This section is from the book "Mrs. Allen's Cook Book", by Mrs. Ida C. Bailey Allen. See also: The Conscious Cook: Delicious Meatless Recipes That Will Change the Way You Eat.
Few housewives understand the preparation of the simplest dishes in the invalid's dietary although in the majority of cases of illness the nursing is done by members of the household. And diet plays a most important part in restoring just as it does in maintaining health. Many a patient drifts into a critical stage because he is not supplied with the proper foods. Even when only suffering with a severe cold the diet should be lightened, as a hearty meal is liable to overtax the digestive organs to the point where they fail to do their work. The undigested food remains in the digestive canal and ferments, the poisons which are generated lower the vitality, and the patient's condition becomes worse. Much trouble arises because the home nurse does not know what to feed and how to prepare it, while other patients are almost starved to death because of the ridiculous notion that food must be almost always withheld during illness. It is just as radical a mistake to starve a sick person as to overfeed him, for, even while confined to bed, he still requires a certain amount of food to carry on the business of living. There are, to be sure, certain illnesses in which food should be withheld, but in that case the patient is extremely sick, and requires the constant service of a physician, who will prescribe the diet.
In hospitals ordinary diets are grouped under the following heads:
1. Liquid Diet.
2. Light Diet.
3. Convalescent Diet.
All the special diets, as diabetic and diet in pneumonia, are dictated by the physician for each individual case.
Light diet includes poached, boiled or coddled eggs, toast, toasted crackers, milk soups, well-cooked cereals, rice, milk toast, cocoa with egg, junket, custards, fruit and wine jellies, sifted apple sauce and all the foods enumerated under liquid diet.
Wheel-Tray Set For Invalid Luncheon.
In convalescent diet the invalid begins to approach his normal food. Broiled chicken, squab, chops or steak, scraped-beef balls (it will be noted that the meats are broiled, not fried), well-baked potatoes, scrambled eggs or omelet, well-cooked spinach, peas or stewed celery, sponge cake a day old, baked apples, stewed figs or prunes, oranges, Malaga grapes, rice or tapioca pudding, and bread a day old may be added to the list for light diet.
As a general rule it may be stated that liquid diet is used in fever cases, in severe gastric disorders (stomach diseases); for two days after delivery in maternity cases, in pneumonia, mumps and cases of severe intestinal indigestion. In fever, liver and pneumonia cases the acid drinks mentioned in the list are often added.
Light diet is the first step up from the liquid diet to solid food and may also be used for a day or so when the stomach is upset, in cases of rheumatism, grippe, for a few days in maternity cases, and in the diseases of children, like the second stage of measles, chicken pox or scarlet fever. It is also used in fever cases for three ~ or four days after the temperature has dropped to a normal state.
Convalescent diet is usually resumed when the patient begins to be dressed, or, at least, is sitting up for a few hours each day; it is generally commenced by the addition of one extra dish to light diet, the variety and quantity being gradually increased until the patient is eating the usual family food. When this occurs, he will be well.
Any invalid should be fed frequently and in small quantities, in order to avoid overtaxing the digestive organs, and yet furnish the necessary nourishment. In acute diseases, for instance, the patient is often fed every two hours in very small quantities. In such cases the amount of liquid is generally prescribed in ounces. In measuring such amounts a graduated glass, with the ounces and drachms clearly marked upon it, will be of incalculable assistance. In case such a glass is not at hand, the number of ounces may be measured by a standard teaspoon; two tablespoons, or six teaspoons, constituting the ounce. If a silver knife or teaspoon is put into the glass, hot liquids may be poured into it without fear of breakage. The administering of liquid diet to a very sick patient from a teaspoon is usually a disagreeable task - taxing the patience of the home nurse to the utmost, and wetting the face and neck of the patient. A glass feeding tube may be purchased at any druggist's, and, as it is made with a bend, this may be placed between the patient's lips, the nurse may hold the cup of liquid, and the patient drink without being raised from the bed, or feeling the liquid trickle down his neck! In cases where the patient is too exhaused to even draw the liquid through the tube, a feeding cup may be used. In using this, slip the mouth of the cup between the patient's lips, and pour in the liquid so gradually that there may be no possibility of choking.
At no time is a person so sensitive to imperfection as during sickness. This is because his world is bounded by the four walls of the room, interest is self-centered, and, unless all foods approach perfection, the patient assumes the lack to be a personal affront. In serving hot milk or cocoa, be sure that the scum is removed, or it may "turn the stomach" and produce nausea. Lemonade, orangeade and egg-nogs should be strained, and all lumps carefully removed from gruels. For this purpose a china strainer will be invaluable. It should be large enough to fit over either a glass or cup; as it is of china rather than wire like the ordinary strainer, and is used only for the invalid, it may be kept surgically clean.
The nurse frequently reports to the physicians that the patient has no appetite. In many cases this may be due to the depressing effect of an ill-kept room, or to "a bad taste in the mouth," which may be removed by a mouth wash of water containing boracic acid (a fourth of a tea-spoonful to a cupful of lukewarm water) or to the general condition of the patient. Whatever the cause it must be ascertained and removed. Frequently more time and thought expended upon the invalid's meals will remedy this condition. Punctuality in serving the meals must be strictly observed, for appetite is largely a result of habit; a meal delayed often appears after all desire for food has gone.
The principal meal of the day should be given when the patient is sitting up. In case the meal is served in bed the pillows must be carefully arranged as a support, and if a bed tray with little standard legs is not in the household, a pillow, smoothed flat, and placed upon the patient's lap, will act as a resting place for the tray.
When a patient is very ill, the nurse is liable to become careless, and instead of choosing the prettiest cup in the house for broth, and setting it in its saucer on a doily-covered tray, she will bring it in a cracked kitchen cup, walking very slowly in order not to spill the contents! Either the cup or the way it is presented may be sufficient to upset a nervous patient, and while it sometimes seems as though the invalid does not notice any little defects, it is often only too true that he is too ill to speak of them and that they jar horribly upon his taut nerves.
The tray should be covered with a clean tray-cloth or napkin, the silver placed upon it in the most convenient position for use, and all hot dishes should be covered. It is always a great pleasure to an invalid to begin to do things for himself, and an individual pot for hot milk or cocoa, necessitating a little effort in pouring it out, will often be the first step toward reasserting the self-respect that is so much a part of health. In so far as possible individual dishes should be used in preparing the invalid's food, as it conveys the idea that he is the subject of special thought. In any home of moderate means there is no necessity for serving mismatched and cracked dishes to the invalid. There is an old French proverb which says that "The eye does half the eating," and it is more true in sickness than under any other circumstances.
When the diet becomes convalescent, the patient can usually eat one or two meals of the day at a serving table. By this time the tray is liable to become overcrowded if all the food is brought in at once, so it is a good plan to reserve the sweet until the main portion of the meal has been eaten. It then acts as a surprise.
Generally a patient should not be consulted as to what he "wants to eat." If he expresses a desire, gratify it, if it is not unreasonable, and in some cases even then. Never serve a food that is difficult to eat (unless during convalescence), like broiled chicken, without either breaking it up before bringing it to the patient, or else preparing it for him after bringing in the tray, otherwise he will become discouraged and refuse to eat it. Stay with him while eating, or else delegate some other member of the family to do so, as otherwise he will eat too fast, and indigestion will result.
Probably the most neglected country diet is that served in maternity cases. The energy of the new mother is at a low ebb, for months her strength has been given to the new life, and. after birth, in normal cases, the drain is continued through the production of milk. For the first six hours after labor a milk diet should be given, light diet should be served for the next three days, five meals a day being needed to keep up strength. Convalescent diet may be used for a few succeeding days, when the usual daily fare may be resumed, with the exception of strongly-flavored vegetables, like onions, or cabbage, or fruits which are acid, like strawberries. Beer should never be taken, as it has no action upon the flow of milk, as is popularly believed.
The following recipes will prove of assistance in preparing sick diets.