.
Pour off the whey, put the curd in a bag and let it
drip for six hours, without squeezing it.  Put  it in a
wooden bowl,  chop fine with a wooden spoon,  salt to
taste, and work to the consistence of soft butter, add-
ing a little cream and butter as  you proceed.  Mould
into  balls  and keep  in a cool place.   It must be eaten
when fresh.
   There are few nicer dishes than this for the sick or
convalescent.
   Besides  these   domestic dishes,  preparations of
malt, extract of malt or maltine, will help to build up
the atrophied tissues and hasten the return of strength.
   Recipes for other dishes which can be used  in con-
valescence will be found  in the next chapter. 
RECIPES.
123
                  CHAPTER XIV.

                     Recipes.

   In this chapter will be found  recipes for a great
variety  of dishes,  and  from  among these  can be
selected something adapted to almost every case of ill-
ness, if not found in the body of the book, under its
appropriate head.

                    Beverages.

   To allay the thirst from which the sick so often
suffer, especially in fevers, is not the least important
part of the treatment.   A proper supply of liquid not
only helps to moderate  the  fever, keep the  kidneys
active, make the tissues soft and the membranes moist,
but it also adds to the patient's comfort, and prevents
to a great extent that restlessness with which it is so
frequently accompanied.
   Fever-patients, especially when there is  delirium or
stupor, in which conditions they are unable to make
their wants known,  often suffer from want of water.
In all such cases water should be offered at frequent
intervals.
   But pure water, if taken too freely, is apt to disor-
der the  stomach and bowels.   It is found that the
addition of certain  substances to water  greatly in-
creases its power to quench thirst.  Acids, in particular,
seem  to possess  this  power.  A weak infusion of
cascarilla  or  orange  peel, acidulated  slightly  with 
124
DIET IN DISEASE.
hydrochloric  acid, was, with  Dr. Graves, a  favorite
thirst-allaying drink for fever-patients.
    The following recipes will afford an ample variety
for all cases:
                      Recipe 83.
                  Raspberry Syrup.
    Put 6 pounds of raspberries into  a china or glass
bowl, with a quart of water in which has been dissolved
2£ ounces of citric (or tartaric) acid, and let it remain
24 hours; then strain it, taking care not to bruise the
fruit.  To each pint of clear liquor add 1£ pounds of
loaf sugar,  and stir it till dissolved. Leave it for a few
days and then bottle securely.
    A little of  this syrup in water forms a refreshing
drink for fever-patients.

                      Recipe 84.
                 Strawberry Syrup
may be made  according to the same rule, using  two
ounces of citric acid.
                      Recipe 85.
                 Raspberry Vinegar.
    Put a pint  and a half of the best wine-vinegar to
three pounds   of raspberries, in a glass or porcelain
vessel; let this stand for two weeks, then strain without
pressure.  Put into bottles, well-corked.

                      Recipe 86.
                 Raspberry Vinegar.
    Mash the raspberries in a  crock,  cover well  with
pure  cider  vinegar.   Let  this  stand  for  twenty-four
hours, giving it an occasional stirring. 
RECIPES.
125
   The next day strain off the vinegar and juice into
another crock, containing the same quantity of mashed
berries as first used.
   Let this stand until the  following day, when the
juice should be again strained off.
   Now add one-half the quantity of water that  you
have vinegar, and to this mixture add three pounds of
white sugar to each quart.
   Now stir over a gentle fire until the sugar is  dis-
solved.  Bring slowly to the boiling point, skimming
meanwhile, and as  soon  as it  boils,  strain again.
Bottle immediately and seal the corks well.
   A  tablespoonful  or more to a  glass of  ice-water
makes a very refreshing drink in sickness.
                     Recipe  87.
                   Jelly Water.
    Jelly,    -                 one tablespoonful;
    Ice-water,   -              one goblet.
   Any jelly may be used,  currant-jelly, cranberry-
jelly,  or other kind.  Very  tart jellies are the  best.
Stir up the jelly in the ice-water until the two are well
mixed.
                     Recipe 88.
                    Apple-water.
               One large, juicy apple;
               Three cups cold water.
   Let the apple be a juicy, finely flavored one.  Pare
and quarter it.   Put on the fire in a closely-covered
sauce-pan, with the water, and  boil until  the apples
stew to pieces.  Strain the liquor as soon as it is taken
from  the fire, pressing the apple  hard in the cloth.
Set away to cool.   Sweeten to taste with white sugar.
Drink ice-cold. 
126
DIET IN DISEASE.
   This is a very refreshing and  palatable drink, and
forms an agreeable change from the more  common
ones.
                    Recipe 89.
                  Lemon Whey.
   Put a quart of new milk into  a sauce-pan  and stir
it over the fire until it is nearly boiling; then  add the
juice of  one lemon and let it simmer for fifteen min-
utes, skimming off the curd as  it  rises.  Add the juice
of another lemon, skim for a few minutes, strain, and
it is ready for use.
                    Recipe 90,
                   Wine Whey.
    Fresh milk,     -            one pint;
    Sour wine,    -              one wineglassful;
    Sugar,   -                  one teaspoonful.
   Put the milk into a  shallow sauce-pan and bring it
to the boiling point.  Pour in half the wine, stir gently
and let  it simmer, and skim off  the curd which rises.
After a  few minutes pour in the rest of the wine, skim
the remaining curd, sweeten, and when cold it is ready
for use.
   Good in fevers.
                     Recipe 91.
                  Whey Powder.
    Sugar-of-milk,    -             two ounces;
    Powdered white sugar,    -      eight ounces;
    Gum Arabic, powdered,     -   one ounce.
   Mix.  Dissolve half an ounce of this in a pint of
water.  This  makes a demulcent  drink for use in bron-
chitis, pleurisy or pneumonia. 
recipes.                   127
                     Recipe 92.
                 To Whiten Whey.
   Beat up the white of an egg with  a portion of the
whey, mix with the rest, boil for a moment and run it
through a jelly-bag.
                     Recipe 93.
                   Mint Water.
    Boiling water,    -              half a pint;
    Green spearmint leaves,   -      a handful.
   Bruise the leaves, put into a dish, cover with boil-
ing water;  steep fifteen minutes.  Drink hot  or cold.
   Good in  nausea.
                     Recipe 94.
                 Tamarind Water.
    Tamarinds,     -    -    one tablespoonful;
    Ice-water,              -  one gobletful;
    Sugar,    -              one teaspoonful;
   Stir the tamarinds  in  the  water  until  dissolved;
strain and  sweeten.
   Good in  constipation.
                     Recipe 95.
                     Lemonade.
   Take two lemons, wipe clean and peel very  thin*
being careful to cut  off none  of the pith, or white.
Now cut off all the pith and throw it  away.  Cut the
lemons into thin slices, take out all the seeds, put the
slices and the rind of one lemon into a pitcher, add a
tablespoonful of sugar, pour onto these  a  pint and a

   * In preparing lemon-peel for flavoring, pare very thin shav-
ings from the surface, getting in none of the white, as this will
render it bitter. 
128               DIET IN DISEASE.

half of boiling water; cover and stand on the ice to
cool.  When cold, strain into another pitcher and it is
ready for use.
   Although this involves more time and attention
than is usually given to the making of lemonade, yet
the superior quality obtained well repays the extra
trouble.
                     Recipe 96.
             Iceland  Moss Lemonade.

            One handful Iceland Moss;
            Two quarts boiling water;
            Two lemons.
   Wash the moss in two* waters.   Peel and slice the
lemons, throwing away the peel. Mash the sliced lemon
up with four tablespoonfuls of sugar; mix this with
the moss, and  pour over it the boiling water.  Let it
stand until cold.  Sweeten to  taste, and take it  ice-
cold.  If too thick, add cold water.

                     Recipe 97.
               Flax-seed Lemonade.
       Four tablespoonfuls whole flaxseed;
       One quart boiling water;
       Juice of two lemons;
       Sugar to sweeten.
   Put the flaxseed in a  pitcher, pour on the  boiling
water, cover it and let it steep  for three hours.  When
cold add the lemon-juice and sweeten to taste.   If too
thick, thin  with cold water.
   Let the patient  have it  ice-cold.  The last  two
recipes  make  soothing drinks  in  throat  and  lung
troubles. 
RECIPES.
129
                     Recipe 98.
                  Egg Lemonade.

   Beat up one  egg to a  froth; make one goblet of
lemonade, using the juice of an entire lemon; sweeten
to taste, stir in the egg and add pounded ice.
   This is  a  delicious and refreshing drink for the
sick, and has, moreover, some nutritive value.

                     Recipe 99.
                  Hot Lemonade.

    Lemon-juice,    -    -    two tablespoonfuls;
    Boiling  water,     -    -  one gobletful;
    Sugar,     -              one tablespoonful.

   Put  all into a hot bowl and stir for  a few minutes.
Drink hot.
   Good when it is desired to induce a perspiration.

                    Recipe 100.
                    Lemon-ice.

            Six lemons;
            One large  sweet orange;
            One pint of water;
            One pint of sugar.

   Grate the peel of three of the lemons, and remove
the rind of  the orange.  Squeeze  out  every drop of
juice from the orange and all the lemons, and steep it
in the rind of  orange and lemons one  hour.  Strain,
squeezing the bag dry: mix in the sugar, and then the
water.   Stir until dissolved, and freeze in  a freezer,
opening three times to mix all together. 
130
DIET IN DISEASE.
                    Recipe 101.
                   Barley-water.

            One pint boiling water;
            Two ounces pearl barley;
            Lemon-peel and sugar.
   Wash the barley well in two or three waters.  Put
this  into a pitcher,  together with a tablespoonful of
sugar and the peel from a quarter of  a lemon, cut very
thin.  Pour onto this one pint of boiling water.  Cover
the pitcher and let it stand on ice until cold.  When
cold strain into another pitcher and it is ready for use.

                    Recipe 102.
                Thick Barley-water.

   Wash the barley as in R. 101.  Put it in a sauce-pan,
pour over it two quarts of cold water, bring to a  boil,
and let it boil for two hours.  Pour into a pitcher with
the thin peel of half a lemon; set it  on ice to become
perfectly cold.   When cold,  take  out the lemon-peel
and sweeten to  taste.

                    Recipe 103.
                   Barley-water.

    Boiling water,    -    -    two cups;
    Barley,              -      two tablespoonfuls.
   Wash the barley and soak it half an hour in a little
luke-warm water, and stir, without draining, into the
boiling water, salted very slightly.  Simmer one hour,
stirring often.   Sweeten to taste and strain  before
using.   This may be used temporarily as a substitute
for milk when the latter disagrees. 
RECIPES.
131
                     Recipe 104.
                   Oatmeal-water.
     Oatmeal,               -   two tablespoonfuls;
     Cold water,    -    -      one pint;
    Stir the meal into the water, and let it stand one
 hour; strain and drink cold.
    A refreshmg drink in hot weather.  Good in consti-
 pation.

                     Recipe 105.
                   Tapioca-water.
     Tapioca,    -          -   one tablespoonful;
     Cold water,         -    - one gobletful;
     Boiling water,              one pint.
    Wash the tapioca and soak it in the cold water two
 hours; pour the boiling water over it and  boil slowly
 until the tapioca is dissolved.
    Food in sickness of the stomach.

                    Recipe 106.
                    Sago Milk.
     Sago,    -                 one tablespoonful;
     Cold water,  -    -         one teacupful;
     Fresh milk,    -    -    -  one quart.
   Wash the sago and soak it over night; put it into a
farina kettle;  boil  till clear; sweeten.   Drink hot or
cold.

                    Recipe  107.
                 Rice-flour Milk.
    Boiling milk,    ~    -     two cups;
    Rice-flour,    -           two tablespoonfuls. 
132               DIET IN DISEASE.
   Wet the rice-flour  up with cold milk,  and stir it
into  the  boiling milk.  Let  it  boil  for ten  minutes,
stirring all the time.   Sweeten to taste and eat warm
with cream.
   This makes a simple, yet nourishing, dish for the
sick.
                    Recipe 108.
                    Toast-water.
   Cut thin slices of bread, and toast till nicely brown,
with no suspicion of burning.   Put several such slices
into  a bowl and pour over enough boiling  water to
cover.   Cover the bowl closely, and let it  steep  until
cold.  When cold, strain, sweeten to taste and put a
piece of  ice into each  glass.  It may be flavored with
lemon-juice.
   This may be freely indulged in.  It is of very slight
nutritive value, and must not be  depended upon as a
food.
                     Recipe 109.
                      Elm Tea.
   Take nice slippery-elm bark, break it into  bits, pour
boiling water over it, cover and let it stand until cold.
Take with ice, and sweeten if desired.

                     Recipe 110.
                Gum  Arabic  Water.
           Gum Arabic, two teaspoonfuls;
           Hot water,  one pint;
           Sugar,  one  teaspoonful;
           Lemon-juice of one lemon.
    Put all into a pitcher: keep it on  a hot  stove  till
 the gum is dissolved.  Use when cold. 
RECIPES.                  133
    The last two may be used as demulcent drinks in
throat troubles and coughs.

                     Recipe 111.
                   Cafe au Lait.
    Fresh, strong coffee, and boiling milk, equal parts.
    Strain the hot coffee through some muslin into the
pot from which it is to be  served.  Add the hot milk
immediately, set the pot  on the  hot stove for five
minutes, and it is ready to  serve.

                     Recipe 112.
                 Coffee and Egg.
   Make a cup of strong coffee, adding boiling milk as
usual, only sweetening rather more; take an egg, beat
yolk and white together thoroughly; boil  the  coffee,
milk and sugar together, and pour it over  the beaten
egg in the cup in which you are going to serve it.
   This  simple recipe is used frequently in hospital
practice.  A  sick person,  needing  nourishment  and
having lost appetite, can  often be sustained by this
when nothing else can be taken.

                     Recipe 113.
                    Egg-Water.
             Cold water, one gobletful;
             Whites of two eggs;
             Sugar to sweeten.
   Stir the eggs gently into the water, but do not beat
them; add the sugar, or a  little salt.
   This is a bland,  and yet nourishing, drink,  which
can be taken by a delicate stomach, when  everything
else is rejected. 
134               DIET IN DISEASE.

                    Recipe 114.
                    Egg-Nogg.

    One egg;
    Milk,   -                one gobletful;
    Sugar,   -              two teaspoonfuls;
    Wine,  -                two tablespoonfuls;
    Powdered sugar,    -    one tablespoonful;
    Powdered ice.
   Break the  yolk of the  egg and the sugar together
and  stir  them into the milk;  add the ice and wine.
Lastly, beat the white of  the egg to a froth and whip
it in.

  0                  Recipe 115.
                  Rennet Wine.

   Cut one calf's rennet  into pieces an inch square;
put into a  bottle with a  quart of sherry wine; cork
tight  and set in a cool place.   After  standing forty-
eight  hours,  it is  ready for  use.  One tablespoonful
will coagulate one quart of milk.

                    Recipe 116.
                  Rennet Whey.
    Fresh, warm milk,    -     one quart;
    Salt,    -                 one saltspoonful;
    Rennet wine,    -     -     one tablespoonful.
   Add the salt and the wine to the milk, stirring only
till mixed.  Let it  stand until cold.   When  it has
coagulated, cut the  curd  across several times with a
knife, to free the whey.  Strain through muslin.
   Eat with a little cream added. 
RECIPES.
135
               Broths and Soups.

                 To Stew Oysters.

    Take one quart of liquid oysters, put the liquor (a
teacupful for three persons), in a stew-pan, and add
half as much more water; salt;  a good bit of pepper;
a teaspoonful of rolled cracker for each person.   Put
on the stove and let it boil; have your oysters ready in
a bowl.  The moment the  liquor begins to boil pour in
all your oysters, say ten for each person.  Now watch
carefully, and as soon as it begins to boil take out your
watch, count just thirty seconds, and take your oysters
from the stove.
   You will have your big dish  ready with one and a
half tablespoonfuls of  cold  milk  for  each person.
Pour your stew on this milk and serve immediately.
Never boil an oyster in milk.—(Delmonico.)
                    Recipe 117.
                   Oyster Broth.
    Oysters,     -               -  one pint;
    Cold water,    -              one half pint;
    A little salt and pepper.
   Cut the oysters into small pieces, put into a sauce-
pan  with water  and salt,  and  simmer ten  minutes;
skim, strain off the broth, and add  the pepper.  A
little milk may be added for those who prefer it.
Serve hot, with toast.
                    Recipe 118.
                  Mutton Broth.
    Lean mutton,   -     one and a half pounds;
    Cold water,   -    -   one quart;
    Salt to season. 
136
DIET IN DISEASE.
   Free the mutton  entirely from fat;  cut it up fine;
put it into a saucepan with the water and salt and
stew it for two hours.   Thicken slightly with flour.
   When cool, remove  all fat from the surface.  Heat
a small quantity, as required.
                    Recipe 119.
                   Chicken Soup.
              One young chicken;
              Cold water, two quarts;
              Salt.
   Cut the chicken up, and pound until the bones are
broken;  add the water and salt, and stew for two
hours; when done strain it, and let it cool.   Remove
all fat, and heat as required.
                    Recipe 120.
                    Veal Soup.
   Take  one pound of  veal—almost any cut will do—
put it into one quart of cold water, salt, boil slowly for
two hours.   Before taking from  the fire stir in a little
flour, previously  made into a thin paste with cold
water, and free from lumps.
                    Recipe 121.
                 Raw-Beef Soup.
   Chop  fine one pound of raw beef, put it in a bottle
with one pint of water and five drops of muriatic acid.
Let this  stand  on the  ice  all night.  In the morning
set the bottle in a pan of water at  110° F. for about
two hours.  Strain through a cloth  until the mass  is
nearly dry.  If the raw taste be objectionable, the beef
to be used should be roasted quickly on one side; then
make as  above. 
RECIPES.
137
    This beef soup may be substituted for milk in those
 cases  in which the latter is called for but cannot be
 taken.
                     Recipe 122.
                   Beef Essence.
     Lean, juicy beef, -              one pound;
     Cold water,    -    -         - one pint;
     Salt to season.
    Free the beef from fat, and pound it; broil it two
 minutes over a very hot fire; mince it fine; put  it into
 a jar  with the cold water and  salt, and let it soak
 several hours; tie a cloth over the mouth of the jar,
 set it in a kettle of cold water, bring this to a boil, and
 let it boil slowly for ten hours.   Strain and season.
    Other recipes for beef-tea will be found in  Chap-
 ter IV.

                      Gruels.

                     Recipe 123.
                  Oatmeal Gruel.
    Take three  ounces of oatmeal and  boil slowly in
four pints of water, till reduced  to two pints.   Strain
through a sieve.  Add milk if it is wanted thin.
                     Recipe 124.
                  Cornmeal Gruel.
    Cornmeal,  -              -    one cupful;
    Boiling water,  -         -    -  one quart;
   Make a  thin  paste of the meal, mashing out all
lumps.   Stir this into the  boiling water, letting  it boil
for three-quarters of an hour, being careful that it does
not burn.  Salt to taste. 
138               DIET IN DISEASE.
                    Recipe 125.
                   Sago Gruel.

    Water,   -              two cupfuls;
    Sago, -         -     -  two tablespoonfuls;
    Sugar,   -         -    three teaspoonfuls.

   Put the sago into water and warm it by setting in
a saucepan of boiling water.  Keep it hot for one hour,
stirring often.  Now boil it for ten minutes,  stirring
well;  season with lemon or vanilla, and pour into a
bowl to cool.   Eat it either warm or cold.

                    Recipe 126.
                 Arrowroot  Gruel.

   Take  three  teaspoonfuls of arrowroot  flour; mix
this into a soft paste with a little cold water; pour
upon  this half a pint of boiling water, stirring well
until  it is thoroughly mixed;  boil for five minutes,
add some milk and a little salt, and sweeten to taste.

                    Recipe 127.
                  Farina Gruel.

    Farina,   -              one tablespoonful;
    Boiling water,    -   - one pint;
    Salt,     -    -    -    a pinch.

   Sprinkle the farina  into the water as it boils, stir-
ring briskly to prevent  lumps forming.  Season with
salt, and simmer half an hour.
   Just  before removing from the fire, stir in a table-
spoonful of cream. 
RECIPES.
139
                     Recipe 128.
     Rice,      -         two tablespoonfuls;
     Cold water,  -    -  one cupful;
     Fresh milk,    -    a pint and a half;
     Sugar and salt.
    Wash the rice and soak it in cold water  one hour;
put into a farina  kettle  with the milk and simmer
until the rice  is well done.   Strain  through a wire
sieve and season.
                     Recipe 129.
                     BOUILLIE.
    The bouillie commonly used in France as the first
food for infants, is made by gently roasting the best
wheat flour in an oven, then boiling it for a consider-
able time  either in water, or in  milk and water, and
adding sugar.

                   Vegetables.

                     Recipe 130.
                     Asparagus.
    " Bind the asparagus  in a bundle with a piece of
tape, keeping the buds all one way;  cut the stalks of
equal length, and be careful to cut off all that is tough.
Put it into  a  porcelain-lined  kettle,  with  enough
slightly-salted boiling water to cover,  and boil until
tender.   Season delicately with  butter and  pepper,
and more salt if desired."
                     Recipe 131.
                 Baked  Potatoes.
   " Wash  and wipe dry as many potatoes as are re-
quired, being careful to  have them of uniform size. 
140               DIET IN DISEASE.
Bake in  a brisk oven  until they yield to pressure
between the fingers;  remove at once from the oven
and  break the skin to let out the steam.  Serve im-
mediately with salt, butter and pepper."
                    Recipe 132.
                 Stewed Celery.
   "After  the celery has been thoroughly washed, cut
the stalks  into pieces four or five inches long, lay them
(all one way) in a saucepan, with just enough slightly-
salted, boiling water to cover.   Boil slowly until ten-
der, drain, and season with butter and pepper."  Of
reputed value in rheumatism.

                     Bread.
                    Recipe 133.
                   Rice Bread.
   Make a sponge of
   Warm water,  -    -    one quart;
   Yeast, -     -   -    -  one teacupful;
   White sugar,  -    -    one tablespoonful;
   Lard,   -                 two tablespoonfuls;
   White flour,   -    -    one quart.
   Beat well together, and  in about five hours, when
it has risen, add three pints of warm milk, and three
teacupfuls rice-flour wet to a thin paste with cold milk,
and boil four minutes,  as  you would  starch.   This
should be  little more than luke-warm when it is stirred
into the batter.   If not  thick enough to make into a
dough, add a little wheat flour.  Knead thoroughly,
and treat  aj you would wheat bread in  the matter of
two risings and  baking.  This is a nice  and delicate
bread for  invalids, and  keeps well. 
RECIPES.
141
                     Recipe 134.
            Unfermented Brown Bread.
    Mix three pounds of brown-flour wilh ten drachms
 of bicarbonate of soda; make this  into a dough with
 twenty-five ounces of cold water containing twelve and
 a half fluid drachms of  muriatic  acid.   Bake im-
 mediately it is prepared.

                     Recipe 135.
                   Bread Panada.
   Place in a saucepan  some very thin slices of bread-
 crumb, and rather more water than will cover it.  Boil
 until the bread becomes pulpy, strain off the super-
 fluous water, and beat  up  the remainder  to the con-
 sistence of gruel.   Season to taste.  Some prefer it
 sweetened, while others  eat it with salt and pepper.

                    Recipe 136.
                       Rusk.
   Toast dry crusts of bread in a moderate oven until
 they are well browned;  do not let them burn.  When
 cold, pound in a mortar, or grind  fine in a coffee-mill,
 until  reduced  to a  coarse meal.  Eat in a dish  with
 milk  or cream, as you would  mush.   Sweeten  if
 desired.

                    Recipe 137.
                 Cracker  Panada.
   Split ten small oyster crackers,  spread each piece
with butter, and lay them  in a bowl.  Sprinkle  with
sugar, pour on enough hot water to cover, and grate a
little nutmeg over them.  Cover  the bowl and let it
stand five minutes. 
142
DIET IN DISEASE.
                     Recipe 138.
                  Cracker Panada.
          Six Boston crackers;
          Two tablespoonfuls white sugar

   Split the crackers and pile in a bowl in layers,  the
sugar and a  little salt scattered among them.  Pour
enough boiling water on them to cover them,  and set
on the hearth, closely covered for more than an hour.
   Eat from the bowl, with more sugar,  if  desired.
The  crackers  should  be  clear, soft and jelly-like,  but
not broken.

                     Recipe 139.
                   Bread Sauce.
   Crumb up two slices  of  stale bread, or two  dry
biscuits; pour on this half a pint of hot water; season
with salt and pepper; boil until it is  smooth and add
a piece of butter.  A  little onion will lend it zest  for
some.

                    Recipe 140.
                 Bread  Jelly.

   Cut the crust  from some slices of stale bread, and
toast nicely without burning.  Pile in a bowl, sprink-
ling sugar and a little salt between;  cover well with
boiling water, and set, with a tight lid on top, in a pan
of boiling water.  Simmer well until the contents of a
bowl are like  jelly.  Eat  warm with  powdered sugar
and nutmeg. 
RECIPES.
143
         Blanc-Manges and Custards.
                    Recipe 141.
             Arrowroot Blanc-Mange.
    Milk,     -              one teaspoonful;
    Arrowroot,   -            four teaspoonfuls;
    Sugar,    -              two teaspoonfuls.
   Make a smooth paste of the arrowroot, with  cold
water.   Stir this into the milk while the  latter is boil-
ing.  Add the sugar,  flavor with vanilla,  stir all the
time and boil until it thickens.  Turn out, and when
cold eat with cream.
                    Recipe 142.
               Arrowroot Custard.
    Boiling milk,  -     -    two  cupfuls;
    Arrowroot,        -    -  three teaspoonfuls.
    One egg and two tablespoonfuls white sugar well
        beaten together.
   Wet the  arrowroot up with a little cold milk, mix
this paste with the  boiling milk,  and stir for  three
minutes.  Take it from the fire  and whip in the egg
and sugar.   Boil  two  minutes longer, flavor with
vanilla or other extract, and pour into moulds.
                    Recipe 143.
                  Tapioca Jelly.
    Cold water,  -        -    -  three cupfuls;
    Tapioca, -                   one cupful;
    Juice of one lemon.
   Put  the  tapioca in a two-quart basin, and pour
over it  sufficient water to cover it. Let it soak four
hours.    Now set the basin in a saucepan of boiling 
144
DIET IN DISEASE.
water; pour more warm water over it, if it is too thick.
Keep the water in  the saucepan boiling, and stir the
tapioca frequently.  Cook until it becomes clear.   If
too thick at this  time,  put in a very little boiling
water.   When quite clear, put in the lemon-juice and
sweeten to taste.  Pour into molds.  Eat cold, with
cream, flavored to  suit.
   This will be found to be an excellent dish, easily
digested, simple, and very tempting to the sick.
                    Recipe  144.
               Farina  Blanc-Mange.
    Milk,     -              one pint;
    Farina,     -           two tablespoonfuls.
   Heai the milk to boiling; stir in the farina and a
little salt.  Boil for twenty minutes in a farina-kettle.
Flavor  and sweeten to taste  and pour into moulds.
Set in a cool place.  Eat with cream and sugar.
                     Recipe  145.
               Tapioca Blanc-Mange.
    Tapioca,  -           one cupful;
    Boiling milk, -    -    three cupfuls;
    White sugar, -    -    three tablespoonfuls.
   Soak the tapioca four hours in two cups cold water,
and stir the whole into the boiling milk.  Sweeten and
boil slowly for fifteen minutes, stirring all the while.
Take off, flavor to suit,  and  pour into moulds.
   Eat  cold  with cream.   Wash  the tapioca well
before soaking.
                     Recipe 146.
                  Tapioca Pudding.
    Take an ounce of tapioca, soak it in an ounce of
cold water for two hours;   pour off this water,  add a 
RECIPES.
145
 pint and a half of milk and boil slowly until it is well
 incorporated;  stir into this one-half ounce of sugar
 beaten up with two eggs.   Season with lemon.
                     Recipe 147.
                  Gelatine Jelly.
    Place one ounce of gelatine in half a pint  of  cold
 water—soak for ten minutes;  add half a pint of boil-
 ing water and stir until the gelatine is dissolved.   Add
 the juice of two lemons, sugar, and the white of an
 egg, well beaten;  stir  these in, boil for two or three
 minutes, strain through a jelly-bag, and let it set.
                     Recipe 148.
             Gelatine  Charlotte Russe.
     One pint cream;
     One-half ounce gelatine, dissolved in a cup of hot
 milk;
     Whites of  two eggs;
     Two tablespoonfuls of  white sugar.
    Whip the cream light, beat the  eggs to  a  stiff
 froth, and mix these and the sugar all three together.
 Flavor  with lemon  or  vanilla, and last  beat  in the
 gelatine, which should be quite cold before  it is added.
 Pour into a dish and set on the ice.  This is a nice
 dish for those who can take anything so rich.
                     Recipe 149.
              Jelly  of Iceland Moss.
            One handful Iceland moss;
            One quart boiling water;
            Juice of  two lemons.
   Wash the moss in five waters, and  let it soak for
an  hour in  a little cold water.   Now stir  it into  the 
146
DIET in disease.
boiling water and simmer until it is dissolved.  Put in
the lemon-juice,  sweeten  to  taste and strain into
moulds.
                    Recipe 150.
                  Chicken Jelly.
            Half a spring  chicken;
            One quart cold water.
   Break all the bones  by pounding the chicken with
a mallet, bones and meat together.   Put this in  a
saucepan, pour on the cold water, cover the vessel,
and let it simmer slowly until the meat is reduced to
shreds and the liquid boiled down one-half.
   Now remove it from the fire, strain it, and press  it
first through a cullender, then through a coarse cloth.
You will have now a thick liquid which you can salt to
taste  (pepper if allowable).  Return it to the fire and
let it  simmer  five  minutes longer.  Pour into a dish
and skim when cool.  This will, when cold, set into  a
jelly.   It is best to keep it on the ice.
   Slice it up  and give to the patient cold, just off the
ice.  It may be eaten  alone, or with  toast, Albert
biscuit,  or  unleavened wafers.  It is very nice made
into  sandwiches by putting  the jelly between thin
slices of bread spread lightly with butter.
   This chicken jelly is  one of  the most delicate meat
dishes for the  sick.  It can be given in a great variety
of cases, it is easily made and very tempting to  a
dainty appetite.  Some patients  can  take this cold
when nothing  else  of a solid nature can be eaten. 
SOUPS and broths.             147
                   CHAPTER XV.

               Soups and Broths.

   A diet which  is adapted to the wants of the sick
 must consist largely of dishes which are liquid in form,
 because an irritable stomach,  or  one which is in any
 way enfeebled by disease, is not equal to the demands
 which  solid  food would make upon  it.   Therefore
 liquid food, which is so much more easy of digestion,
 must form a very important part of  the invalid's
 dietary.  Such  dishes  must  be both  palatable  and
 nutritious.  The  most important class of liquid food
 consists of soups and  broths.
                    Recipe 151.
                Stock, or Bouillon.

  In  making stock  always begin with cold water.
  Salt  should never be  added until the  meat is tho-
 roughly done.  If put in  early it hardens  the meat.
  To each pound of fresh, lean meat,  allow one quart
 of cold water.
  Have the bones well cracked, and extract the marrow,
 which should be put into the pot.
  Put the beef, bones  and water into a covered vessel
 and set it where it will heat gradually.
  Let it boil very slowly for six or seven hours.
  Look at it occasionally to see if the water is sinking
too rapidly.
  Should this occur,  replenish  with  boiling water,
taking care not to add too much. 
148               DIET  IN DISEASE.
  When it has boiled seven hours, pour it  out of the
iron pot into a crock, and let it stand, well covered, till
the next day.
  About an hour before  it is wanted for use,  remove
the cake of fat which will have formed on the surface,
and take out the meat and bones.
  Strain the stock back into the iron pot, through a
napkin placed in a colander, so that no bones, meat or
sediment shall pass.
  Set it over the fire, and when warm throw in a little
salt to bring up the scum, which must be skimmed off.
  Made in this way, this is the stock for bouillon; if, in
the cooking, it be allowed to boil down one-half,  instead
of replenishing with hot water, it is soup stock.
  With  this stock, by the addition of different season-
ings or vegetables, a great variety of bouillons, or soups
may be  made.

             General Considerations.

  Stock is the most  important part of soup-making—
it is the basis of the soup.
  Soup stock cannot  be made "in a hurry;" good soup
requires two days.
  Fresh meat only must be used—it cannot be made
from old scraps.
  The least bit of tainted meat will spoil a whole mess
of soup.
  Season  in moderation—it is difficult to restore  a
soup which has been  over-seasoned.
  Soup  stock should be allowed to cool slowly—if
cooled too quickly it will not keep so well.
  Do not allow stock to become cold in an iron vessel
—if it cannot be kept constantly warm on  the stove, 
BOUILLON.
149
 it must be put into an earthen  crock  until wanted
 for use.
   In winter any kind of stock ought to keep good for
 a week.
   In warm weather  three days  is about as long as it
 will keep.
   Vegetables should not be put into soup more than
 an hour before it is wanted; if put in too soon they make
 the soup sour and spoil the flavor.
   On the second day  soup should not be allowed to
 boil more than half an hour after ebullition begins.
   The difference between bouillon and soup  is that the
 latter is  "boiled  down,"  or reduced by  prolonged
 boiling.  Soup is richer, but less delicate than bouillon.
 Bouillon, also, gives the best flavor of the meat.
   When milk or cream  are to be added to soup,  they
 should first be brought to a boil, and added while hot.
   When eggs are added to soup, beat them thoroughly
 and add while the soup is hot,  but  not boiling.   The
 best plan is to beat up the egg with a little of the warm
 soup, and then add it gradually.
  Recipe No. 151,  for making bouillon, is  that which
gives the best article.   However, it can be, and often
is, made on the same day that it is wanted for use, but
it is always best if prepared the day before.  If it is to
be used  on  the same day that it is made,  proceed as
already directed until the six or seven hours cooking
has been completed.  About an hour before it is wanted,
remove the meat, empty the pot, and carefully strain
the stock back into it;  then add seasoning and  vege-
tables,  according  to  the variety of soup or bouillon
desired. 
150
DIET IN DISEASE.
                    Recipe 152.
                    Beef-Tea.

      Fresh, lean beef    -    -  one pound;
      Cold water -         -    one pint.
  Free the meat from all  fat, gristle and bones, cut
it into fine pieces,  and soak it  two hours in the cold
water.   Now put it into a double boiler, and let the
water in  the  outer vessel boil three hours.   Then
strain,  and season to taste  with  salt  and pepper.
Skim off all fat,  and serve hot.
                    Recipe 153.
                    Beef-Tea.
      Lean Beef -         -    one pound;
      Cold water    -            one pint.
  Chop the meat very fine, and let it soak in the water
one  hour; put  all  into a stout bottle,  set this in  a
kettle or sauce-pan of  warm  water,  and let the latter
boil  one hour.  Strain  the beef-tea from the  bottle,
season and serve.
                    Recipe 154.
                  Mutton Broth.

      Lean Mutton     -    -    one pound;
      Cold water    -            one quart.
  Free the mutton  from fat, and cut it into thin slices
with a  sharp knife;  put  it  into a suitable dish with
the cold water, but no salt, and let it  boil until the
meat falls to pieces—about an hour and a half. Strain
it,  add pepper and  salt  to taste,  and what other
seasoning is desired, and let it  simmer  half an hour
longer.   Serve hot. 
CREAM OF RICE.
151
                     Varieties.
  This broth can be enriched by adding a teacupful of
hot milk five minutes before it is  removed from the
stove.
  It can also be prepared with a tablespoonful of rice,
previously soaked in warm water.   The rice should be
cooked  in a separate dish until soft, then pressed
through a sieve, and added to the broth at the time
that it is strained.
  It may be flavored with celery, parsley, tomato,  or
any other seasoning, as given in Recipe No. 157.

                     Recipe 155.
                   Chicken-Broth.
      Chicken  -                   one-half;
      Cold water -    -    -      one quart;
      Celery    -                     a little.
  Chop  the  chicken into neat  pieces, breaking the
bones and  removing  all fat;   put it into  a  small
sauce-pan, add the water and celery, and let it simmer
for two hours.   Salt and pepper to  taste, strain into a
bowl, remove any fat that may remain on the surface,
and serve.
                     Recipe 156.

                  Cream of Rice.
    Rice     -             one-half teacupful;
    Chicken stock    -               one quart;
    Milk     _____   one pint.
  Wash  the rice carefully,  picking out all imperfect
grains,  and put  it into  the stock,  made according to
the last Recipe (No. 155).  Let it simmer for one hour,
adding a little boiling water if it  gets  too low.  Now 
152               DIET IN DISEASE.

take out the rice, rub it through a sieve,  return it to
the stock; season to taste,  and, just before serving,
add the  milk,  which  has been allowed to come  to
a boil.
  Invalids soon tire  of plain beef-tea  or plain broth, if
given day after day.  This difficulty,  however,  may be
overcome by using a variety of seasoning,  which will
render the broths more  agreeable to the palate, and
vary  that monotony which would  otherwise   attend
their  use.
                     Recipe 157.
                    Seasonings.
  Therefore, in preparing beef-tea or  broth, from time
to time season with  some one of the following:
            1. A little chopped celery.
            2. A little chopped parsley.
            3. A few blades of mace.
            4. The juice of a lemon.
            5. A very little onion.*
            6. A little strained tomato.
            7. Asparagus, when in season.
            8. A few cloves.
                     Recipe 158.
                    White Soup.
    Soup stock   -          -    - one quart;
    Tapioca  -                    one-half cup;
    Cream       -                 one pint;
    Cold water     _    _     _    one-half pint;
    Small onion       -            sliced;
    Mace     -    -    -     -    a little.
* According to Sydney Smith's judicious advice,
  "Let onions' atoms lurk within the bowl,
  And, scarce suspected,  animate the whole." 
BISQUE.
153
  Let the tapioca be soaked over night;  add it  to the
stock, and boil them together one hour.
  In another vessel put the cream, water, onion and
mace,  and salt and pepper to taste.  Let this simmer
twenty  minutes, and  them strain it into the  stock.
Serve immediately.  It must not be left on the stove.

                    Recipe  159.

                      Bisque.
    Tomatoes   -           one quart can;
    Milk      -              three pints;
    Flour  -         -     - one tablespoonful;
    Soda      -              scant tablespoonful.
  Put the tomatoes on to  stew.  Put  the milk in a
double boiler, reserving a cupful to mix with the flour.
Mix the flour carefully  with  the cold milk, stir  it into
the boiling milk, and cook ten minutes.
  To the tomato add the soda, stir it well, and then rub
it through a strainer tine enough to keep back all the
seeds.   Now add to the milk salt and pepper to taste,
and a small piece of butter;  then add the tomato, and
stir all well together.   Serve immediately.
  If half the quantity is made  stir the tomato well in
the can before taking out half.
  This makes a very delicate and nourishing soup, for
either an invalid or the table.

                    Recipe  160.
                   Sago  Broth.
    Soup stock  -    -         -  one  quart;
    Sago      -                    one-half cup;
    Egg   ----- one  yolk. 
154
diet in disease.
  Soak the sago two hours in a little warm water; add
it to the stock, previously warmed, and let them simmer
gently one hour, stirring often.  Beat the yolk with a
little  of the warm broth, add it, let it boil up once,
season to taste, and serve.
  This is a nice broth, simple and nourishing.   Eat
with dry toast.
                    Recipe 161.
                Smoked-Beef Broth.
    Chipped beef     -    -   one-half pound;
    Cold water     -         - one pint;
    Sweet milk -    -    -   one pint.
  Put the beef into a  double boiler, and cover  with
cold water.  Let it heat slowly—it must not  boil.
  When it has simmered  for an hour add the pint of
milk, which has already simmered in another vessel,
and then remove it from the fire at  once. Strain and
season to taste.
  If this should become cool it may  be rewarmed, in
a double boiler, but it must not boil.  Boiling  will curdle
the milk.
  After an attack of of biliousness or of sea-sickness,
this is easily retained by the enfeebled stomach, and it
is very refreshing.
                     Recipe  162.

                  Mock Clam-Soup.
   Take a piece of codfish four  inches  square;  boil it
 for fifteen minutes each time, in two or three waters.
 Then pour off all the water and cover it with one pint
 of  cold milk and  one pint of cold water; boil for one-
 half hour, and strain.  Season to taste. 
CREAM OF CELERY
155
  This makes a  very good substitute for  clam soup.
It may be made  stronger or weaker to suit the palate.
                    Recipe 163.
                 Cream  of Celery.
    Soup stock   _    _   _    _  0ne quart;
    Celery    -                  three stalks;
    Cream  -----  one-half pint.
  Cut the three stalks of crisp celery into  half-inch
pieces and put them into a sauce-pan; add one-half
of the stock, and boil for one hour.  Now strain  all
through a sieve,  rubbing the  celery through, putting
the pulp thus obtained,  together with the  broth, into
a sauce-pan, and add the other  pint of stock; boil;
set  on one side of the stove to keep hot.
  Boil the cream, and add it to the soup, stirring all
the time.  Season to taste with  salt and pepper, and
serve with small pieces of toast.

                 Miscellaneous.
                    Recipe 164.
                   Baked Potato.
  Select a nice potato, and bake it in the usual manner.
  When it is done, cut off one end.  With  a fork care-
fully scoop  out  the contents of the potato from the
skin;  season it with pepper,  salt, a little butter and a
teaspoonful  of cream; beat it  up with a fork until very
light, and then put it back into the skin from which it
was removed. Let it  brown over the top in a quick
oven, and then serve.
  This is a nice way to serve  potato for an invalid or
convalescent.  By holding the  potato in a napkin it
can be easily managed with a fork. 
156
diet in disease.
                    Recipe 165.
                 Cracker Gruel.
  Crumble a soda-cracker into a cup of cold milk; let
it stand two or three hours.  Now put it into a sauce-
pan with another cup of cold milk ; add pepper,  salt,
and a teaspoonful of butter.  When it comes to a boil,
drop in a whole egg.  Remove instantly from the fire
and beat until it is light.

                    Recipe 166.
               Unleavened Wafers.
  Mix good, dry flour to a stiff dough with milk (water
can be used) and a little salt; roll out thin.  Cut into
round cakes,  and roll these again almost as thin  as
letter-paper.  Bake very quickly.
  These are simple, palatable, and go well with all kinds
of broths and soups.  Try them.

                    Recipe 167.
                 Cream Lemonade.
              White of one egg;
              Juice of one lemon;
              Some chopped ice;
              3 teaspoonfuls fine sugar;
              4 tablespoonfuls cream.
  Beat  the white of the egg to a dry froth,  add the
sugar and strained lemon-juice,  beat well together and
pour  into a tumbler  half-full of chopped ice.  Now
slowly fill the tumbler with cool sweet cream, while
constantly stirring the mixture.
  This is tempting,  refreshing and nourishing. 
miscellaneous.
157
                     Recipe 168.
              Iceland Moss Lemonade.
     Iceland moss     -         -  one teacupful;
     Boiling water -              one quart;
     Lemons                   _  two;
     Sugar and ice -              sufficient.
   Wash the  moss  in five waters; pour the  boiling
 water on it, and leave till cold. Add the lemons, peeled
 and sliced, leaving out the peel.  Sweeten well, and
 add ice.  Do not strain.  If it thicken too much, add
 cold water.
   This  is a nice lemonade  to be used in pulmonary
 disease, to allay thirst and cough.

                    Recipe  169.
                 Slippery-Elm Tea.
   Break the  elm-bark into  bits,  pour boiling  water
 over it to cover, and let it stand till cold; sweeten and
 add ice.  A little lemon-juice may be added.

                    Recipe 170.
                   Cough Syrup.
   Strain the  juice of three lemons, and add as much
 sugar as can be moistened in it; then add  six  table-
 spoonfuls of cold water, and one teaspoonful of pow-
 dered gum-Arabic. Let it simmer over a slow fire until
 the sugar is melted.  When a smooth syrup is formed,
 remove, and allow it to cool.
  This  can be  given in  teasponful doses,  to allay
cough.  It can be made without the gum-Arabic if this
 is  not at hand.  It is easy to make and easy to take,
and so simple that no physician will object to its use. 
* 
INDEX.
Albumen-water.......................... 43    Blanc-manges............................. 143
Alcoholism, diet in..................... 109    Bran-water................................  88
Alcohol in fevers........................ 50    Breads....................................... 140
        in heart disease............ 108    Bread, brown............................  62
Alimentation, rectal................... 72           jelly,...........................45, 142
Alkali in milk............................. 24           rice................................ 140
Alkaline drink........................... 105           sauce...........................71, 142
Apples, baked............................. 71           unfermented...............63, 141
Apple-water..........................69, 125    Bright's disease, diet in..............  90
Arrowroot.................................. 16    Broth, chicken........................... 151
         jelly........................... 121         '  mutton............................ 150
Asparagus................................... 139           sago................................ 153
Asthma, diet in........................... 106           smoked-beef.................. 154
Austen, Miss.............................. 57    Broths................................  135,147
                                     Butter.........................................  18
Baby, to nurse............................  37
      to wean............................  39
      to feed..............................  41
Baked potato.......................... ■ ■•■ 155
Banting.......................................  16
Barley-water......................... 30, 130
Bartholow, Dr...........................  13
Beale, Dr....................................  65
Beef....................................... 13,  76
    essence...............................137
    broth...................................  53
Beef-tea, in cholera infantum.....  42
         recipes.....................51, 150
Beverages................................... 123
Biliousness, diet in..................... 117
Bisque......................................... 153
Bonny-clabber...........................  57
Bottle, care  of.............................  34
Bouillie......................................139
Bouillon...................................... 137
Buttermilk................................  49
          159
Cafe-au-lait................................. 133
Casein......................................... 23
Celery, stewed........................... 140
Chambers, Dr............................. 90
Charlotte russe........................... 145
Cheese...................................... 14
Chicago water............................ 27
Chicken.................................14, 118
        broth........................53, 151
        jelly.............................. 146
        soup............................. 136
Chlorosis..................................... 103
Cholera, diet in........................... 113
         infantum..................... 40
Churchill, Dr.............................. 82
Clabbered-milk.......................... 15
Clam-soup................................... 154
Clark, Sir C................................. 21
Cod-liver oil.......................... 18, 80
            in consumption....... 77 
160
INDEX.
Cod-livei'uil, insciofula............  100
Codfish....................„..................  59
Coffee and egg...........................  133
Collapse......................................  103
Condensed milk.........................  23
Constipation, diet in..................  66
Consumption, diet in.................  75
Convalescence, diet in...............  117
Corpulent, diet for the...............  97
Corn..........................................  17
Corn-starch................................  16
Cottage-cheese...........................  122
Cough-syrup..............................  157
Cracker gruel.............................  156
Crackers.....................................  59
Cream.........................................  18
Cream lemonade........................  156
Cream of celery..........................  155
Cream of rice.............................  151
Curd..........................................  23
Custard.....................................•..  143
        arrowroot......................  142

Diabetes, diet in.........................  83
          milk cure..................  89
Diarrhoea, diet in.......................110
                 chronic...........  Ill
Digestion, aids to.......................  64
Digestive fluid...........................  65
Diphtheria.................................  114
Dysentery, diet in......................  110
Dyspepsia, diet in.......................  55
Dyspepsia-crackers.....................  59

Eggs...................................... 14,  112
Egg and coffee............................  115
Egg-nogg....................... 52, 115.  134
Eggs and milk...........................  91
Egg-water..................................  133
Elm-tea.......................................  132
Enema, beef-tea.........................  73
        blood.............................  74
        cod-liver oil..................  75
        milk..............................  73
Ewing, Mrs. E. P.......................  56
Extract of meat.........................103

Farina blanc-mange...................144
Fats..................................... 18,  23
Fevers, diet in...........................  47
Fish...........................................  14
Flint, Dr.....................................  13
Florence Nightingale.................  31
Flour-ball..................................  44
Foods..........................................  11
      classification of.................  12
      organic............................  12
      inorganic..........................  19
      nitrogenized,..................  12
      non-nitrogenized............  15

Game.........................................118
Gastritis, diet in........................ 116
Gelatine................................ 15,  26
         charlotte russe............ 145
        jelly............................. 145
Gluten bread..............................  86
       cakes.............................  87
       flour..............................  85
       gems..............................  86
       mush..............................  87
       pudding.........................  88
       wafers.............................  88
Goat's milk.................................  22
Graham flour..............................  17
Gravel, diet in............................  92
Graves, Dr.................................  47
Green-sickness........................... 103
Gruels......................................... 137
Gruel, arrowroot........................ 138
       cornmeal........................ 137
       farina.............................. 138
       oatmeal..........................137
       rice................................. 139
       sago................................. 138
Guillot, M...................................  41
Gums.........................................  18
Gum-water,................................  26

Heart-disease, diet in................ 108
Hominy......................................  71
Hypophosphites.........................  82

Iceland-moss jelly...................... 145
Iodine__...................................  18
Inunctions..................................  18
Iron............................................  19

Jaundice....................................117
Jelly-water ...............................125 
INDEX.
161
Koumiss....................................  78

Lemonade................................. 129
           cream...................... 157
           egg............................ 129
           flaxseed.................... 128
           hot........................... 129
           Iceland mo-s.......... 128
Lemon-ice................................... 129
Lemon-whey............................. 126
Lime-water................................  27
Litmus-paper.............................  32

Malt infusion..............................  65
     extract..............................  82
Marion Harland.......................... 60
Meats..........................................  13
      salted................................ 14
Meat, extract of.......................... 137
      raw................................... 112
Milk............................................  15
     of wet-nurse.....................  38
     in Bright's disease............  90
     butter..............................  15
     clabbered..................... 15, 60
     cow's..................................  23
     condensed....................... 23
     in diabetes........................  85
     in fevers.............................  48
     goat's................................  22
     and lime-water..................  27
     punch................................130
     thickened.......................... Ill
     toast...................................119
Mock clam-soup........................ 154
Musculine.................................  13
Mutton  ...... ..............................  13
       broth........................ 52, 150
       chops.............................. 118
Mush.................................... 70, 71

Niemeyer...................................  91

Oatmeal......................................  17
        gruel........................ 49,  70
        water.................. 29, 68, 131
(Esophagus, stricture of..............  73
ails.............................................  17
Oil, olive....................................  18
 Omelette.................................... 118
 Oysters....................................... 14
 Oyster-broth.............................. 135

 Panada, bread...........................141
         cracker........................ 142
 Pepsin......................................... 64
 Phosphate-of-lnne..................... 19
 Porridge.................................... 69
 Pork.......................................... 14
 Potato, baked............................. 155
 Potatoes............................. 17, 139
 Potato-surprise........................ 119
 Pridham, Dr............................... 107

Raspberry syrup........................ 124
           vinegar..................... 124
Recipes......................................123
Rennet wine.............................. 134
Rheumatism, diet  in.................. 104
Rice............................................Ill
Rice-flour milk........................... 131
Rickets, diet in...........................101
Routh, Dr...................................  41
Ruddock, Dr.............................. 103
Rusk.........................................141

Sago............................................  16
    blanc-mange.......................121
    broth...................................153
    custard...............................112
    milk.................................... 131
Salt....................................... 19,  28
Salts, in milk..............................  24
Salter. Dr...................................107
Scarlet-fever, diet in.................. 54
Schmier-kase........................... 61
Scrofula, diet in..........................100
Scurvy, diet in........................... 102
Sea-sickness, diet in.................... 95
 Seasonings................................. 152
 Soups.......................................... 135
 Soups and broths.......................147
 Soup, chicken............................. 136
       raw beef........................... 136
       veal...«.............................136
 Smoked-beef broth.....................154
 Spanish cream.......................... 112
 Starches................................... 16 
162
INDEX.
Stock.......................................... 147
Stomach, ulcer of........................ 116
         inflammation of......... 116
Strawberry syrup....................... 124
Sugar ........................................  16
Sugar-of-milk........................ 24,  27

Tamarind-water.......................   69
Tapioca blanc-mange................. 144
        jelly.............................. 143
        pudding........................ 144
        water........................... 131
Tissue-builders...........................  16
Toast..........................................  56
     water................................. 132
Tomato-soup...............................119
Travelers, diet for.......................  93
Typhoid fever...........................„  53
Typhus fever..............................  54
Veal..........................................  14
Vegetables.................................. 139
Vogel.........................................  25
Venison......................................  14

Wafers, unleavened..............62, 156
Water................................... 19,  27
      Chicago...........................  27
      Waukesha........................  27
Wet-nurse, to choose..................  37
Wheat.........................................  17
Wheaten grits.............................  70
Whey, wine...............................  43
       lemon.............................125
       powder.......................... 126
       rennet.............................134
       to whiten........................126
White soup............................... 152
Wine-whey........................... 43, 126 
                       (LIQUID.)

  For Dyspepsia,  Mental  and Physical
     Exhaustion, Nervousness, Dimin-
              ished Vitality, Etc.

Prepared according to the directions of Prof. E. N. Horsford,
                of Cambridge, Mass.

  A preparation of the phosphates of lime, magnesia, pot-
ash and iron with phosphoric acid in such form as to be
readily assimilated by the system.
   Universally  used by physicians of all schools.
   It is not nauseous, but agreeable to the taste.
   No danger can attend its use.
   Its  action will harmonize with such stimulants as are
necessary to take.
   It makes a delicious drink with  water and  sugar only.
   Prices Reasonable.  Pamphlet giving further particulars
mailed free.  Manufactured by the
             Rumford Chemical Works, Providence, K. I.
FOR SALE BY
          GROSS  &  DELBRIDGE,
48 Madison St., CHICAGO. 
      Beef  Peptonoids.
A Concentrated Powdered Extract of Beef, Partially Digested
       and Combined with an Equal  Portion of Gluten.
   We have pleasure in presenting, for the consideration of the Medical Pro-
fession, "BEEF PEPTONOIDS."  We consider this product the most valuable
that ever emanated from our Laboratory, and we feel confident it will be
welcomed by the Profession in all parts of the world.

   BEEF PEPTONOIDS contains only the nutritious portions of the beef.
It contains no water and no inert matter of any kind.  We combine the dry
Extract of Beef with an equal portion of Gluten to prevent a tendency to
deliquescense, and in order to present the  preparation in a powdered and
portable form.  Itis well known that Gluten is the most nutritious substance
found in the Vegetable Kingdom, and in nutritive elements is closely allied to
Beef.
   Four ounces of BEEF PEPTONOIDS represents as much nutritive and
stimulating properties as forty-eight ounces of the best lean Beef.

   Four ounces of BEEF PEPTONOIDS contains more nutritive elements
than ten pounds of any  extract made by Liebig's formula, and from four to
bix times more Albuminoids and Fibrinoids than any Beet Extract ever
ofiered to the Medical Profession.

   The favor our preparation of BEEF PEPTONOIDS received at the hands
of Drs. Agnew, Hamilton, Bliss, Reyburn, Woodward. Barnes. &c, the corps
of eminent Physicians,  who employed the preparation with so much advan-
tage in the treatment of the late President Garfield, p  oves conclusively its
great value, not only as a food to  be taken by the mouth, but also, how inv
port ant an agent it has be> n found in feeding by the Rectum.

   Please refer to the  very able  article  of Dr. D. W. Bliss, in New York
Medical Record, July 15th, 1832, in which he so  frequently refers to BEEF
PEPTONOIDS, having  been used to so great an advantage, not only in the
case of the late President Garfield, but many others as well.

   We employ a reliable and experienced person to select the Beeves before
they are slaughtered, and to superintend the killing and dressing.  Greatcare
is exercised in this respect, and none except the  most healthy and suitable
beeves are employed in making our BEEF PEPTONOIDS.

   The use of BEEF PEPTONOIDS is indicated as follows:

   Convalescence from all Diseases. Fevers, Pneumonia, Weak Digestion,
Diarrhoea, Dysentery, Phthisis. Cholera Infantum, Marasmus, Sea Sickness.
Excessive use of Alcoholic Stimulants, Per Rectum in all cases where the
Stomach cannot digest  the food, and in debility resulting from any cause.
Also, a valuable adjunct in voyages and camp life.

   We will be pleased to have the Profession everywhere test our assertions
regarding this preparation, and for that purpose  we will be happy to mail a
sample to any regulai practitioner desiring it; also, circulars fully explanatory.

   Thanking the  Profession for generous  support in the past, we beg to
remain,
                 Very respectfully.

                           REED  & CARNRICK.

                                      182 Fulton St., New fork.
FOR SALE  BY

              GROSS & DELBRIDGE,

                               48 Madison St., Chicago. 
 
 
 
NLM051649028