Milk Bovril

Milk may be completely disguised by making "Invalid Bovril," or other meat extract preparation, as directed upon the bottles, but using boiling milk instead of water.

Milk Tea

Place several teaspoonfuls of tea in a hot jug and pour upon them three or four tablespoonfuls of boiling water; stand three minutes and add a pint of boiling milk; stand another minute and then strain off the leaves and serve.

Milk fortified with sugar of milk is too sweet for the liking of most tuberculous patients, but the carbo-hydrates may be increased considerably by fortifying with starch.

Milk Fortified With Starch

Ingredients : Milk, 1 pint, cornflour, arrowroot or farina, 2 oz., Benger's liquor pancreaticus, 1 teaspoonful.

Mix the cornflour into a thin paste with a little milk, boil the rest of the milk and pour it upon the mixed cornflour, stirring continually until the whole mass thickens. Now add the liquor pancreaticus, stirring continually until the preparation is as thin as ordinary milk, which should occur in 1 or 2 minutes. The preparation is immediately boiled to prevent further change occurring. Essence of lemon, etc., tea, coffee, bovril, etc., may be used for flavouring.

Milk Fortified With Casumen Or Other Soluble Casein

Ingredients : Milk, 1 pint, 3 tablespoonfuls (1/3 oz.) moderately heaped of casumen.

Mix the casumen with the milk by dredging the powder into the milk while stirring and bring to boiling point, stirring vigorously all the time to prevent "burning".

It is possible to get double this amount of casumen into solution but this process requires more care.

This fortified milk may be used for the preparation of the cornflour above mentioned or the milk may be flavoured with tea, coffee, cocoa, bovril, Benger's food, etc., or may be taken as it is.

Milk Fortified With Casein

The most palatable result is obtained by adding dilute HC1 to 1 pint of separated milk in sufficient amount to precipitate the casein; then strain through muslin and wash well to free the precipitate from lactose and acid. Dissolve in the required amount of new milk (1 1/2 or 2 pints) with the aid of a small quantity of soda bicarbonate and warmth.

Meat Juice With Milk

Ingredients: 3/4 lb. rump steak or fillet of beef free from fat, 1 pint of milk, bovril or Brand's essence to flavour.

Pass the steak through a fine mincing machine or scrape very finely, this gives 7 oz. of meat pulp. Mix thoroughly with the milk and pass through a fine strainer or muslin, not a hair sieve. This should yield about a pint of fluid of the consistency of cream. Half a teaspoonful of bovril or some Brand's essence may be used for flavouring. Care should be taken to squeeze as much meat pulp as possible through the strainer. The preparation may be warmed by standing in a vessel of hot water, but excessive heating causes coagulation.

Meat Solution

Leube-Rosenthal meat solution, to be obtained of Messrs. Poths and Co., of 4, Berry Court, St. Mary Axe, E.C., at 205. per doz. 1/2 lb. tins.

Two or three teaspoonfuls should be stirred with a very little hot water in a wineglass and the glass filled with Burgundy or port according to medical direction. The preparation may be served at any desired temperature. Half a tin of this solution may be taken daily.

Raw Meat Sandwiches

Scrape finely a sufficient amount of fillet of beef, pound it in a mortar, adding pepper, salt and any flavouring such as bovril or some sauce. Cut very thin bread and butter and make as thick a sandwich as possible. One oz. of bread should be sufficient for l 1/2-2 oz. of meat and 1/2 oz. of butter.

Albumin Water

Beat up the whites of two eggs without making froth, add 14 oz. of water and 1/2 glass of sherry. Flavour with lemon and essence of lemon. A few crystals of citric acid may be added if the patient suffers greatly from thirst. Sugar, etc., to taste. Put the fluid into a Sparklet syphon and aerate. This is useful when high fever is present.

Artificial Koumiss

Ingredients : 3 quarts skimmed milk, 1 quart buttermilk, 6 oz. sugar. A small amount of yeast is occasionally required.

Keep at a temperature of 80° Fah. until separation commences, then bottle in Sparklet syphon.

Milk may be still further fortified with cream to the extent of 2 oz. of single cream to the pint without making the milk too rich. This is useful when vomiting is very persistent.

The following preparations are specially useful in dysphagia.

1. Custards

Heat 1/2 pint of milk and add 2 beaten up eggs and stir until thick. The milk used may contain milk casein at the rate of 1 tablespoonful to the pint or may have been previously flavoured with meat extract, e.g. invalid bovril, in which case a savoury custard results.

2. Cheese Custard

Dissolve 2 oz. of old cheese grated in 1/2 pint of milk with the aid of a pinch of bicarbonate of soda and gentle heat. Make into a custard with eggs in the usual way and bake.

3. Velvet Soup

Clear soup or stock (without salt) containing a tablespoonful of casumen to the pint, should have one or two beaten eggs stirred in when very hot immediately before serving.

4. Steamed Fish

Place a few scraps of butter on a fillet of fish, cover with grease paper and cook between two plates for 15 to 20 minutes. Fish so treated is practically a semi-solid.

5. Scrambled Eggs

Use four eggs and 1/2 oz. of butter for each meal.

6. Creams And Blancmanges Made With Gelatin

Creams And Blancmanges Made With Gelatin are much better taken by patients with dysphagia than those thickened with farinaceous materials.

7. One Third Of An Oz. Of Gelatin

One Third Of An Oz. Of Gelatin will thicken milk sufficiently to make it possible for the patient to take it satisfactorily when plain milk can only be taken with great pain.

8. Egg And Milk

Egg And Milk is sometimes more easily taken if slightly thickened with gelatin.

9. Benger's Food

Benger's Food may be made of any degree of consistency, while milk fortified with casein may be used instead of plain milk.

10. Junket

Junket is frequently well taken but should be prepared shortly before it is required.

11. Typhoid Bread And Milk

Typhoid Bread And Milk is frequently appreciated by patients. Boil half a round of bread without crust in half a pint of milk for 10 minutes, strain through fine muslin and serve.