A System Of Diet And Dietetics | by George Alexander Sutherland

This book is not a reflection of the fancies of the public on the subject of their food, or of the methods of the individual who believes in an infallible system for the dieting of his patients. Until our knowledge of physiology is more perfect than at present the scientific basis of dietetics must be an unstable one. Nevertheless patients must be dieted, and the physician must be guided by the teaching of history, by experimental physiology, and by clinical experience in the proper regulation of their diet. All that has been attempted in this book is to set down the principles and practice of men who have had special experience of the subjects on which they write.

Title	A System Of Diet And Dietetics
Author	George Alexander Sutherland
Publisher	Oxford University Press.
Year	1908
Copyright	1908, Henry Frowde
Amazon	A System of Diet and Dietetics

Oxford Medical Publications.

Edited By G. A. Sutherland, M.D., F.R.C.P

Editor's Preface: This book is not a reflection of the fancies of the public on the subject of their food, or of the methods of the individual who believes in an infallible system for the dieting of his patients. Until...

Chapter I. Introduction - General Principles: The subject of food is one upon which countless experiments have been made by myriads of men during thousands and perhaps millions of years. In all parts of the world, from prehistoric times until now...

Classification Of Diets: Although experiments on food have been going on for ages, it is only within a few decades that the results of these experiments have been classified scientifically. To exemplify such a classification ...

Cooking: In considering the value of a dietary we must remember that it is not the food which is actually eaten which nourishes the patient but only those portions of it which are digested and absorbed. By pro...

Condiments: The experience of mankind has shown them that food unpleasing to the palate is apt to produce disgust or even vomiting, while palatable food is eaten with pleasure, retained with ease and digested wit...

Constipation: Although one would say that the typical diet ought to be one which is entirely digested, is completely absorbed and simply suffices for the wants of the system, yet in practice this is not so. The int...

Assimilation: In the intestines the insoluble starches and protein matters are converted into soluble dextrines, albumoses and peptones. These are absorbed and pass in the portal blood to the liver. Albumoses and p...

Stimulants: The experiments of Pawlow, Starling, and others show that when food is taken the stimulation of the salivary glands which it produces is passed on to the stomach, intestines and other organs, the acti...

Metabolism: We have thus far followed the food through the intestine, the circulation and the excreting organs, but, as I mentioned before, all our tissues live in a fluid medium, namely, the lymph in which they ...

Dyspepsia: The functions of digestion ought normally to be carried on without any pain or inconvenience. On the contrary, satisfaction of the appetite should be a source of pleasure, and digestion should be prod...

Chapter II. The Evolution Of Man's Diet: A knowledge of the changes which man's diet has undergone from early times cannot but be of great value to the physician whether in enabling him to construct a rational dietary in health and disease o...

Food Of The Evolving Man: Vegetable Food The vegetable food of the evolving man was drawn from the following sources : Seeds Seeds constituted his most important vegetable food, on account of the large amount of prote...

Factors Determining The Food Of Evolving Species: The factors which determine the food of a species are three in number : - 1. The kind of food available, i.e. the character of the local flora and fauna. 2. The specific attractiveness of certai...

2. The Instinctive Liking For Certain Kinds Of Food: While an instinctive desire for certain foods is peculiar to each species, it will be found that all animals in their choice of food are influenced, consciously or unconsciously, by three main conside...

3. The Ability To Secure The Desired Food: Obviously the higher the intelligence and the more efficient the bodily equipment for securing food (e.g. that making possible the climbing a tree or the grasping an object), the more successful is th...

The Diet Of The Primates Below Man: Zoologists include under the Order Primates, besides man himself, the lemur-like animals (Lemuroidea) and the man-like animals (Anthropoidea). The latter include the great tailless apes (gorilla, chim...

The Diet Epochs: The dietetic career of the evolving man from simian times onwards has been characterized by three signal advances, each of which has greatly augmented his supply of food. Before considering these a wo...

3. Diet in The Early Hunting Period: The hunting period (10th-ll.25th grade)1 may be said to have begun with the employment of special weapons and devices in hunting and fishing such as are employed by extant pre-cibiculturists. Until th...

4. The Pre-Cibicultural Cookery Period: The importance of the invention of cookery relates almost entirely to its effect on vegetable food. It is probable that before man learnt the art he had already begun to prepare his vegetable food in ...

Cookery. The Antiquity Of Cookery: There can be little question that one of the earliest uses to which man put fire was to cook his food. Cookery was doubtless in the first instance practised in a desultory fashion, and not until it wa...

The Evolution Of Cookery: The simplest method of cooking, and doubtless that first employed, is by holding the food over, or actually placing it on, the fire, or in hot embers. Vegetable food does not as a rule allow of this p...

Cookery First Employed For Vegetable Foods: The question whether at the beginning of the cookery epoch the process was employed equally for animal and vegetable food, or for the one more than for the other, is of great interest. We believe that...

The Food Of Existing Pre-Cibiculturists: There still survive many peoples who are genuine pre-cibi-culturists, i.e. who neither cultivate the vegetable kingdom nor breed animals for food. They go naked, or nearly naked, spend most of their t...

Pre-Cibiculturist Vegetable Food: Roots Root-digging is an important industry among the pre-cibiculturists and furnishes a surprisingly large store of food. The task of digging falls to the women, and since the sole implement emplo...

Pre-Cibiculturist Drinks: Water The drink of the pre-cibiculturists consists of water obtained from pool, lake, spring, or stream. Though the Australians are known to dig wells down to a depth of eight feet, primitive tribe...

5. Diet in The Cibicultural Period: The cibicultural epoch began, we may conjecture, some 30,000 years ago. One of the first advances in the direction of vegetable food culture was the storage of supplies to provide against seasons of d...

Concentration Of Diet: We have seen the diet of the evolving man becoming epoch after epoch more and more concentrated. At the present time this process has reached its acme, so that a high degree of concentration is perhap...

The Artificial Rearing Of Children: Another striking feature of the cibicultural age is the practice of bringing children up by hand. Among the pre-cibiculturists no infant can survive unless the mother can suckle it. Indeed, recognizin...

Summary Of The Changes Which Have Taken Place In The Diet Of The Evolving Man: We may now rapidly review the chief changes which have taken place in man's diet during the successive phases of his evolution. 1. Relative Quantities Of Animal And Vegetable Food Our ancestors ...

Influence On Function Of The Successive Changes In The Diet Of The Evolving Man: The dietetic changes which we have been considering have been met by corresponding changes in function and structure. Function The ability to digest animal food rose and fell with the quantity c...

Influence On Structure Of The Successive Changes In The Diet Of The Evolving Man: Though the functional changes which have taken place in the digestive system of the evolving man have necessarily a structural basis, those changes are, as far as they can be detected, far less marked...

The Seasonal Rotation Of Food: A minor point, but one which should not be overlooked, is that change of season once had, and on the diet of the pre-cibi-culturists still has, a much greater influence than on our own to-day. The foo...

Chapter III. The Physiology Of Digestion, Absorption, And Nutrition: The energy needed for the various activities of the body is furnished by the processes of oxidation which take place in every living cell. The oxygen used is obtained from the atmosphere. The chemical...

Digestion: The term digestion is applied to all those processes by which the food substances are converted into a convenient form for absorption. Digestion is carried on in the alimentary canal. This, regarded s...

Digestion. Part 2: As soon as the food reaches the stomach digestion proper begins. In this process the food is first rendered soluble and secondly converted into a form suitable for absorption. It is not sufficient for...

Digestion. Part 3: The products of ferment activity have a retarding effect upon the reaction; it is interesting to note that only those products exert this inhibition which have a definite stereochemical structure and ...

Digestion. Part 4: The total amount of gastric juice produced is proportional to the amount of food, but the rate of flow varies with the nature of the food ; a dry food, such as bread, exciting more flow in the first h...

Digestion. Part 5: The pancreatic juice is a clear, strongly alkaline albuminous fluid, containing ferments. These are, however, only brought to their full activity by mixture with the succus entericus and bile, and thi...

Food Absorption: We have now traced the food materials through the upper part of the small intestine. However various in appearance and in composition the ingredients of the diet may have been, they are now, in a heal...

The Digestibility Of Food-Stuffs: The unabsorbed parts of the food are discharged from the body in the faeces, which do not, however, consist solely of such matter but also contain products derived from the intestine. The undigested r...

Nutrition: We must now consider briefly the fate of the food-stuffs after absorption and the way in which they serve to nourish the body. When we attempt to trace the course and the transformations of these mate...

Nutrition. Continued: It appears then that the cells of the body are offered protein of a constant form, that of the serum albumin and serum globulin of the blood and lymph. It is possible, and even probable, that a second...

Fate Of Carbo-Hydrate: The dextrose taken up in the intestinal capillaries passes by the portal vein into the liver. During digestion the portal blood contains from '2 to .4 per cent of sugar, whilst during fasting the amou...

Chapter IV. The Results Of Experimental Work On Diet: General Considerations Protoplasm can only live under certain narrow conditions, of which the presence of oxygen, a moderate degree of warmth and of moisture, and a more or less regular supply of f...

Definition Of Food, And Conditions Which Food-Stuffs Must Satisfy: A food has been defined by C. Voit as a substance which can cause the addition of a necessary element to the body or prevent or diminish the discharge of such material. To this is added that the sub...

Composition Of Food Materials: The composition of the chief foods used in this country is given in the following tables. The foods are arranged in alphabetical order under the headings. Animal Food Meat ........ page 115 P...

Graphic Representation Of Diets: The greatest hindrance to the practical study of dietetics is the troublesome arithmetic which has to be done, to calculate the heat value and the composition of an ordinary meal. Even if a diet is to...

Graphic Representation Of Diets. Continued: The proportion of protein in the food, if 100 grammes be taken as a normal quantity, should be above the 10 line, for 100 grammes in a diet of 3,000 calories represents 13 per cent of the total calori...

The Cost Of Food: The cost of food is of prime importance, both to families and to institutions. It should be considered in relation to the fuel value, and to the values in protein, rather than to the price per pound. ...

The Effect Of Cooking: Cooking sterilizes the food and renders it more palatable. It also alters its composition in various ways, according to the method employed. The effect of cooking upon the composition of meat has b...

The Construction Of Diets In Health. I. The Amount Of Food Needed: In constructing diets we have first to determine what amount of food is required for each individual in order that the body may be supplied with sufficient energy to keep it in health and vigour; and ...

The Construction Of Diets In Health. I. The Amount Of Food Needed. Part 2: Even in adults the extent of surface should be considered with the diet. Stout people have a relatively smaller surface than thin, and this is one reason why they often have a smaller appetite. Anothe...

The Construction Of Diets In Health. I. The Amount Of Food Needed. Part 3: We may say then that experimental investigation in a calorimeter, and experience, teach that, as we should expect from the principle of the conservation of energy, the muscular work done by any indivi...

II. The Proportions Of The Food-Stuffs Required In The Diet Of Man: We have seen that the common experience of mankind and the evidence of scientific inquiry agree that a sufficient amount of food must be taken daily to yield from 2,500 to 3,000 calories. When we come...

The Amount Of Protein Required In The Diet Of Man: The amount of protein regarded by Voit as a standard was 118 grammes, or just over 4 oz., for a man of 11 stone taking 2,800 calories a day. This is 1.7 grammes of protein per kilogramme. This figure,...

The Amount Of Protein Required In The Diet Of Man. Part 2: It is clear that on the one hand the theoretical reasoning from the fact that an excess of nitrogen is so rapidly eliminated from the body, and on the other the result of experiment, show-that about 5...

The Amount Of Protein Required In The Diet Of Man. Part 3: The experiments upon man show that men can live in health for several months and do routine work on a diet containing about 50 grammes of protein per day, or half the usual quantity. It is not shown t...

The Amount Of Carbo-Hydrate And Fat Required In The Diet Of Man: In a diet of 2,800 calories per day, if 410 calories be furnished by 100 grammes of protein there remain 2,390 to be supplied by carbo-hydrate or fat, or both. 583 grammes of carbo-hydrate, or 257 of ...

Standard Diets: The consideration of the principles upon which diets are constructed has led us to the following proportions of foodstuffs for a man of 11 stone of moderate activity : - Protein .... ...

5. Ration Of The British Army In The Crimea (From Gautier): Bread, 24 oz.; meat, 17 oz.; rice, 2 oz.; sugar, 2 oz.; coffee, 1 oz.; tea, 1/4 oz.; rum, the equivalent of 1/2 oz. of carbo-hydrate, lemon juice, salt and pepper. This contains : Protein, 154; ...

Childhood And Youth: The large amount of food required by infants relatively to their weight has been referred to above in the section dealing with the relation between diet and the extent of surface and rate of growth an...

Influence Of Sex on Diet: It is not certain that sex has any direct influence upon the amount of food needed. Women require less than men because they are commonly smaller, have a larger proportion of fat than the average man,...

Diet In Training: It is probable that the question of diet in training has been considerably over-discussed. Certain it is that diet will not produce muscular efficiency, whereas regular graduated exercise upon an ordi...

Water: The body is made up of about 60 per cent of water, about 20 per cent of fat, and 40 per cent of dry substances. Water is, therefore, an essential constituent, and must be constantly supplied to replac...

Water. Continued: The restriction of fluid is often used as a therapeutic means, especially in aneurism, nephritis, heart disease and obesity. In health, if fluid is entirely withdrawn, the body receives only that cont...

Mineral Substances: A great deal of attention has been paid by experimentalists to the metabolism of inorganic salts. With the exception of the part played by sodium chloride in the causation of some forms of oedema, it ...

Lime: Lime is an important mineral constituent of the food. Chos-sat showed in 1842 that pigeons fed upon a diet poor in lime suffered from disarrangement of the feathers, diarrhoea and thirst, and died in ...

General Remarks On Nutrition In Disease, Including Febrile Conditions: Before considering in detail the effect of disease upon the nutritional needs of the body, it may be premised that a consideration of experimental work on this subject shows that, on the whole, the en...

Fevers: Many experiments have been made in man and animals to gain information as to the actual disturbances of metabolism in fevers and to determine how recovery may be aided by diet. Fevers are commonly ...

Chapter V. Diet Cures And Special Diets: Various systems of diet have been devised to meet the requirements of disease, the fancies of the faddist, and the desire of the layman to teach the members of the medical profession things of which t...

The Milk Cure: A simple milk diet is one in which milk alone is given fresh, uncooked, boiled or peptonized, whole or diluted with a simple diluent. This is the method of feeding in many febrile and digestive disord...

The Whey Cure: Whey differs from milk in containing much less protein and that in the form of lact-albumin, about 0.85 per cent, a slightly higher proportion of sugar, and a mere trace of fat, 0.04 per cent. Its val...

Koumiss And Kephir Cures: Koumiss is the fermented milk of mares or asses. It is used largely by the Tartars and Khirgis tribes and other nomadic tribes of the South-eastern Steppe country of Russia. It is given as a cure for ...

Lactobacilline Treatment: Analogous to the koumiss or kephir cures, dependent as they are on the presence of lactic acid and lactic acid bacilli, is the treatment of intestinal and other affections by buttermilk or by lactobac...

The Purin-Free Diet: A few preliminary remarks on purins and purin metabolism are necessary in order to form a due appreciation of the value of the purin-free diet. Purins are bodies with a base C5 N4 H4 (purin) and inclu...

Meat Diets: The ingestion of large quantities of meat has been recommended for tuberculous affections because of the infrequency with which they are associated with gouty states. That is to say, it is assumed tha...

Vegetarianism And Its Modifications: The strict vegetarian takes no animal food and no tubers or foods grown underground, limiting the diet entirely to fruits and vegetables grown in the sunlight. Others live on a diet of fruit and nuts,...

Vegetarianism And Its Modifications. Part 2: Almonds and pistachio nut kernels are valuable, for they contain protein 20, fat 50, carbo-hydrates 10 per cent, or even higher proportions. Chestnuts yield the largest amount of carbo-hydrates of any...

Vegetarianism And Its Modifications. Part 3: By choosing suitable pulses, nuts and cereals, a diet can be devised which is devoid of animal food and not very bulky. The nuts would have to be relied on for fats. Vegetarian, fruitarian, or nutaria...

The Grape Cuke: The grape cure is usually carried out at places like Meran and Montreux, but is available wherever grapes can be obtained. It is a mode of treatment which depends for its good results on change of die...

Tufnell's Diet: Tufnell's treatment of aneurism is a modification of the methods adopted by Albertini and Valsalva, who treated their patients by bleeding, rest and modified diet. Bellingham omitted the bleeding and ...

The Weir Mitchell Diet: Weir Mitchell's treatment for neurasthenia and disorders of malnutrition, independent of organic disease, depends on isolation, massage and overfeeding. The isolation and the moral effect which can be...

The Training Diet: A few words may be added about the diet of athletes. Usually it has been based on an excessive supply of meat, on the assumption that the wear and tear of muscular tissue is great and that meat is the...

Chapter VI. Patent And Proprietary Foods: A proprietary or patent food is one which is made from one or more simple articles of diet, and is more or less modified in the process of preparation. These foods may be made from milk or milk pr...

Pure Foods: Proprietary foods are sometimes ordered with a view to increasing the quantity of some particular primary food-stuff in the diet, whether protein, fat, or carbo-hydrate. Yet there are ordinary article...

The Composition Of Proprietary Foods: Most of the analyses, except where otherwise stated, are those given by the makers. Name. Water. Protein. Fat. Carbo-hydratee. Ash...

A. Condensed Milk, Without Added Sugar: This may be made from skimmed milk, whole milk, or milk enriched by the addition of cream. The milk is condensed to about one-third of its original bulk. The Composition Of Unsweetened Condensed Mi...

B. Condensed Milk With Added Cane Sugar: The bulk of the samples of condensed milk in the market are made from milk, with the addition of large quantities of cane sugar to act as a preservative. The composition is very variable, for the orig...

C. Dried Milk Preparations: A large number of preparations of dried milk are now obtainable. Some of them are preparations of pure casein; some are derived from separated milk, and contain a little fat and more or less sugar; so...

D. Predigested Or Peptonized Milk: It is advisable that milk of this nature should be made at home by means of the Allenbury peptonizing powders, Fairchild's zymine powders, or Fairchild's peptogenic milk powder, which is chiefly compo...

II. Cows' Milk With Carbo-Hydrate (Cereal) Additions: A. The Starch Practically Unchanged E.g. Anglo-Swiss, American-Swiss, and Franco-Swiss foods. These all appear to be made from condensed milk, baked wheat flour, and sugar. Analysis shows them r...

III. Carbo-Hydrate Foods: A. Practically Unchanged Starch Many of these foods are made from wheat flour or mixed flours which are practically unchanged. Some are said to be baked, but the effect of baking is very slight. Ba...

IV. Nitrogenous Foods. Meat Teas, Meat Extracts, Meat Juices, Peptones And Peptonoids, And Dried Meat Powders: (l) Foods prepared from meat are sold under the name of meat teas, meat extracts, meat juices, peptones and peptonoids, and dried meat powders. Some are supposed to have marvellous nutritive value bec...

Nitrogenous Foods. Meat Teas, Meat Extracts, Meat Juices, Peptones And Peptonoids, And Dried Meat Powders. Continued: According to Liebig 34 lb. of beef should yield 1 lb. of extract, which should contain extractives 56-60 per cent, salts 18-24 per cent and water. It should be practically free from fat, protein and g...

V. Fat Foods: Substitutes for cod-liver oil are sold : e.g. Pilchard Oil; Cotton Seed Oil with 6 per cent oleic acid; Lipanin, olive oil with 6 per cent oleic acid; and various cod-liver oil emulsions, containing o...

VI. Combination Foods: Pemmican is a good instance of fat and protein in combination. It is the dried product of the best beef and fat, 50 parts of the former to 40 of the latter, and is most nutritious. Everton Toffee is a...

Chapter VII. The Invalid's Dietary: Albumin Water Take the white of a fresh egg and cut it in numerous directions with scissors. Shake it up in a flask with a pinch of salt and six ounces of pure cold water. Strain through muslin. As...

Chapter VIII. Alcohol In Health And Disease: The term alcohol in popular language refers to the ethylic variety of the di-carbon series (C2H5OH). Alcoholic drinks, however, contain other substances besides alcohol, and the effects of these lat...

The Racial Effects Of Inebriety: Before discussing the racial effects of inebriety, that is to say, before asking how far drunkenness in the parents influences the offspring - a subject of great importance, and one regarding which mu...

The Physiology Of Chemical Stimulation: We may now touch upon a different aspect of the drink problem. How are we to account for the deep-rooted and widespread love of alcohol shown by mankind? One fact stands out prominently in this connex...

Is Alcohol A Food?: The question whether alcohol is a food has been much debated. Like sugar, to which it is chemically allied, it is capable of furnishing energy by its oxidation; the alcohol in a pint of Guiness' stout...

Alcohol's Action On The Digestive System: Experiments show that alcohol retards digestion in vitro, but we cannot conclude from this that a moderate quantity of it has a similar effect in the living stomach : in this case we have to take into...

Degenerations From Chronic Alcoholism: The most characteristic degenerative changes met with in chronic alcoholism are fatty change and atrophy of the parenchyma, with a corresponding increment of connective tissue. These changes, as might...

Alcohol's Action In Weakening The Defences Of The Body: It has long been observed that intemperance renders the tissues vulnerable to disease, that in the sot wounds are apt to fester, that he is not only more liable than his temperate brother to contract ...

Alcohol's Action On The Cardio-Vascular System: (A) The Arteries On entering the stomach alcohol causes the gastric blood-vessels to dilate. Absorption is rapid, the maximum amount being present in the blood about fifteen minutes after ingestion...

Alcohol's Action On The Nervous System: The nervous system consists of a sort of hierarchy of centres, of which the highest subserve the highest functions of mind - reason and judgment - and the lowest (in immediate connexion with the non-n...

Alcohol's Action On The Muscular System: We have seen that alcohol through its action on the nervous system interferes with the accurate performance of delicate movements. Here we have to consider its influence on the muscles themselves - on...

The Position Of The Medical Man In Regard To The Question Of Alcohol: The public look to the medical man for guidance on the thorny question of the use of alcohol, and it is very desirable that he should be able to speak ex cathedra in regard to it. Unfortunately, medic...

Circumstances Under Which Alcohol Should Be Forbidden: The use of alcohol as a matter of routine should not be sanctioned before the age of twenty-one years. Certainly none should be taken at school. A glass of wine may perhaps be allowed on festal occasi...

Quantity Of Alcohol Permissible: Speaking generally, we may say that a daily allowance of a wine-glass of whisky, or a couple of glasses of port, or a pint of mild ale, constitutes strictly moderate drinking. Many who would indignant...

The Therapeutics Of Alcohol: As a cardiac stimulant alcohol is of use in syncope and in certain cases of acute fever, such as enteric and pneumonia. In the latter class of case it is chiefly of service in tiding the patient over ...

Chapter IX. Artificial Methods Of Alimentation: In a number of diseases of the alimentary canal the administration of food by the natural channel is either impossible or inadvisable, and the physician must have recourse to methods of artificial nou...

Rectal Alimentation: Nutrient enemata date back to the days of Galen, but it is on the work of Voit and Bauer, of Leube and of Ewald, that most of the modern practice is based. In the early days nutrient enemata were comp...

Absorption Of Albumin: Most of the teaching on the absorption and metabolism of albumin is based on Ewald's work. Ewald's results are expressed in the form of a graphic chart, which, though at the first glance it appears ve...

Absorption Of Fat In Rectal Feeding: Much of our knowledge of the absorption of fat is based on the work of Munk and Rosenstein. Their observations were made on a patient with a lymph fistula through which the absorbed chyle could be col...

Absorption Of Sugar In Rectal Feeding: The absorption of sugar has been studied by Voit and Bauer, Schoenborn, Strauss, Leube, Plantenga, Deucher, Zehmisch, and others. Deucher gave a patient during nineteen hours five enemata containing e...

Rectal Feeding. Clinical Deductions: The important point for the clinician is, Can rectal feeding be relied on as a means of nourishing a patient if gastric rest is indicated as a therapeutic measure, or can it be relied on to improve nu...

Subcutaneous Feeding: When nourishment by the ordinary channel is contra-indicated or impossible, rectal alimentation may be impracticable from disease of the bowel preventing the retention of the nutrient injections, or, ...

Feeding By The Stomach Tube: Feeding by the stomach tube is employed in mental cases where food is refused, for sufferers from muscular paralysis, when swallowing becomes impossible, and in certain affections of the tongue, of th...

Chapter X. Diet In Fevers And Acute Infectious Diseases: General Considerations The increased metabolism and consequent tissue waste involved in the febrile process makes the consideration of the diet in acute infectious disease a matter of great importa...

Diet In Enteric Fever: It is universally admitted that in no acute infectious disease must more care be exercised with regard to the diet than in enteric fever. The conditions presented by this fever are such as to force up...

Diet In Enteric Fever. Part 2: Rules For The Administration Of Milk Milk, however, still remains, in my opinion, far the best staple food for the enteric patient, and all that is necessary to render its employment perfectly safe...

Diet In Enteric Fever. Part 3: Indications For Increasing The Diet In Convalescence Assuming a patient has satisfactorily passed through his fever, and his temperature is approaching the normal line, when is the first increase o...

Drink Of The Patient During The Fever: In the acute stage of the fever we have seen that the patient is restricted to a fluid diet. But it was emphasized that the milk is to be regarded as the solid part of the patient's food and must be g...

Alcohol In Enteric Fever: It is entirely a mistake to suppose that enteric fever patients need alcohol necessarily as a routine. On the contrary, it is certain that much harm may be caused by its indiscriminate use. The too li...

Modifications Of Diet To Meet Various Conditions In Enteric Fever: In a case in which care has been taken with the dieting it is unusual for troublesome diarrhoea to occur. On the contrary, this symptom usually subsides when the patient is fed suitably. Occasionally ...

Liberal Feeding In Enteric Fever: There is no doubt that theoretically much is to be gained by giving a liberal and varied diet. When we consider the extreme wasting which often occurs, even when the patient is taking freely all the f...

The Acute Stage In Enteric Fever: Suggestions For Dieting With Solid Food: No account of the dietetics of enteric fever can be considered adequate without some reference to the interesting dietary suggested by the Russian physician, Bushuyev. His published results did much t...

The Acute Stage In Enteric Fever: Soft Solids And Mixed Diet: Shattuck in the Massachusett's General Hospital feeds his enteric fever patients on the following lines. 1. Milk, hot or cold, with or without salt, diluted with lime water, soda water, Apollinaris...

Liberal Feeding In Convalescence In Enteric Fever: As the diet which I personally feel most justified in recommending, and which has been already described in detail, includes the use of solid foods early in convalescence, it will be unnecessary to ad...

The Empty Bowel Theory In Enteric Fever: Attention has recently been called by Ewart to the advantages of a diet which leaves little or no residuum. The object here is to give plenty of food to the patients, but to dispense with the faeces s...

Starvation Treatment In Enteric Fever: The same idea which underlies the empty bowel theory is no doubt responsible for the attempts made to treat enteric fever with either no food by the mouth at all, or at the most with very small qu...

Value Of Large Quantities Of Water In Enteric Fever: It has been seen above that a liberal supply of cold water to drink may be fairly considered as a necessity for the enteric patient, and that three or four pints should be the minimum allowance. The f...

Diet In Diphtheria: The extremely depressing character of this infection, and the great exhaustion which it entails, would appear to mark it out as a disease in which liberal feeding is especially indicated. On the other...

Diet In Diphtheria. Continued: The Significance Of Vomiting In Convalescence It is well to regard vomiting in diphtheria as of serious import until it has been proved to be the contrary. It may be merely the result of injudi...

Diet In Scarlatina: In our treatment of any of the acute fevers it is necessary to keep in view the conditions which may complicate its course and convalescence. Were it not for this there would be but little to say resp...

Diet In Scarlatina. Continued: Restricted Diets Jaccoud, Moizard, and many of the French writers attach much importance to a purely milk diet (regime lacte absolu). This should be invariably used in the febrile stage, and should...

Diet In Measles: Diet In The Acute Stage The usual rules for feeding in fever may be observed as long as the temperature remains elevated. Milk in regular quantities at regular intervals is usually quite sufficient...

Diet in Whooping Cough: Diet In The Catarrhal Stage As the appearance of the whoop is usually the first certain sign of the disease, the question of diet in this prodromal period needs little or no discussion. It is only ...

Diet in Influenza: The manifestations of influenza are so exceedingly variable that it is difficult to lay down hard and fast rules for the dieting of the disease. It is, however, so remarkably depressing in its effects...

Diet in Other Infectious Diseases: Very little need be said regarding the dieting of other infectious diseases. All may be safely treated more or less on the lines indicated in the preceding pages. The continued fevers, such as typhus ...

Chapter XI. Diet In Tuberculosis: Tuberculosis is one of the wasting diseases, and the rationale of its treatment consists in improving general nutrition, repairing waste, and in increasing what we know as the resistant and recuperati...

Diet In Tuberculosis. Continued: Method Of Observation Every patient on admission was carefully examined and observed for a day or two. This enabled us to estimate the extent and activity of the disease, and to ascertain the amoun...

The Standard Diet in Tuberculosis: To arrive at a standard diet suitable for the treatment of the average adult suffering from tuberculosis, we have worked out the average nutritive value of the diets taken by 200 of our patients who m...

On The Treatment Of Tuberculosis With Very Large Diets, Often Spoken Of As Forced Feeding: The treatment of tuberculosis, especially of pulmonary tuberculosis, with very large diets has been so frequently advocated, and is still so widely practised, that it is necessary to refer to it. T...

On The Construction Of Diets Having The Same Nutritive Value As Our Standard Diets: The diet prescribed to patients suffering from tuberculosis should contain the food-stuffs generally used by people in ordinary life. To construct any dietary of a certain definite nutritive value it ...

Diets For The Leisured Classes: The diets prescribed to people suffering from tuberculosis should be as far as possible similar to those taken by the same individuals when in ordinary health; the nutritive value, however, must be so...

Diets For The Leisured Classes. Continued: When varying the puddings, it must be remembered that they should always be made of highly nutritive food-stuffs. Fruit should be given at least three times a week in the form of stewed fruit, tarts, ...

Diets For The Working Classes: When prescribing diets for the working classes, we have to bear in mind the following important points : (1) the diet, in its general lines of construction, must be similar to the meals which the poor...

Diets For The Working Classes. Part 2: The prices of the various food-stuffs from which the total cost of this diet (11.74d. per day) has been calculated are those at which we have actually bought the various articles at ordinary shops and...

Diets For The Working Classes. Part 3: What Food To Buy And How To Cook It The following is intended to give you a rough idea as to how you can arrange your meals most satisfactorily, and the amounts of the various foods you require. ...

Concentrated Diets: The maintenance of a high level of nutrition is of essential importance for the efficient, treatment of tuberculosis, and inability on the part of a patient suffering from this disease to take a fairl...

Diet in Anorexia: The following two dietaries which are examples of the concentrated diets we are in the habit of prescribing will be found very useful. The first, which is our ordinary standard diet fortified and s...

Laryngeal Tuberculosis With Dysphagia: The general principles which we have laid down for the dieting of tuberculosis generally apply to tuberculosis of the larynx. In disease of this organ, which is nearly always co-existent with tubercul...

Diet in Haemoptysis: It is very difficult to dissociate the dietetic treatment of haemoptysis from the general treatment of this complication. The dietetic treatment of haemoptysis varies very considerably with the cause ...

Diet in Tuberculosis Of The Intestines: The special indications in the treatment of this condition are : 1. To prevent irritation of the diseased area. 2. To prevent excessive peristalsis. To fulfil these conditions the diet must b...

Directions For The Preparation Of Certain Foods Useful In The Treatment Of Anorexia, High Fever, Dysphagia, Etc: 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 Pla...

Chapter XII. Diet In Gout: General Principles No hard-and-fast lines as to dietary can be laid down in the treatment of gout. Each individual must be carefully considered as regards his habit of body, his capacity for the di...

Diet In Gout. Part 2: Maintenance Of A Healthy Alimentary Tract If, as is probably the case, the toxin or toxins of gout are produced in the intestinal tract, it is obvious that the first efforts at treatment should be ...

Diet In Gout. Part 3: Purin-Free Diet A purin-free diet is one selected from milk, cheese, butter, white bread, cereal foods, nuts, and fruit. Milk suits gouty people very well, and milk has a special effect in reducing...

Diet In Gout. Part 4: Fruits Any fruit which from experience is known to agree with the individual may be taken by gouty subjects. Apples and oranges generally agree best. Uncooked fruit should never be taken at a meat ...

Diet In Gout. Part 5: Simplicity Of Meals The diet of gouty patients should be simple, that is, the meals should not be made up of too many articles. Simplicity of food means facility of digestion. Moderation in both ea...

Diet In Gout. Part 6: Diet In Acute Gout It is preferable that no food be taken for the first twenty-four hours of an acute attack of gout, but water should be drunk freely. During the acute attack the patient should be...

Alcoholic Drinks in Gout: Stated as a general principle, a person who is subject to gout is better without alcohol in any form. There are, however, some who require a little alcohol, either to aid digestion or to enable them t...

Gout-Inducing Properties Of Alcoholic Drinks: The question is - To what constituent or constituents of wines and beers are their gout-inducing properties due? They are not due to the alcohol alone, for in countries such as Scotland, Norway, Swede...

Water And Mineral Waters In The Treatment Of Gout: The free employment of water in the treatment of gout dates from ancient times. At the Temples of Asklepios at Epidaurus and Athens, water was used extensively both internally and externally, and acti...

Ionic Theory And Radio-Activity In The Treatment Of Gout: If the efficacy of a natural mineral water depended solely on its watery constituent I do not for one moment think that the resort of sufferers to the various natural springs would have successfully s...

Uses Of Mineral Waters In The Treatment Of Gout: If gout is primarily due to the absorption of toxins from the intestinal canal dependent upon a catarrh of the intestinal mucosa, many of the natural mineral waters must be efficacious in altering the...

Diet In Acute Rheumatism: The diet daring the acute stage should consist mainly of milk, to which some common salt (about 15 grains to each half pint of milk) may be added with advantage. Vegetable soups may also be given, but...

Diet In Chronic Rheumatism (Fibrositis): Under this heading are included not only the chronic joint affections, which may be left as sequelae of acute or subacute rheumatism, and which may certainly and correctly be called true chronic rheum...

Diet In Rheumatoid Arthritis: The not infrequent mistake of diagnosing rheumatoid arthritis as gout, and the consequent placing of the patient on a restricted and spare diet, has undoubtedly led to the development of severe and in...

Chapter XIII. Diet In Diabetes: Of recent years the dietetic treatment of diabetes has been recognized to be not quite so simple as it was thought to be formerly, inasmuch as it is now recognized that different varieties of the affe...

Diet In Diabetes. Part 2: The different varieties of diabetes may not only be separated from one another by the differences alluded to above in the composition of the urine and in the degree to which the urine responds to diet...

Diet In Diabetes. Part 3: Another general principle applicable to all cases of diabetes is that changes in the diet in either direction should be made gradually. There would seem to be some risk of the production of diabetic c...

Diet In Diabetes. Part 4: Renal disease is not the only complication of diabetes that interferes with the usual dieting necessary. Phthisis occurs frequently as a complication of diabetes, and it is not as a rule advisable to ...

Chapter XIV. Diet In Obesity: The deposition of fat in the body is the result of a food supply in excess of that required to provide for the loss of energy in the production of work, heat, and other metabolic changes constantly ta...

Diet In Obesity. Part 2: In infancy a moderate degree of obesity is natural, for the food supply is good and bodily activity small in the early months of life. Excessive fatness in the breast-fed babe is almost invariably due...

Diet In Obesity. Part 3: Alcohol should be avoided, for it is a fat-sparer. The malt liquors are particularly unsuitable, for they contain a distinct amount of carbo-hydrate, some of them, e.g. Allsop's lager, cider and champ...

1. Banting's Diet For The Treatment Of Obesity: Banting's Diet was devised for him by Dr. Harvey. It consisted of animal food, 13-16 oz.; bread, 2 oz.; fruit and vegetables, 6-12 oz.; total fluid, 35 oz. 9 a.m.....A large cup, 9 oz., of tea with...

2. Ebstein's Diet For The Treatment Of Obesity: Ebstein's Diet is a modification of Banting's, containing more fat and less protein. The carbo-hydrates are much restricted, but a liberal allowance of fat is given on the grounds that it is more sati...

7. The Salisbury Diet For The Treatment Of Obesity: The Salisbury Diet is sometimes adopted. Towers Smith advocated a diet on these lines, viz., rump steak 3 1/2 lbs., cod-fish 1 lb., and 6 pints daily of hot water for period of two weeks. During th...

9. Hoffman's Diet For The Treatment Of Obesity: Hoffman's Diet consists of protein and fat, in four meals. Plasmon, nutrose, etc., can be added. Calorie value 2,000-2,500. 1. Milk, 200; cream, 50; meat, 100; 2 eggs, butter. 2. Meat, 200; peas...

A Special Diet For The Treatment Of Obesity: 7-7.30 a.m. . . . One orange, apple or pear. Half a pint of water. 8-8.30 a.m. . . . Tea, 5-6 oz.; milk, 1/2 oz.; sweetened with saccharin. One or two boiled or poached eggs. Dry toast or bread,...

Fluids And Alcoholic Drinks For The Treatment Of Obesity: Dancel devised a diet in which the amount of fluid ingested was much reduced, on the assumption that excess of fluid increased corpulence. He only allowed from 6-12 oz., gave purges, ordered much exer...

Proprietary Remedies For The Treatment Of Obesity: There is no drug which will reduce the body-weight except by its effects on metabolism, usually acting by impairing the functions of the digestive organs. The expensive remedies advertised for the cur...

Chapter XV. Diet In Arteriosclerosis: Arterio-Sclerosis is a term used to signify a thickening of the arterial wall, from whatever cause arising. It may occur in either a focal or a diffuse form. In the focal form it is known as athero...

Diet In Arteriosclerosis. Continued: That arterial hypertonus may be the result of dietetic errors there can be no doubt. The latter may operate in one of two ways : by causing the blood to be poisoned by the products of disordered diges...

Chapter XVI. Diet In Diseases Of The Stomach: General Considerations The prescription of a diet in gastric disorder has a scientific basis. In the first place there is required a knowledge of the whole process of digestion and absorption in he...

Diet in Gastric Ulcer: The illness entailed by an ulcer of the stomach is usually a long one, and patients come before us at different stages in this long career. At all stages the dietetic treatment is of the greatest impo...

Diet in Gastric Ulcer. Part 2: The technique of rectal feeding is discussed elsewhere. I prefer 10 oz. or 15 oz. injections of normal saline solution containing 1 oz. of dextrose at 100 F. every 4 or 6 hours, as being more cle...

Diet in Gastric Ulcer. Part 3: If at the end of four weeks from the beginning of mouth feeding this amount of food can be taken without any discomfort, it is very unlikely that further trouble will occur in the next stage. Presumab...

Diet in Gastric Ulcer. Part 4: If for any reason surgery cannot be employed, the best chance of cure is afforded by a milk-carbo-hydrate diet, which must be liberal from the first in view of the malnutrition. In many cases improvem...

Diet In Hyperacidity, Hyperchlorhydria, Acid Dyspepsia: This condition must be considered as a secretory neurosis, either inborn or provoked by errors of diet and life. In cases of long duration it is possible that secondary glandular proliferation may occ...

Diet In Hyperacidity, Hyperchlorhydria, Acid Dyspepsia. Part 2: Constipation also is generally a source of trouble. If the condition is of long duration and does not yield to treatment, it usually leads to pessimism and depression. Even after a complete cure I bel...

Diet In Hyperacidity, Hyperchlorhydria, Acid Dyspepsia. Part 3: In the second place there are different views on a more important point, viz. the relative advantages of an amylaceous and a protein diet. The dilemma may be stated thus. (1) It is certain that in hyp...

Diet In Hypersecretion: In considering the subject of hyperacidity it was stated that at the height of digestion the degree of acidity rises to 70 or 100 on Ewald's scale, that the resulting pain and discomfort abate as the ...

Diet In Motor Insufficiency And Dilatation: Under this head are included a large number of conditions which have this point in common, that the stomach is not emptied within the normal limits of time. With this defect there is often associated ...

Diet In Gastroptosis: Dietetic treatment can have no influence on the position of the stomach, and any attempt at a cure can only be made by exercises, mechanical support, and surgical treatment. But something can be done ...

Diet In Gastritis: A. Acute Gastritis In the common form of acute gastritis the changes are almost entirely limited to the mucosa. The condition is therefore often termed (1) simple gastritis or gastric catarrh. It i...

(B) Diet In Chronic Gastritis: This term was formerly used to denote nearly every form of chronic dyspepsia. Now that the great gastric neuroses and functional disorders are defined and separated off, chronic gastritis, though stil...

Diet In Carcinoma Of The Stomach: The prescription of a suitable diet in carcinoma of the stomach presents great difficulties and no one dietary will suit all cases. But there are certain general principles which should be observed. I...

Diet In Flatulence: If flatulence is defined as discomfort arising from an abnormal amount of gas in the stomach with or without eructation of gas, it is a symptom in many conditions. It is so frequently placed in the fr...

Chapter XVII. Diet In Diseases Of The Intestines: General Considerations Dietetic treatment is not so important in intestinal as in gastric disorder, inasmuch as the common errors of diet produce their effect in the stomach, and the intestine is s...

Diet In Diseases Associated With Diarrhoea: Our knowledge of diarrhoea, its causes and varieties, is far from exact, but a classification is useful, even though it may not carry us far towards a diagnosis in individual cases. (1) Diarrhoea m...

A. Diet In Catarrhal Enteritis: For the causes of this condition and for the prophylactic treatment based on a knowledge of these causes, reference may be made to catarrhal gastritis. The gastric and the intestinal disease arise in ...

B. Diet In Nervous Diarrhoea: This condition seldom needs any elaborate dietetic treatment, but it may be mentioned here as contrasting with the chronic inflammatory state already described with which confusion is possible. It is ...

C. Diet In Colitis: (A) Primary The colon no doubt is often affected as well as the small intestine in the catarrhal conditions already described. But in some cases the physical signs and the appearance of blood and m...

D. Diet In Intestinal Ulceration: Three of the various forms of intestinal ulceration need to be considered in relation to diet. As regards ulcerative colitis nothing need be added to the recommendations made in the preceding section....

Chapter XVII. Diet in Constipation: Constipation is due to many causes, which are separate or combined, and every case requires examination before dietetic treatment can be considered. It is very commonly present in association with gas...

Diet in Enterospasm: Common constipation, due to sluggishness of the intestinal movement and of the rectal reflex, is painless. There may be some slight sensation of discomfort, but there is no pain. Constipation produces...

Diet In Mucous Colic (Mucous Colitis, Muco-Membranous Colitis): The diet in this condition is an important part of the treatment. From the evidence I think we must regard the conditions as a perversion of secretion, a secretion-neurosis. If any actual change in th...

Diet In Appendicitis: In cases which are seen and recognized from the first, food should be given sparingly. The ideal state, in which a perforative lesion of the appendix may be best sustained, requires an empty, motionle...

Diet In Intestinal Obstruction: In acute forms of obstruction all food should be withheld until the surgical treatment is completed. The mouth may be washed out with water acidified with lemon-juice, but little or nothing should be ...

Diet In Haemorrhoids: It must be allowed that there is little or no opportunity for the prevention of haemorrhoids by dietetic treatment. It is doubtful whether any errors or peculiarities of diet have any relation to thei...

Chapter XVIII. Diet In Diseases Of The Liver And Pancreas. Jaundice: It might naturally be thought that the exclusion of bile from the intestines would seriously modify the processes of digestion, and therefore it will be well to give a summary of the effects upon the ...

Diet In Gall-Stones: If these are in the common or hepatic ducts they will almost certainly cause jaundice, and then the diet that has already been recommended for that condition will be appropriate. As far as we know ...

Diet In Congestion Of The Liver: Congestion of the liver is a term applied by the public to explain many symptoms, but we have no exact knowledge of any congestion of the liver which occurs in temperate climates except that which is ...

Diet In Tropical Liver: If a European lives for many years in the tropics he is likely to suffer from an illness in which the liver becomes enlarged. Post-mortem examinations show that this is because it is congested. Those ...

Chapter XIX. Diet In Diseases Of The Lungs: General Considerations Diet in diseases of the lungs is of importance, not so much from its curative effect as from the point of view of mitigating the symptoms and relieving the discomfort of the ...

Diet In Asthma: Asthma is a chronic disease with acute exacerbations. The nervous idiosyncrasy which is present in the subjects of this affection is usually accompanied by certain idiosyncrasies as regards diet. An a...

Diet In Bronchitis: I. Acute Bronchitis An attack of acute bronchitis is to be treated as regards the diet on the same lines as any other febrile illness. The foods ordered will be milk, soups, egg in milk or coffee, ...

Diet In Bronchitis. Continued: As regards the treatment of such cases we shall only consider the dietetic part. The first and essential thing is to remove the excess of adipose tissue, and to relieve the lungs of the work of carbo-...

Diet In Lobar Pneumonia: It is now generally recognized that lobar pneumonia is a fever, with local manifestations in the lungs, and complicated in many cases with inflammation in other tissues. The diet during the attack, th...

Alcohol In The Treatment Of Pneumonia: Amidst the uncertainties that still surround the subject of pneumonia one fact seems to be generally accepted, namely, that the chief danger is death from cardiac failure. In considering the question ...

Alcohol In The Treatment Of Pneumonia. Continued: When we turn to the nervous system we find evidence early in the disease that the medullary centres are affected. The rapid breathing so characteristic of the disease is not a sign of pulmonary embarr...

Diet In Pleurisy: In an attack of acute pleurisy the ordinary diet for a febrile illness is to be employed. When effusion takes place, either as the result of an acute attack or in a chronic form, more special treatmen...

Chapter XX. Diet In Diseases And Disorders Of The Heart: It is well to remember that the dietetic treatment of heart troubles includes prevention as well as alleviation; the treatment of functional disorders as well as those attended by actual disease of th...

2. Errors In Diet And Abuses Of Food, Drink Or Drugs: (A) Errors In Diet Errors In Diet are as frequent causes of heart symptoms as dyspepsia itself, and although such errors usually cause dyspepsia this is by no means always the case, and heart troub...

3. Diet In Nervous Disorders - Functional Or Organic: Under this heading we shall first consider the heart troubles of hysteria, neurasthenia, mental strain and worry, and then mention must be made of those occasionally attending true cerebro-spinal dise...

4. Diet In Anaemia And Debility: The treatment of anaemia and debility will be described elsewhere. Many of these cases complain more of their heart symptoms than of anything else. In a number of them, all that has been said regardin...

5. Diet In Febrile States And Toxaemia: Probably all febrile conditions are attended by a state of toxaemia, but there are other toxaemias which are afebrile. Amongst the febrile conditions we have all the infectious troubles including p...

Diet In Organic Diseases. Acute Heart Disease: In considering the treatment of organic diseases of the heart it will be well to divide them into acute and chronic. Acute endocarditis and pericarditis can conveniently be taken together. The indi...

Diet in Chronic Disease - Morbus Cordis: Dietetic treatment of chronic heart disease will be influenced by the following considerations : - 1. The cause, e.g. rheumatism, gout, Bright's disease, etc. 2. The age of the patient. 3. Th...

4. Diet In The Condition Of The Heart: (A) Perfect Compensation Under these circumstances the patients are well, living an ordinary life, more or less, and in some of them no special care in diet seems necessary. It is always wise, of c...

Diet In Aneurism: The dietetic treatment of aneurism has undergone many changes, and a good deal of difference of opinion exists as to whether the diet should be particularly modified or not. We think that the starvati...

Diet In Angina Pectoris: In the treatment of patients suffering from heart pang the careful management of the diet is second in importance only to the need for rest. True angina will be treated here : anginoid attacks (or...

Chapter XXI. Diet In Diseases Of The Blood And Blood-Forming Organs: The dietetic treatment of the anaemias is in many cases one of the most important therapeutic indications, for pathological conditions of the gastro-intestinal tract and the blood as a whole react upo...

Diet In Chlorosis: We have still little knowledge of the causes of chlorosis, though innumerable theories as to its origin have been propounded at different times. Its onset has been ascribed to gastric indigestion, to ...

Diet In Chlorosis. Part 2: Several writers have endeavoured to prove that the abdominal symptoms are the result of ill-fitting or too tightly laced corsets, which interfere with the proper position and action of the muscular vi...

Diet In Chlorosis. Part 3: The common deficiency in the fatty foods requires attention. Milk of course contains a fair proportion of fat, but it should be reinforced with cream as early as possible, and butter should be taken f...

Diet In Pernicious Anaemia: Pernicious anaemia contrasts in many ways with chlorosis. It is not confined to the female sex, occurring as it does a little more frequently among men than among women; nor to any particular age, as ...

Diet In Anorexia Or Gastric Symptoms: Anorexia Or Gastric Symptoms of any kind may prove a serious hindrance to the administration of food. In these cases it is generally advisable to confine the patient to bed, though as much fresh air a...

Diet In The Splenic Anaemias: The association of anaemia of a severe type and enlargemes of the spleen has been recognized clinically for many years. a considerable proportion of these cases the enlargement of the spleen is due to...

Diet In The Secondary Anaemias: The diet in the secondary anaemias requires but brief consideration. It is essential to recognize the wide range of conditions which may produce anaemia. General and local infections, intoxications ...

Diet In The Leukaemias: The symptoms in the leukaemias are in the main of a general kind, the direct result of the associated anaemia; and in the later stages of the disease, may, as in any severe cachexia, be related to the...

Chapter XXI. Diet In Scurvy: At the present day scurvy presents few terrors to the inhabitant of the civilized world, for the means of inter-communication are now so rapid and cheap that practically every variety of vegetables an...

Diet In Purpura: In the majority of cases with purpuric eruptions, the symptoms do not implicate the alimentary tract, and there is no reason to connect it with the origin of the disease; but in a minority such sympto...

Diet In Addison's Disease: The symptoms in Addison's disease are mainly of a general kind, the result of the altered nutrition which the loss of the suprarenal function entails, and local disturbances are secondary to the gener...

Diet In The Thyroidal Diseases: It has been known for long that the origin of endemic goitre may be closely associated with a particular water, and that the disease may disappear with the introduction of a fresh and pure supply; but...

Chapter XXII. Diet In Diseases Of The Kidneys: General Considerations The place of diet in the treatment of affections of the kidney is one of considerable importance inasmuch as so many renal affections run a prolonged and chronic course and m...

Diet In Diseases Of The Kidneys. Continued: In many of these cases of persistent albuminuria the condition is not one of progressive disease, but rather the result of a former attack of nephritis, and such patients often live for many years wit...

The Toxaemia Of Renal Disease: The Toxaemia Of Renal Disease shows itself not only in the development of uraemia, but also by other manifestations, as, for instance, the well known gastro-enteritis that is so frequently present in ...

Diet In Albuminuria: Albuminuria is a most important means of recognizing the presence and sometimes the variety of renal disease present, but the degree of albuminuria is not a safe guide for dietetic treatment. This is ...

Diet In Acute Nephritis: From the standpoint of treatment two varieties of acute nephritis may be recognized. In the one, dropsy is present in addition to marked changes in the composition of the urine. In the other dropsy is...

Diet In Chronic Nephritis: In the dietetic treatment of chronic nephritis we meet with the greatest difficulties because many factors have to be taken into consideration. In the first place the presence or absence of complicati...

Diet In Chronic Nephritis. Part 2: In a considerable number of cases, however, even where dropsy is present, the diet may be with advantage more liberal than this, and small quantities of poultry, meat and fish given. The articles sele...

Diet In Chronic Nephritis. Part 3: Alcohol is probably inadvisable in all forms of chronic Bright's disease, at any rate as a routine. It may be necessary from time to time to order small quantities as a cardiac stimulant, possibly som...

Diet In Granular Kidney: Diet is of great importance not only in the treatment of granular kidney, but also much may be done by suitable food to prevent the development of this disease in those prone to it. Further, there can...

Diet In Amyloid Kidney: Amyloid degeneration of the kidneys is not such a common lesion as it used to be, owing to the improvement in the treatment of septic cases. Still, from time to time amyloid disease is still found ass...

Diet In Functional Albuminuria: Various types of functional albuminuria have been recognized in the past and attributed to different causes, such as exertion, cold bathing, dietetic causes, and the most important of all, that depend...

Diet In Calculous Affections: There are probably at least three factors concerned in the formation of calculi. In the first place, the composition of the food must play a part of some importance, but in addition to this two other ...

Uric Acid Calculi: The uric acid present in the urine is, as mentioned above, of twofold origin, partly derived from the metabolism of the tissues endogenous and part derived from the decomposition of the foods exogenou...

Diet In Oxaluria: In the dietetic treatment of oxaluria, care must be taken not to admit in the dietary food containing an abundance of oxalates, and the diet should be regulated from the point of view of treating any ...

Chapter XXIII. Diet In Diseases Of The Nervous System: Nervous diseases are best divided, for the purposes of the consideration of this subject, into organic and functional. In organic disease structural changes are present which are the result of inflamm...

Diet In Diseases Of The Nervous System. Part 2: Thus, then, in eases of organic nervous disease, no special rules are required as to diet, for we do not know of any diet which materially modifies the progress of those diseases. Still, there are cer...

Diet In Diseases Of The Nervous System. Part 3: Besides the organic diseases of the nervous system, there are certain morbid conditions in which the nervous symptoms consist mainly of disturbances in the functions of certain organs, no doubt determ...

Diet In Epilepsy: It might be expected that in a disease like epilepsy, which shows itself in the definite if irregular recurrence of convulsive phenomena, the influence of diet might have been accurately ascertained. ...

Diet In Graves' Disease: Graves' Disease is one of the diseases which, on account of the obvious derangement of certain parts of the nervous system, is usually included amongst nervous diseases. The diet, in some cases of thi...

Diet In Cerebral Neurasthenia: Cerebral Neurasthenia is that variety in which a condition of incapacity for work and for responsibility has been induced by excessive mental work, by constant and onerous responsibility, usually asso...

Diet In Cerebral Neurasthenia. Continued: In reference to all those varieties of neurasthenia - and it must be remembered that either sex may suffer - rest, change of environment, abundant feeding, and such drugs and food as will improve the ...

Chapter XXIV. Diet In Diseases Of The Skin: General Considerations In a discussion of the dietetic treatment of diseases of the integumentary system we are faced with the uncertainty or complicated etiology of many of them. To enable the rea...

Diet In The Dermatoses: The Dermatoses excited by ingested aliments and medicaments are next to be considered. Here an inherited or acquired vulnerability often comes into play. It is well known that certain articles of diet...

Diet In The Phase Of Tuberculosis Known As Lupus Vulgaris: The Phase Of Tuberculosis Known As Lupus Vulgaris , constantly illustrates for us the importance of attending to the deficient resistance of the soil. It often occurs in persons who have inherited a d...

Diet In Pruritus, Or The Symptom Of Itching: Pruritus, Or The Symptom Of Itching , is due to disturbance of function of the sensory nerves, and may occur quite apart from any co-existent eruption which involves these nerves. The conditions deter...

Diet In Urticaria: Urticaria is the result of a special kind of reaction of the skin in which the vaso-motor nerve system is specially involved, and may be excited by external or internal irritants, directly as in a net...

Diet In Lichen Urticatus And The Prurigos: Lichen Urticatus And The Prurigos are closely related to urticaria, and here again we meet with a highly susceptible vasomotor or sensory nerve system set in action by a variety of excitants, which of...

Diet In Eczema: Eczema is an inflammatory reaction of the skin of a different type, and probably due to a diversity of causes, often complicated. For a patient may inherit a state of nutrition predisposing to it, or ...

Diet In Dermatitis Herpetiformis: Dermatitis Herpetiformis , formerly included with pemphigus, is an uncommon eruption of which the etiology is often obscure. Some cases are thought to be from nervous breakdown, or from intestinal aut...

Diet In Lichen Planus: Lichen Planus of E. Wilson is also generally considered to be dependent on the state of the nervous system. This opinion is founded on the facts that the subjects are often obviously neurotic, and not...

Diet In Generalized Erythrodermia: Generalized Erythrodermia is rare, and the etiology often obscure. It is known that various chronic skin eruptions, such as eczema and psoriasis may take on this severe phase, and such a skin conditio...

Diet In The Erythemata: The Erythemata , which vary in type from the rashes simulating those of some of the acute specific fevers to macular, papular, nodular, and bullous eruptions, haemorrhagic or not, are probably all of ...

Diet In Lupus Erythematosus: Lupus Erythematosus may be discussed here. It is believed by many dermatologists to be intimately connected with tuberculosis, i.e. brought about in some way by the products of tubercle bacilli. My ow...

Diet In Herpes Simplex Or Febrilis: Herpes Simplex Or Febrilis is well known to be excited, probably reflexly, about the muco-cutaneous orifices chiefly by a multitude of recurrent causes, such as the catamenia, sexual congress, febrile...

Diet In Pemphigus: Pemphigus is a term applied to a collection of bullous eruptions of uncertain etiology, after exclusion of the bullous phases of such eruptions as streptococcic impetigo, erythema multiforme and liche...

Diet In Pityriasis Rubra Pilaris: Pityriasis Rubra Pilaris is another rare relapsing eruption, the pathogeny of which is unknown, but there are no special indications for any particular diet. Psoriasis again, a recurrent eruption o...

Diet In Xanthoma: Xanthoma is considered by some to be a neoplasm, but to my mind it is a special reaction of the skin brought about by one or more agents. We see one form occurring in various liver affections associat...

Diet In Acne Rosacea: Acne Rosacea is a term which includes so-called seborrhoeic dermatitis of the face, but especially recurrent and the stereotyped hyperaemia of the face caused by constant external producers of local b...

The Teeth Of The Aged: All are familiar with the toothless gums of the aged. In advanced age the teeth tend to loosen and drop out, from atrophy of the alveolar processes. This occurs sooner among civilized than among primi...

The Teeth Of The Aged. Continued: The Ideal Dietary The most suitable diet for the aged is that which constitutes the ideal diet for man in general. Such a dietary demands (a) moderation in quantity, (b) simplicity in quality, ...

The Factor Of Idiosyncrasy: The Factor Of Idiosyncrasy is an important one. Individuals differ greatly, quite irrespective of age, in their digestive and metabolic capacities. We meet with children who are unable to tolerate foo...

The Dietetic Indiscretions Of The Aged: Some people, unfortunately, and more especially men, tend as they get older to care more and more for the pleasures of the table. As the mental horizon narrows and other interests wane, the subject of...

The Dietetic Instincts Of The Aged: Though doubtless the appetite for plain food tends to lose its keen edge with advancing years, and the dietetic instinct - the liking for different kinds of food - to alter somewhat, the changes in th...

Chapter XXVI. The Feeding Of Infants And Children In Health: The great difficulty in connexion with the question of diet in adult life is that we have no authoritative standard which will command general acceptance. For infants, on the other hand, we have both ...

I. Breast-Feeding. Breast Milk: Milk when freshly drawn from the breast is a warm, sweet, sterile, alkaline fluid with a specific gravity of about 1030. The chief solid ingredients,1 which amount to 13 per cent, are proteins (1-2 pe...

Variations In Breast Milk: The chemical composition of breast milk, after the first week, does not appear to vary much during the normal period of lactation. Although the composition of breast milk has been given above, it must...

II. Feeding Infants With Cows' Milk: Cows' Milk In the absence of breast milk, the substitute which has gained universal acceptance and approval is pure, fresh, cows' milk. It is not however to be regarded as a perfect substitute, and...

Modifications Of Cows' Milk In Infant Feeding: It may be stated as a generally accepted axiom that the more closely the artificial diet of an infant approaches in composition that of breast milk, the more likely is it to be a successful substitute...

Modifications Of Cows' Milk In Infant Feeding. Continued: The Dilution Of Cows' Milk Reduces The Amount Of Sugar from 4.50 per cent to 1.50 per cent when two parts of water are added. Some additional sugar must therefore be added to bring it up to the necess...

The Number Of Meals: The number of feeds in the twenty-four hours must be arranged according to the age of the infant, and the times fixed must be closely adhered to. It is very rarely that one meets with an infant who is...

The Quantity Of Food For A Newly Born Infant: A newly born infant should be put to the breast within a few hours, and afterwards at regular intervals. The quantity of nourishment at first may be small but it is sufficient for the purpose until na...

III. Mixed Infant Feeding: In many cases a mother with the best intentions finds herself unable to supply a sufficient amount of breast nutriment for the infant. The defect may be either in the quantity or the quality of the mi...

Signs Of Successful Infant Feeding: By many the only test employed as to the success of the diet is the gain in weight. This is too limited a view. An infant may be gaining in weight but may not be thriving. Fat in infancy is easily pro...

A Change Of Infant Diet: Before jumping to the conclusion that some other food must be tried for an infant it is extremely important to make sure that the food employed is the element at fault. In the vast majority of cases i...

Other Modifications Of Cows' Milk And Special Foods: The more elaborate methods of modifying milk require careful consideration because they represent attempts to overcome difficulties in connexion with this food material. Some of them are of a scientif...

1. Sterilized Milk: There are various methods of sterilizing milk. We have already referred to the sterilizing action of boiling the milk, but by the term sterilization is meant the exposure of milk to a temperature ...

2. Pasteurized Milk: In the process of pasteurization the milk is subjected to a temperature of from 158 F. to 170 F. for half an hour or longer. It may be carried out at home in an apparatus specially construct...

3. Laboratory Milk: The most scientific modification of milk which has ever been attempted is that known as the American or percentage method. It has been evolved by the genius and enthusiasm of Dr. T. M. Rotch of Ha...

4. Municipal Milk: Within recent years the feeding of infants has been taken up by some municipal authorities as a means of preventing the great mortality during the first year of life. The French, led by the late Profe...

5. Budin's Method Of Feeding Infants On Sterilized Milk: Professor Budin introduced the method of feeding infants on sterilized milk, without dilution or addition. He was led to adopt this plan because in his experience infants fed on diluted milk were obli...

6. Top Milk: The importance of securing a full amount of fat in the dietary, and especially in the natural form of gravity cream, has led to the adoption of top milk mixtures by many. The upper portion of the milk...

7. Whey: This is sometimes employed as a modification of milk by which the insoluble proteins are removed. Whey is prepared by adding a drachm of liquid rennet to half a pint of warm milk (104 F.). After ...

8. Citrated Milk: Attempts have been made to overcome the casein difficulty in cows' milk by the addition of citrate of soda. In 1893 Wright drew attention to the importance of the calcium of cows' milk in producing th...

9. Predigested Milk: Another method of overcoming the difficulty in digesting the casein of cows' milk is to employ some digestive ferment to peptonize the milk before use. The stomach is then not called on to perform the...

10. Addition Of Decoctions Of Cereals: We have already referred to the use of barley-water as a diluent. This, if made as directed for infants, is not of any nutritive value, but is a bland fluid which diminishes, to a slight extent, the d...

Diet From Nine To Twelve Months: We have been considering hitherto the food materials suited to an infant during the first stage of life which terminates at nine months. This epoch is marked by the eruption of the first tooth, which ...

Dr. Cheadle's Formula For Bread Jelly: Dr. Cheadle's Formula For Bread Jelly is more elaborate but produces a very digestible food. A thick slice of stale bread (4 oz.) is soaked in a basin of cold water for six or eight hours and then squ...

Diet During The Second Year Of Life: The same guiding principle is to be observed here, namely, that the child should have an amount of the three chief elements, proteins, fats, and carbo-hydrates, sufficient for the nutrition of the bod...

Diet From The Second To The Seventh Year: The alterations in the diet at this period are as regards the quantity rather than the quality of the food materials. The active exercises which characterize a child at this age call for an increased ...

Diet During School Life: The child has now reached an age when, in addition to the requirements of the body for growth, repair and exercise, we have to consider the work of the brain in connexion with the diet. It is recogniz...

Diet During School Life. Continued: The chief meals of the day should be three in number, breakfast, dinner and supper. Of these the first two should be the substantial meals, while supper should consist of less stimulating material. Bo...

Chapter XXVII. Diet In The Diseases Of Children: General Considerations On Disorders Of Digestion On entering on the subject of disorders of digestion in early-life it may be stated at once that diet plays the chief part both in the causation and...

Disorders Of The Stomach: The stomach is the source of much trouble in infancy, and the leading symptoms of disturbance are vomiting, flatulence, and pain. The belching of wind and the regurgitation of food are not necessary p...

Chronic Intestinal Indigestion. Chronic Gastrointestinal Catarrh. Chronic Indigestion. Marasmus: We pass from the more acute disturbances of the stomach to those more chronic affections in which the functions of the stomach and bowels are interfered with. In many cases the correction of errors in...

Chronic Intestinal Indigestion. Chronic Gastrointestinal Catarrh. Marasmus. Part 2: Cases of fat indigestion may also be treated by means of buttermilk, which is very similar in composition to skimmed milk. It differs in the markedly acid reaction, due to the lactic acid fermentation...

Chronic Intestinal Indigestion. Gastrointestinal Catarrh. Marasmus. Part 3: The extreme form of malnutrition from gastro-intestinal catarrh is known as marasmus. Some infants are born with very low vitality and with an alimentary tract which is apparently incapable of dealing...

Food Fever: This is a disorder which has been specially described by Dr. Eustace Smith as consisting of an attack of fever which comes on suddenly, is accompanied by signs, more or less pronounced, of digestive ...

Diet In Acidosis Or Acid Intoxication: The condition of acidosis or acid intoxication may be considered here, first because it is believed by many to be the result of faulty metabolism associated with the diet, and secondly, because the sy...

Diet In Diarrhoea: Diarrhoea is one of the commonest signs of intestinal disturbance in infancy and childhood. A large number of cases will be found to be associated with improper feeding. Diarrhoea may be one of the ch...

Chapter XXVII. Diet In Constipation: Constipation is a common trouble in infants, both breastfed and bottle-fed. Without being immediately injurious to the child's health, it is the source of much discomfort, and may induce a permanent w...

Diet In Abdominal Tuberculosis: There are three chief forms in which abdominal tuberculosis is manifested in early life. First, there may be tuberculous enteritis, an ulcerative form of inflammation affecting chiefly the lower part ...

Diet In Congenital Pyloric Stenosis: This is an affection of early infancy to which attention has only recently been directed. Cases are still being frequently overlooked, the proper treatment is not carried out, and the infants die. As ...

Diet In Rickets: The exact aetiology of rickets is still unsettled, but certain factors in its production have been determined. We are not concerned here with all the causes, but there is a consensus of opinion as to ...

Diet In Rickets. Part 2: It is sometimes stated as regards these foods, condensed milk and starchy preparations, that if deficiency of fat is the source of trouble, this can easily be remedied by adding some cream or butter. ...

Diet In Rickets. Part 3: A dietary suitable for different ages may be drawn up as follows : - Between Nine And Twelve Months Cows' milk which has been brought to the boil, and slightly sweetened and salted (1-1 1/2 pint...

Chapter XXVII. Diet In Scurvy: It is found that over 75 per cent of the cases of scurvy occurring during the whole period of childhood arise between the sixth and twenty-fourth months, and hence the term infantile scurvy is fully...

Chapter XXVIII. Diet In The Diseases Of Hot Climates: General Considerations Some tropical diseases, such as sprue and dysentery, are in the main best treated by modifications in diet, whilst in other tropical diseases diet is of subsidiary importance...

Diet In The Diseases Of Hot Climates. Part 2: Thus diet may be an actual cause of disease. Excess of protein material in Europeans, and deficiency of proteins in the poorer classes of natives and in some institutions, are instances of this. A ...

Diet In The Diseases Of Hot Climates. Part 3: Fresh milk is better diluted if for use by invalids. In most febrile diseases thirst is excessive, and if considerable quantities of milk are rapidly swallowed, the hard and massive curd which then fo...

Diet In Malaria: The benign malarial fevers call for no special dietary. During the febrile paroxysms food need not be given; if given it would probably not be retained. Fluids may be taken freely, and such as promote...

Diet In Blackwater Fever: As in malaria, the individual attack is of short duration, nevertheless during this brief period an extreme degree of anaemia is attained. The greatest danger is suppression of urine; consequently the...

Diet In Yellow Fever: In this disease gastric irritability, shown at first by acid vomiting and later in the grave cases by the vomiting of altered blood - black vomit, is usually present. The early vomit may be bilious, o...

Diet In Relapsing Fever: During the febrile paroxysm, which lasts up to a week, light fluid diet only can be taken. The tendency to collapse at the time of the crisis renders it necessary that nourishment be systematically ad...

Diet In Dengue Fever: No special diet is necessary. The ordinary dietetic treatment of a febrile condition may be followed. If the articular pains are severe or persistent, meat should be avoided. ...

Diet In Malta Fever: A liberal dietary is requisite as this irregular fever may last for months or even years, and great debility and anaemia ensue. When the temperature is high, fluid diet only can be taken, but as soon ...

Diet In Kala Azar And Trypanosomiasis: In these chronic febrile conditions, no special diet is required. Although light, the food must be abundant, nutritious, and varied, as in both diseases wasting and debility occur. In the apyrexial pe...

Diet In Beri-Beri: Diet in beri-beri has to be considered mainly as to its effect in causing any embarrassment of the heart. The nerve supply to the stomach is usually impaired, and there is a great tendency to dilatati...

Diet In Anchylostomasis: In uncomplicated cases, no special dieting is required except that preliminary to the treatment for expulsion of the worms. The patient after treatment should be well fed; a liberal diet including mea...

Diet In Filariasis: In the febrile conditions associated with this group of diseases light fever diet is all that is required, or that the patient would care to take. In chyluria the amount of discharge in the urine a...

Diet In Bilharziasis: The actual discharge of blood is due to local lesions, and no special dieting is required in many cases. It is, however, so often associated with cystitis and still more frequently with irritability o...

Diet In Plague: During the acute stages of the disease food in a concentrated fluid form such as strong soups, broths, and milk should be given. As cardiac failure may occur during convalescence, stimulants must be a...

Diet In Gastro-Intestinal Diseases: General Principles Regulation of the dietary plays an important, if not the most important, part in the management of the various morbid conditions to which the alimentary canal is so peculiarly pr...

Diet In Cholera: During the acute stage of cholera food is out of the question. If swallowed and retained it can only do harm, for in the condition of the stomach at this period of the disease digestion and absorption...

Diet In Acute Dysentery: In the suddenly developed and urgent types of dysentery - usually bacillary in origin - it is advisable, unless the patient from some special cause, such as starvation, is in a very prostrate conditio...

Diet In Chronic Dysentery: For some time after recovery from acute dysentery, and in the various types of sub-acute relapsing dysentery and of chronic dysentery of tropical origin, and which are usually associated with the pres...

Idiosyncrasies In The Matter Of Food: Idiosyncrasies In The Matter Of Food are not uncommon and have to be taken into account. Mental peculiarities have also to be considered and care may have to be exercised by avoiding a too sedulous in...

Diet In Sprue: In no other disease is it more necessary to enforce the principles of physiological rest together with an adequate supply of digestible non-irritating food than in sprue. The patients, as a rule, are ...

I. The Milk Treatment For Sprue: Of these methods the most generally applicable and effective is the first - the treatment by an exclusively milk diet. It ought always to be tried in the first instance. Its success depends, in great ...

II. The Meat Treatment For Sprue: When it is deemed advisable to have recourse to this system of dieting, either from the outset or in consequence of failure of the milk treatment, it is well to commence with teaspoonful, gradually in...

III. The Fruit Treatment For Sprue: One of the most important recent advances in the practical management of sprue is the introduction of the strawberry as an adjuvant to the milk treatment. A diet of milk and strawberries, the amounts ...

Diet In Hill Diarrhoea: The treatment of hill diarrhoea is practically the same as for sprue. Bichloride of mercury is generally prescribed as an intestinal antiseptic, and the milk is peptonized or lactopeptin or ingluvin g...

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