Where we have a disease in which the patient must be confined to the bed for several weeks, care must be taken to prevent the wasting of the tissues due both to the disease itself and to the lack of food. The food given must be of an easily digested sort. In the case of typhoid fever the seat of the disease is the intestinal tract, so that the food given must be of such a kind as can be largely digested in the stomach and have very little waste to be dealt with by the intestines. The best results have been obtained by giving the patients milk the fuel value of which has been increased by the addition of cream and milk sugar. Broths are also given, cream soups, and fruit juices in large quantities. The patient is fed at two-hour intervals, and the total number of calories taken at each feeding carefully measured. In this way it is possible for a person to leave the hospital after a long siege of typhoid weighing as much as he did when he was brought in. The fearful emaciation which was thought to be a part of typhoid fever is no longer considered inevitable.

Digestive troubles

Fevers, especially typhoid

With tuberculosis we have a disease in which there is a large wasting away of tissue. This must be counterbalanced by an excess of food eaten. At the same time it is important not to upset the digestive tract by this excess of food. It is customary to feed the patient as much as possible until he has regained his normal weight. In order to maintain the normal weight, it is then necessary that he should eat a third more fuel value than would be his normal diet. This is usually made up by the free use of milk, eggs, and fats.

Diabetes is a disease which requires the constant supervision of a physician but it is also one where the health of the patient depends absolutely upon the food which is eaten. This should of course be regulated by the physician, but much can be done by the patient himself if he understands the situation. The cause of the disease is a loss on the part of the body of the power of using carbohydrates, so that sugar, instead of being burned up by the tissues for energy, is carried in the blood and excreted in the urine. This condition can be controlled by the food eaten. The basis of a diet for such a patient should be protein material and fats. Carbohydrates can only be used in a restricted quantity, depending upon the extent to which the disease has developed in the individual. When the point of safety has been ascertained by a study of the urine, the diet can then be kept within that amount by a table of equivalents which can be had from the doctor. The housekeeper must then make up a variety of meals, using only the quantity of starchy foods prescribed by the doctor.

Tuberculosis

Diabetes

There is a general disagreement among physicians as to the exact cause of gout and rheumatism but it is generally admitted that one of the effects of them is an excess of uric acid in the blood. This is the acid that is formed in the process of the utilization of protein foods. Hence usually gout has been described as an aristocratic disease, the high living and perhaps pretty steady drinking of the upper classes producing this trouble in middle and later life. To avoid these diseases those people who have a gouty tendency should be careful not to eat an excess of foods of all kinds, but particularly of protein foods. Foods which tend to disturb the digestive system should be avoided as should also those foods which have a tendency to putrefaction and which cause constipation. This reduces the diet to plain, wholesome food, well chosen, thoroughly cooked, and used in moderate amounts. Excess of food is, after all, the most important element of danger and one that is aggravated if the food is rich.