This disease must be treated dietetically, as are the other acute infectious fevers. In pneumonia, appetite is diminished and thirst is increased; frequently delirium makes a patient oblivious to hunger and thirst; when this is the case, the sufferer should be fed regularly. Liquid food is the easiest and best to administer. When milk is well tolerated, it should be employed as the staple article of food, but care should be taken not to overload the stomach, for if it is distended, it will impede respiration and circulation. The bowels should also be well emptied at the onset of the illness and moved daily thereafter. It is not necessary that the diet consists of milk only. Broths, eggs and milk, thin custards, and gruels may also be eaten. In severe cases a modicum of nourishment should be given every two hours; in milder ones, somewhat more may be given at longer intervals. In the mildest cases soft-cooked eggs, cornstarch pudding, gelatin jellies, milk-toast, and soft-boiled rice may be eaten in small amounts, in order to vary the monotony of the milk diet.

In severe cases, especially in advanced life, it is of great importance to maintain strength. Sufficient nourishment can usually be given by the mouth, but occasionally it may be necessary to resort to nutritive enemata.

While breathing is rapid and labored, swallowing is more or less of an effort, because it quickens respiration, which is therefore made more difficult. Under these circumstances only a few swallows of liquid food can be taken at one time. When delirious, patients frequently refuse food. Fortunately, pneumonia is usually of short duration, and abstinence from food for a few days is not of serious import, except when the illness attacks those who are feeble or is prolonged by a spread of the pulmonary inflammation. Those cases in which fever does not disappear by crisis on or before the fifth, seventh, or ninth day must be fed with care.

A transient febrile albuminuria is of the commonest occurrence in pneumonia, but it does not demand a special diet. When it does occur, the bowels should be emptied thoroughly and liquids, particularly water and milk, should be given freely. Occasionally true nephritis arises, and then a milk diet is essential. Pains should be taken to prevent abnormal fermentation in stomach or bowels and the retention of fecal matter.

Alcoholic beverages have been given with the greatest freedom in this disease. An ounce of whisky or brandy an hour has been a not unusual dose. Alcohol is not, however, used so freely as in the past, since many more valuable remedies have been discovered. From what has already been written of its mode of action, it is evident that it is valueless as food and often of little use as a cardiac tonic. Conditions often exist that counterindicate its use. The employment of nitroglycerin, strychnin, saline infusions, and oxygen gas has greatly lessened the use of alcohol. Cases of all grades of severity can be treated successfully without it. Patients who have been accustomed to drink alcohol freely are especially prone to develop delirium tremens during an attack of pneumonia. To them whisky is usually given in gradually diminished doses. Among such patients the mortality is especially great.

After crisis the diet should not at once be changed from liquids to soft foods, as the best results are had if this change is not begun until the third day after, when convalescence is established and appetite and the ability to digest and assimilate food have returned. But once it is begun, a change from milk to soft food and then to solids can be made rapidly, except when the course of the illness has been long or the patient is unusually feeble; then as much care in making the change is necessary, as after typhoid fever. Usually the most vigorous patients are able to eat solid food at the end of the first week after convalescence is established. In such cases care must be exercised that patients are not overfed, for too much food is more harmful than a variety of simply prepared solid food.

Tea and coffee may be given during the whole course of the disease if they are craved. The last named is a useful adjuvant to cardiac tonics.

Patients having croupous pneumonia should always be treated in large, well-ventilated rooms. The air should be kept uniformly at from 650 to 700 F. An abundance of fresh air is needed.