Subject to individual exceptions, a febrile period of three or four days requires no organic nourishment, in an adult of average strength. Indeed, many patients are rather benefited by a fast which allows the emunctories some rest and stimulates the body to draw upon its store of fat.

In young children and old persons, especially of debilitated constitution, it is advisable to nourish throughout even a brief fever, unless, as in various intestinal diseases, assimilation is practically prevented by the conditions present and recovery is delayed by the embarrassment of the mechanic and chemic effects of food.

In any fever lasting more than a week, nutrition is important and it becomes more and more imperative as the limit of tolerance of inanition - 40 days - is approached.

There seems to be an element of truth in the old, crude conception, that certain foods were "heating." The diet appropriate to most fevers is semi-solid, consisting of milk, cereals, meat juice - but not meat teas which contain almost no nutriment and, on the contrary, waste products - eggs, custards, fruit juices etc.

As a rule, fever patients should be fed every four or five hours, occasionally as often as every two hours. It is practically never advisable, under any circumstances, to feed oftener than this, except that any one meal_ may be divided by short rests.

Neither is it of appreciable value, unless merely to induce the patient to begin to eat, to introduce so small quantities as a spoonful of milk at a time.

The endeavor should be made in all cases in which nutrition is of serious import, to introduce 50 grams of protein a day and a total amount of organic food corresponding to 2000 - 2500 call

However, the average patient has available 5 - 1.5 kilograms of chemically pure fat. The oxidation of 250 grama (1/4 kilogram) daily, would yield approximately the total number of calories required. Tims, with the addition of 50 grams of protein a day, the average patient should theoretically subsist 3 - 9 weeks on his own tissues.

Whether because metabolism is greatly increased in fevers or because of failure of lipases or because of other reasons not understood, nourishment by the patient's own fat is not an adequate reliance, even if sufficient protein is given.

In all infectious diseases, aside from the necessity of disinfecting the discharges, clothing, bedding etc., and of maintaining quarantine in many infections, it is important to prevent the food and drink of the patient, his eating utensils and the passage of trays to and from the sick room, from being means of conveying infectious matter.

All remnants of food should be destroyed, preferably by fire, placing them in paper bags, which are burned with due precautions against spattering from explosions of steam before the temperature has reached a point sufficient to kill germs. This precaution is particularly important when cookstoves and hot-air furnaces are

Table utensils, napkins etc., with analogous precautions, should be slertilized by boiling for ten minutes or more.

While the principle that one cannot spoil bad eggs applies to some degree to the danger of conveying infection to the patient himself, the possibility of introducing germs of an independent disease, as in hospitals and, more generally, of introducing saprophytes which will cause complications in the stomach and intestine, should be borne in mind. Thus, while it is rather far-fetched to boil the water for a typhoid patient, unless there is danger of other contamination, the ordinary principles of asepsis and cleanliness applying to food and drink, should be enforced for fever patients.

Unless in a window box or refrigerator, or proper receptacle, food should never be kepi on band in the sick room.

For her own protection, the nurse should be careful not to taste food that might have been contaminated from the patient, not to eat without first carefully cleaning her hands and it is better that she should not eat at all in the sick room.

Particular care is necessary to avoid refusal of food or reflex inhibitions of digestive secretions, by offending the aesthetic sense of the patient in any way. Hence, nourishment should always be served in a cleanly and dainty manner, and not immediately after defaecation.

On the other hand, feeding in fevers is usually a serious business and, until convalescence sets in, a distinct appeal to the appetite is usually unnecessary.

The various flour pastes and slops commonly prescribed in cook books for invalids are of little value.