Dietetic Treatment Of Mild Cases

In the milder cases characterised by nervousness, muscular tremors, indigestion, dyspepsia, a foul breath, coated tongue, and urine loaded with urates or crystalline deposits, if the patient can be induced to stop all alcoholic drink and take abundant water or alkaline effervescing waters (Vichy, Seltzer, Apollinaris, etc.), together with a proper diet, much can be done to ward off an acute attack. A very good example of the appropriate diet is the following from Foods and Dietaries;

Breakfast

A lightly boiled egg, or a little bit of whitefish or of bacon, or a light savoury omelet; toast, or bread and butter; a cup of weak tea or of coffee and milk.

Early Dinner, 1 O'Clock

A slice of roast mutton, or the wing of a chicken, or a plain cutlet, with a spoonful of mashed potato and some well-boiled green vegetable. A few spoonfuls of any plain milk or bread pudding, with occasionally some stewed fruit.

Beverage

A glass of plain or aerated water, to be taken slowly towards the close of the meal.

Afternoon

A cup of tea with milk may be allowed, with toast or rusk.

Supper, 7.30

A light meal of fresh fish, or of bird, or of calf's head, or of tripe, with dry boiled rice or bread.

Beverage

Small glass of milk and soda water".

In cases of periodic alcoholism, in which the patient has no craving for drink between his attacks, it is best to recommend for the intervals a non-stimulating diet, avoiding condiments and richly cooked or highly seasoned food of all sorts. Fruits, plainly cooked cereals, and vegetables should constitute the staple diet, and animal food should be eaten only in moderation.

In some of these cases overindulgence in food excites the craving for alcohol.

Dietetic Treatment Of Severe Cases

The treatment of the severer cases, in which dyspeptic or gastro-intestinal symptoms predominate, but in which delirium tremens is not necessarily present, is mainly that of gastric catarrh, described elsewhere. It must be adapted to the degree of inflammatory or cirrhotic changes which have already taken place in the different organs. The patients usually feel much worse in the mornings, having nausea and vomiting or loathing for food, but later in the day they may recover considerable appetite and power of digestion. Advantage should be taken of this fact in feeding them. The following menu from Foods and Dietaries is very well adapted to this stage of chronic alcoholism:

Breakfast, Say 8 O'Clock

A cup of weak tea with an egg beaten up in it, and a slice of toast.

Second Meal, 10.30

A cupful of good meat soup, thickened, or a cup of peptonised milk, warmed, with toast or rusk.

Early Dinner, 1 O'Clock

A tablespoonful of pounded meat on toast, or a small teacupful of fresh meat juice, with fingers of toast. A couple of spoonfuls of sago, custard, or tapioca pudding.

Beverage

Half a tumblerful of milk and soda water (equal parts).

Afternoon Tea, 4.30

A cup of weak tea or of cocoa nibs, with rusk or a plain biscuit.

Evening Meal, 7 O'Clock

A cup of soup or of mutton broth, as at the forenoon meal.

9.30 Or 10

A cup of peptonised milk and a slice of thin bread and butter.

Food During The Night

In case of wakefulness there should be within reach, and arranged so as to be readily warmed, peptonised milk".