a day, for a few days, according to the case,—two parts of milk to one
of cream. If the urine is scanty, he reduces it to one and one half
pints a day, taken in four or five installments. After the three to
seven days of milk diet he gradually introduces starches and fats.
* * * * *
=Brights Disease.= This term covers forms of diseases of the kidneys,
associated with albumin in the urine.
Where for any reason the kidneys have difficulty in discharging the
nitrogenous waste of the system, the work of the dietitian must be to
eliminate protein from the diet as closely as may be consistent with
the body necessities. Besides restricting the amount of nitrogenous
foods, the kidneys must be assisted in eliminating the nitrogenous
waste, and the products of the inflammation, by a copious drinking of
water. Hot water and hot diluent drinks are best, such as toast water,
barley water, cream of tartar, lemon and acid drinks. In acute cases
the patient is put on a milk diet of from two to three pints of milk
a day, given one-half pint every three or four hours, diluted with
one-third as much hot water. If the case be a prolonged one, broths may
be included.
Even in cases which are chronic and not acute, it is well to follow a
milk diet for a number of weeks. The quantity of milk, for an exclusive
milk diet, must depend upon the age and size of the patient as well as
upon his ability to exercise. If he is confined to his room, from five
to seven pints of milk a day are sufficient. If he is taking a great
deal of exercise, he may take from eighteen to twenty glasses of milk a
day. If he loses weight on the milk diet, bread and rice may be added.
It is unwise to begin a milk diet at once, by feeding from eighteen
to twenty glasses of milk a day, but this amount may be approximated
within a week’s time and the change in diet should be begun by cutting
down all meats and legumes and gradually eliminating starches. In
changing from a milk diet to a diet including more hearty foods, the
transition should be gradual.
A. F. Pattee gives the following diet for Brights Disease.
=DIET: Soup.=—Vegetable or fish soup, broths with rice or barley.
=Fish.=—Raw oysters or clams, fresh fish broiled or boiled.
=Meats.=—Eat sparingly, chicken, game, fat bacon, fat ham.
=Farinaceous.=—Stale bread, whole wheat bread, toast, milk toast,
biscuits, macaroni, rice, cereals of all kinds.
=Vegetables.=—Onion, cauliflower, mashed potatoes, mushrooms, lettuce,
watercress, spinach, celery, cabbage.
=Desserts.=—Ripe raw fruits, stewed fruits, rice tapioca, bread and
milk puddings, junkets, cocoa.
=Liquids.=—Toast water, weak tea, pure water, peptonized milk, malted
milk, fresh buttermilk, milk with hot water, equal parts, whey,
unfermented grape juice.
=AVOID.=—Fried fish, corned beef, hashes, stews, pork, veal, heavy
bread, batter cakes, lamb, mutton, beef, gravies, beans, peas, malt or
spirituous liquors, tobacco, coffee, ice cream, cake, pastry.
* * * * *
[Sidenote: Nervous Disorders]
The condition of the nerves depends upon the general condition of the
system and upon general nutrition. There is no one food or set of foods
which directly affect any nervous trouble, unless this trouble be
localized by disturbance in some particular organ. Then the effort must
be to correct the difficulty in that organ.
There is no disturbance in any part of the body requiring less medicine
than a disturbance in the nerves. The correction must come through
general hygienic treatment. Regular exercise, alternated with regular
rest periods, the formation of the habit of complete nerve relaxation,
the general regulation of an easily digested, nutritious diet, with
deep breathing exercises, are the best remedies.
In many cases of nerve debility the nerves seem to be stronger in the
latter part of the day. Where this is the case the hearty meal should
be eaten at this time.
* * * * *
=Neurasthenia.= In cases of Neurasthenia, or “Tired Nerves,” all vital
organs are more or less affected, because the nerves do not properly
direct digestion, absorption, assimilation or elimination and, for this
reason, the diet should be light and of easily digested foods. _A free,
correct breathing of fresh air, day and night, is imperative._ It is
important also to thoroughly masticate all food and drink freely of
water. A change of thought, induced by a change of scene or companions,
is helpful.
* * * * *
[Sidenote: Gout]
This difficulty is usually the result of high living. It most often
attacks people past middle age, who have indulged in rich pastries,
puddings, meat three times a day, or who have frequently indulged in
alcohol.
Being supposedly caused by an excess of uric acid and other waste
deposited in the joints, resulting from too much protein and an
insufficient elimination of the waste of the system, the dietetic
treatment must be a low protein diet. Alcohol is absolutely prohibited
and the quantity of carbohydrates and fats must be cut down as well as
the protein.
In _acute cases_ a diet of bread and milk, or toast and milk, with
light vegetable broths should be followed for one to three days.
In _chronic cases_ the diet may consist of the following:[11]
=Soups.=—Vegetable broths.
=Fish.=—Fresh fish, shell fish, raw oysters.
=Meats.=—It is better to omit all meats. If meat is eaten at all, it
should be confined to game, chicken and fat bacon.
=Farinaceous.=—Cereals, crackers, dry toast, milk toast, macaroni,
graham or whole wheat bread, rye bread, oatmeal and any of the
breakfast foods.
=Nuts.=—With salt.
Vegetables.—Celery, lettuce, watercress, all greens, with vinegar,
string beans, green peas, potatoes, carrots and beets.
=Fruits.=—All fruits, stewed or fresh. Unpeeled apples are especially
recommended. (Greens, with vinegar and unpeeled apples increase the
action of the kidneys.)
=Desserts.=—Plain puddings, junket, rice, stewed or fresh fruits.
=Liquids.=—Pure water, toast water, barley water, butter milk, malted
milk, milk.
Eat eggs sparingly and in severe cases, not at all.
=AVOID.=—Alcohol, coffee, tobacco, dried fruits, nuts, cheese,
candies, pastries, pies, spices, rich puddings, fried foods, vinegar,
pickles, lemons, rhubarb, mushrooms, asparagus, sweet potatoes,
tomatoes, gravies, patties, rich soups, lobster, salmon, crabs,
mackeral, eel, veal, pork, goose, duck, turkey, salted, dried, potted
or preserved fish or meat, (except bacon).
* * * * *
[Sidenote: Rheumatism.]
Since the medical profession is unable to determine just what
rheumatism is, it is difficult to prescribe a diet. The theory so long
believed that it is an excess of uric acid in the system is no longer
held by most of the advanced physicians. Some authorities hold that it
is a nerve difficulty; others that it is an excess of lactic acid. Some
authorities put one on an entire meat diet, in case of rheumatism, and
others entirely exclude meat. Uric acid may accompany the disease.
Assuming that it is due to the failure of the system to promptly
eliminate its waste, whether this failure to eliminate be through
a weakened condition of the nerves, and the consequent failure to
properly direct the body activities, the correction of the difficulty
must lie in building up the general vitality and in aiding the system
in its elimination. Hot sweat baths, a free use of water and a free use
of fruits, particularly the citrous fruits, such as lemons, oranges,
limes, etc., are desirable, because they increase the alkalinity of
the blood. The acid unites with other acids of the body acting as
a re-agent. Often when the acids of the stomach are strong, sodium
carbonate (baking soda) produces an alkaline reaction.
The diet should be cut down in quantity. Meat may be eliminated if an
excess of uric acid exists and the above suggestions under the diet for
_Gout_ be followed.
Fruit juices should be used freely because of their alkaline reaction
and because of their diuretic effect. Lemonade, orangeade and all fresh
fruits and vegetables are diuretic.
Regular exercises, until the body is thoroughly heated, deep breathing
of pure air day and night and a copious drinking of water are necessary.
* * * * *
[Sidenote: Uremia or Uremic Poisoning]
Interference in the action of the kidneys is apt to result in a
retention within the system of the elements, which the kidneys, in
normal condition, eliminate from the system, such as urea, uric acid,
urates, sulphuric acid, sulphates, sodium phosphate, xanthin bodies and
conjugated sulphates. These substances are not thrown off by the skin,
or by the lungs, and must all be eliminated through the kidneys. They
are the result of the oxidation and the breaking down of the proteins
of the body. If the kidneys do not throw these off, the result is
Uremic Poisoning, and the dietetic treatment must be to cause a free
action of the kidneys by the use of diuretics. Of these the citrous
fruits, (lemons, oranges, limes, etc.,) are the best; they neutralize
acids and produce an alkalinity of the blood. They should be used
freely.
Meats, eggs and legumes should be eliminated from the diet. A free
drinking of water, milk with limewater, cereals, buttermilk, kumyss,
barley water, toast water, lemonade, orangeade, vegetables and fruit
should constitute the diet. Exercise and free breathing of fresh air
are imperative. All food should be thoroughly masticated.
* * * * *
[Sidenote: Excess of Uric Acid]
An excess of uric acid may not always cause uremic poisoning, but
it indicates an excess of protein in the system above the amount
eliminated by the kidneys and the skin. This excess is often the cause
of chronic ailments, such as bronchitis, asthma, hay-fever, severe
nerve depression, gout, rheumatism, neuralgia, tonsilitis, grippe,
influenza, colds, etc.
The natural relief is to control the diet, supplying less protein and
to increase the elimination through a free action of the kidneys, of
the pores of the skin, and of the lungs. Systematic exercise, deep
breathing, a copious drinking of water and fresh air day and night,
are the best reliefs.
One may either eliminate the proteins from the diet, or may cut down
the entire quantity of food, and, by exercise, breathing, a freedom of
the pores of the skin and a free drinking of water, so as to create an
activity of the kidneys, may continuously eliminate more uric acid than
is consumed in the food.
The regulation of the quantity of the food, rather than the cutting
down of the proteins and the feeding of a larger proportion of
starches, is the course pursued where one is inclined to an excess of
uric acid and still has an excess of fat.
In case of an excess of uric acid in thin persons, such proteins food
as meat and eggs may be eliminated and the diet consist almost wholly
of carbohydrates and fats.
The diet is the same as that given above for _Gout_.
* * * * *
[Sidenote: Obesity]
All diets for obesity must be prescribed for the individual condition.
A large number of the obese are afflicted with rheumatism, sluggish
livers, sluggish action of the intestines and weak nerves, and the
diet must be governed accordingly.[12]
The regulation of food for reduction of flesh must, also, be governed
by age, sex, by the manner of breathing and by the amount of daily
exercise.
Exercise, breathing and diet are the scientific means of reduction, the
food must be regulated in accordance with the quantity of carbohydrates
and fats daily consumed in heat and energy.
* * * * *
[Sidenote: Leanness]
No definite diet can be given for flesh building, because a lack of
sufficient fat to round out the figure is due to faulty digestion or
assimilation and the cause must first be eliminated.
It may be that the strength of the muscles and nerves of stomach, liver
and intestines must first be built up by exercises and deep breathing,
and it may be that the habit of nerve relaxation must be established.
Where one’s nerves are tense much nourishment is consumed in nervous
energy and the nerves to digestive organs and muscles being tense,
interfere with digestion and assimilation.
It is apparent that the cause must first be corrected, because to
overload the digestive organs with sugars, starches and fats, further
weakens them.
FOOTNOTES:
[10] Alida Frances Pattee; “Practical Dietetics” Mt. Vernon, N. Y.
[11] A. F. Pattee; “Practical Diatetics,” A. F. Pattee, Publisher, Mt.
Vernon, N. Y.
[12] Editor’s Note: The causes and relief of Obesity are fully
discussed in my book of this series “Poise, Obesity and Leanness, their
Causes and Relief.”
APPENDIX
MEASURES AND WEIGHTS.
A few tables of measures may be helpful here because accurate
measurements are necessary to insure success in the preparation of any
article of food.
All dry ingredients, such as flour, meal, powdered sugar, etc., should
be sifted before measuring.
The standard measuring cup contains one-half pint and is divided into
fourths and thirds.
To measure a cupful or spoonful of dry ingredients, fill the cup or
spoon and then level off with the back of a case-knife.
In measures of weight the gram is the unit.
A “heaping cupful” is a level cup with two tablespoonsful added.
A “scant cupful” is a level cup with two tablespoonsful taken out.
A “salt spoon” is one-fourth of a level teaspoon.
To measure butter, lard and other solid foods, pack solidly in spoon or
cup and measure level with a knife.
TABLE OF MEASURES AND WEIGHTS[13]
4 saltspoons = 1 teaspoon, tsp.
3 teaspoons = 1 tablespoon, tbsp.
4 tablespoons = ¼ cup or ½ gill.
16 tablespoons (dry ingredients) = 1 cup, c.
12 tablespoons (liquid) = 1 cup.
2 gills = 1 cup.
2 cups = 1 pint.
2 pints = 1 quart.
4 quarts = 1 gallon.
2 tablespoons butter = 1 ounce.
1 tablespoon melted butter = 1 ounce.
4 tablespoons flour = 1 ounce.
2 tablespoons granulated sugar = 1 ounce.
2 tablespoons liquid = 1 ounce.
2 tablespoons powdered lime = 1 ounce.
1 cup of stale bread crumbs = 2 ounces.
1 square Baker’s unsweetened chocolate = 1 ounce.
Juice of one lemon = (about) 3 tablespoons
5 tablespoons liquid = 1 wineglassful.
4 cups of sifted flour = 1 pound
2 cups of butter (packed solid) = 1 pound
2 cups of finely chopped meat (packed solidly) = 1 pound
2 cups of granulated sugar = 1 pound
2⅔ cups of powdered sugar = 1 pound
2⅔ cups brown sugar = 1 pound
2⅔ cups oatmeal = 1 pound
4¾ cups rolled oats = 1 pound
9 to 10 eggs = 1 pound
1 cup of rice = ½ pound.
APOTHECARIES WEIGHTS[13]
20 grains = 1 scruple, ℈
3 scruples = 1 drachm, ʒ
8 drachms (or 480 grains) = 1 ounce, ℥
12 ounces = 1 pound, lb.
APOTHECARIES MEASURES[13]
60 minims (M) = 1 fluid drachm, f ʒ
8 fluid drachms = 1 fluid ounce, f ℥
16 fluid ounces = 1 pint, O or pt.
2 pints = 1 quart, qt.
4 quarts = 1 gallon, gal.
APPROXIMATE MEASURES[13]
One teaspoonful equals about 1 fluid drachm.
One dessertspoonful equals about 2 fluid drachms.
One tablespoonful equals about 4 fluid drachms.
One wineglassful equals about 2 ounces.
One cup (one-half pint) equals about 8 ounces.
METRIC MEASURES OF WEIGHT[13]
In measures of weight the gram is the unit.
1 gram 1.0 gm.
1 decigram 0.1 gm.
1 centigram 0.01 gm.
1 milligram 0.001 gm.
FOOTNOTES:
[13] Practical Diatetics, Alida Frances Pattee, Publisher, Mt. Vernon,
N. Y.
Classification of Diets.
The purpose is not to give below such receipts as are found in ordinary
cook books, but simply to suggest foods useful for invalids, for
semi-invalids, or for chronic, abnormal conditions of digestive organs.
BEVERAGES.
Beverages are primarily to relieve thirst; they may also contain food
elements; they may be used for their effect in heat and cold; for their
flavor which helps to increase the appetite; or for their stimulating
properties.
=WATER.= Pure and carbonated; mineral waters contain iron, sulphur,
lithium, etc.
Hot drinks should be served at a temperature of from 122 to 140
degrees F. When water is used as a hot drink it should be freshly
drawn, brought to a boil and used at once. This sterilizes and
develops a better flavor.
Cold water should be thoroughly cooled, but not iced, unless ice water
is sipped very slowly and held in the mouth until the chill is off.
Water is best cooled by placing the receptacle on ice rather than by
putting ice in the water.
* * * * *
=FRUIT JUICES.= Under fruit juices are
Grape juice, apple juice,
Currant juice, pineapple juice,
Orangeade and lemonade.
They are especially grateful to fever patients and are often used to
stimulate the appetite. They are particularly valuable for the acids
which they contain, which stimulate the action of the kidneys and the
peristaltic action of the digestive tract; they also increase the
alkalinity of the blood.
Apples contain malic acid, lemons citric acid and grapes tartaric
acid. The ferment in the ripe pineapple juice aids in the digestion of
proteins.[14]
* * * * *
=Lemonade.= Wash and wipe a lemon. Cut a slice from the middle into
two pieces to be used in the garnish before serving; then squeeze the
juice of the rest of the lemon into a bowl, keeping back the seeds.
Add sugar and boiling water; cover and put on ice to cool; strain and
pour into a glass.
* * * * *
=Fruit Lemonade.= To change and vary the flavor, fresh fruit of all
kinds may be added to strong lemonade, using boiling water as directed
above.
* * * * *
=Egg Lemonade.= Beat an egg thoroughly, add 2 tablespoonsful of sugar,
2 tablespoonsful of lemon juice and gradually pour in one cup of cold
water. Stir until smooth and well mixed. Serve thoroughly cold. This
drink is very easily digested, the lemon having partly digested the
egg; 2 tablespoonsful of sherry or port may be added.
* * * * *
=Bran Lemonade.= Mix ¼ cup of wheat bran with 2 cups of cold water.
Allow this to stand over night and in the morning add the juice of a
lemon.
* * * * *
=Pineapple Lemonade.= Mix ½ cup of grated pineapple with the juice of
1 lemon and 2 tablespoonsful of sugar; add ½ cup of boiling water, put
on ice until cool, then add 1 cup of ice cold water. Strain and serve.
* * * * *
=Grape Lemonade.= To one cup of lemonade, made as directed above,
rather sweet, add ½ cup of grape juice.
=Orangeade= is prepared as lemonade. The juice of one sour orange to 2
tablespoonsful of sugar and ½ cup of boiling water is about the right
proportion.
* * * * *
=Mixed Fruit Drink.= Mix ¼ cup of grated pineapple, the juice of ½ a
lemon, the juice of ½ an orange, 1 cup of boiling water and sugar to
taste. Put on the ice until cool. Strain and add more cold water and
sugar according to taste.
* * * * *
=Pineapple Juice.= Pour ½ cup of pineapple juice over crushed ice and
serve in a dainty glass. This is especially helpful in cases of weak
digestion and in some throat troubles—as stated above, the pineapple
aids protein digestion.
* * * * *
=Lemon Whey.= Heat one cup of milk in a small sauce pan, over hot
water, or in a double boiler. Add two tablespoonsful of lemon juice;
cook without stirring until the whey separates. Strain through cheese
cloth and add two teaspoons of sugar. Serve hot or cold. Garnish with
small pieces of lemon.
* * * * *
=Wine Whey= may be made in the same way, using ¼ cup of sherry wine to
1 cup of hot milk.
* * * * *
=Grape Juice, Apple Juice and Currant Juice= are tonics and make a
dainty variety for the sick room. They should be used according to
their strength, usually about ⅓ of juice to ⅔ water. They should be
kept cold and tightly corked until ready to serve.
* * * * *
=Grape Lithia.= Add 4 ounces of Lithia water to 1 ounce of grape juice
and two teaspoons of sugar.
* * * * *
=Grape Nectar.= Boil together 1 pound of sugar and ½ pint of water
until it begins to thread. Remove from the fire and when cool add the
juice of 6 lemons and one quart of grape juice. Let stand over night.
Serve with ice water, Apollinaris, or plain soda water.
* * * * *
=Tea Punch.= Pour boiling lemonade, sweetened to taste, over tea
leaves. Allow the liquid to stand until cool. Then strain and serve
with shaved ice and slices of lemon. This makes a delicious cooling
drink for hot weather.
LIQUID FOODS.
Under this heading such liquids are given as are actual foods.
=MILK.= Milk is a complete food and a perfect food for infants, but
not a perfect food for adults. It may be used as
Whole or skimmed;
Peptonized; boiled;
Sterilized, pasteurized;
Milk with lime water, Vichy or Apollinaris;
With equal parts of farinaceous liquids;
Albuminized milk with white of egg;
Milk with egg yolk, flavored with vanilla, cinnamon or nutmeg;
Milk flavored with coffee, cocoa, or meat broth;
Milk punch; milk lemonade;
Koumiss; kefir or whey, with lemon juice, as above.
* * * * *
=EGG PREPARATIONS=. These consist of
Albumin water (diluted white of egg), flavored with fruit juice;
Egg lemonade; egg orangeade;
Egg with meat broth;
Egg with coffee and milk;
Chocolate eggnog.
Often the white of egg, dissolved in water or milk, is given when the
yolk cannot be digested, because of the amount of fat which the yolk
contains.
Where one is inclined to billiousness, the egg is better digested if
beaten in wine.
The albuminous or egg drinks are best prepared cold.
* * * * *
=Eggnog.= To make eggnog, separate the white and the yolk, beat the
yolk with ¾ of a tablespoonful of sugar and a speck of salt until
creamy. Add ¾ of a cup of milk and 1 tablespoonful of brandy. Beat the
white until foamy, add to the above mixture and serve immediately. A
little nutmeg may be substituted for the brandy. The eggs and milk
should be chilled before using. Eggnog is very nutritious.
* * * * *
=Egg Broth.= Beat the yolk of 1 egg, add 1 tablespoonful of sugar
and a speck of salt. Add 1 cup of hot milk and pour it on gradually.
Flavor with nutmeg.
Dried and rolled bread crumbs may be added, or beef, mutton or chicken
broth may be used in place of the milk, and the sugar may be omitted.
The whole egg may be used if desired.
This is very delicious made with beef broth, instead of hot milk.
Pineapple juice or coffee may be used.
* * * * *
=Coffee Eggnog.= 1 egg, 1¼ teaspoons of sugar, ½ scant cup of milk or
cream, ½ scant cup of coffee.
* * * * *
=Egg Malted Milk.= Mix 1 tablespoonful of Horlick’s Malted Milk with
1 tablespoonful of crushed fruit and 1 egg; beat for five minutes.
Strain and add 20 drops of acid phosphate, 1 tablespoonful of crushed
ice and ¾ cup of ice water. A grating of nutmeg may be used for flavor.
* * * * *
=Grape Yolk.= Separate the white and the yolk of an egg, beat the
yolk, add the sugar and let the yolk and sugar stand while the white
of the egg is thoroughly whipped. Add two tablespoonsful of grape
juice to the yolk and pour this on to the beaten white, blending
carefully. Have all ingredients chilled before blending and serve cold.
* * * * *
=Albuminized Milk.= Beat ½ cup of milk and the white of one egg with
a few grains of salt. Put into a fruit jar, shake thoroughly until
blended. Strain into a glass and serve cold.
* * * * *
=Albumin Water.= Albumin water is used chiefly for infants in cases of
acute stomach and intestinal disorders, in which some nutritious and
easily assimilated food is needed. The white of 1 egg is dissolved in
a pint of water, which has been boiled and cooled.
* * * * *
=Albuminized Grape Juice.= Put two tablespoonsful of grape juice into
a dainty glass with pure chopped ice. Beat the white of one egg, turn
into the glass, sprinkle a little sugar over the top and serve.
* * * * *
=FARINACEOUS BEVERAGES.= These are all made by slowly adding cereals,
such as barley, rice, oatmeal, etc., to a large quantity of boiling
water and cooking from two to three hours and then straining off the
liquid and seasoning to taste. They are particularly valuable when
only a small amount of nutriment can be assimilated. Since the chief
ingredient is starch, long cooking is necessary to make soluble the
starch globules and to change the starch into dextrin, so that it can
be more readily digested. Since these drinks are given only in case of
weak digestion, it is important that they be taken slowly and held in
the mouth until they are thoroughly mixed with the saliva.
* * * * *
=Barley Water.= (Infant feeding). Mix 1 teaspoonful of barley flour
with two tablespoonsful of cold water, until it is a smooth paste. Put
in the top of a double boiler and add gradually one pint of boiling
water. Boil over direct heat five minutes, stirring constantly; then
put into a double boiler, over boiling water, and cook fifteen minutes
longer. This is used as a diluent with normal infants and to check
diarrhoea.