B. Foods Occasionally Allowable

There are foods which may be allowed to some patients but not to others, and many of them constitute exceptions to the foregoing general rules. Such are:

Vegetables

Mealy, well-baked potatoes, not too young or new, raw tomatoes, spinach, thoroughly boiled onions, very young tender fresh peas, very young Lima beans, string beans, asparagus, stewed celery, celery plant (sea-kale).

Starchy Foods

Where it is desirable to give starchy food in some form, macaroni, spaghetti, or rice may be allowed, or one of the prepared foods, such as Carnrick's or Mellin's. All starchy foods should be most thoroughly cooked, for salivary digestion is often feeble in connection with gastric disorders.

Fats

Bacon, very fat, sliced thin and well broiled; cream, good fresh butter, olive oil.

Eggs

Many patients find that eggs disagree with them constantly. There are a few who can take them with impunity if rightly cooked - that is, cooked very slowly and soft. They sometimes agree better when not given with other food, but as eggnog.

As a rule, sweet fruits disagree, though they can be eaten by some patients.

C. Desirable Foods To Be Recommended In Ordinary Cases Are: Cereals

Wheaten bread, porous or aerated, stale or toasted; dry, unsweetened rusk or zwieback; soda crackers. (The bread from some bakers is easier of digestion than that from others.) Macaroni, sometimes oatmeal, but without sugar.

Fats

In moderation only; butter to be very thinly spread and well rubbed in. Sometimes a thin rasher of bacon.

Vegetables

Chiefly as purees, thoroughly cooked, made of tomatoes, asparagus, or sometimes potatoes or fresh peas. (Fresh green vegetables as in preceding list.) Lettuce.

Fish

Oysters, fresh-boiled or broiled fish without rich sauces. They may be eaten with a little fresh butter and salt. (Some persons cannot eat fish at all).

Eggs

In any form if they are found to agree (except hard-boiled or fried).

Sweetbreads, Meats

Broiled steak or chop, tender roast beef or mutton, chicken (roasted or boiled), boiled capon, roast partridge, grouse, woodcock, plover, prairie chicken, squab. All meats should be short-fibred and tender. They need not be very rare. Grilling is the best method of cooking them.

Fruit

Baked or stewed apples or prunes. Occasionally a little fresh fruit in season, better eaten between meals to prevent constipation. Oranges, peaches, grape fruit.

Naturally, in bad cases the diet must be still further restricted, and a bread-and-milk regimen may have to be enforced until improvement occurs.

Beverages

Tea is generally injurious, especially if drunk with meals, but weak tea taken clear in very hot water is sometimes beneficial by enabling patients to imbibe the fluid which they need. Strong tea is astringent; it precipitates pepsin and provokes constipation. Coffee, on the contrary, favours peristalsis, and is mildly stimulating to the nervous system. Drunk with milk and sugar it often excites dyspepsia and increases flatulency. Taken black after dinner it is an adjunct to digestion. If it produces insomnia or "nervousness" it should, of course, be discontinued. Yeo says that both tea and coffee may cause dyspepsia in those who are under mental strain, but not otherwise in the same individual. Light China teas are less injurious than the stronger Indian varieties. Coffee contains more tannin than tea, which has only a trace. It does not itself ferment, but the milk and sugar drunk with it does.

Cocoa (not chocolate, which is too sweet) may be allowed. An infusion of cocoa nibs often agrees.

Milk and Vichy or milk and Seltzer may be drunk as a beverage in non-flatulent cases.

As a general rule, malt liquors and beers of all kinds must be forbidden, although Fagge recommends the use of light, still, bitter ale or of porter in some cases; but he says, "Whatever causes flushing of the face after meals is bad." Alcoholic dyspepsia is only cured by entire cessation of drinking. This the patients are unwilling or unable to accede to unless very strongly influenced or frightened as to the probable outcome of continued indiscretion. In simple atonic dyspepsia the use of pure wine, or weak brandy, or whisky and water and drunk at meals may prove serviceable. Sometimes a little dry wine, claret, or hock may be allowed twice a day with meals.

Tobacco, smoked in moderation, in the form of mild cigars or in pipes (not cigarettes), promotes digestion by slightly stimulating the nervous system and increasing peristalsis.