Oftentimes starches and sugars are not digested easily, while fats and oils are better managed. Eggs are usually tolerated, and should form an important element of diet. Scraped meat, raw or slightly cooked, is well digested by many; the usefulness of raw beef is attested by long experience, and Richet and Hericourt have claimed a special antituberculous virtue for the muscle-juice (zomotherapy). Broths, gruels with milk and cream, fruits cooked and raw, meat-juices, jellies with bread, and buttermilk, cream toast, kumiss, matzoon, Mellin's food, malted milk, Robinson's barley with milk or cream, custards, eggs, raw, soft cooked, or in lemonade, ice-cream, and many more soft and liquid foods may be tried. If the patient's appetite will warrant it, occasionally a meat meal may be given him; for instance, a chop, or some steak or roast beef, or lamb, chicken breast, a squab, or some similar dainty, with a little potato, or peas, string-beans, boiled rice, or macaroni.

The stomach should be washed by drafts of hot water before meals and by provoking, if need be, regular and free bowel movements. In this class of cases it is best to take a glass of warm milk about one hour before the fuller meals. This seems to prepare the stomach for greater work, and, strange to say, improves appetite. In all classes of cases, a glass of hot water about an hour before each of the three principal meals, and especially before breakfast, seems to do much good.

Debove introduced the pratice of gavage, or forced feeding - that is, the introduction into the stomach, through the stomach-tube, of considerable quantities of nourishment. This mode of feeding is indicated only when appetite is altogether lost or when there is much disgust for food. When no food or almost no food is eaten, forcible feeding may be resorted to three or four times daily. The most suitable foods for administration in this way are milk and its preparations, eggs, raw or with milk, meat extracts, meat-juices, meat powder, and gruels. If digestion is imperfect, these foods may be partly or wholly digested before they are given. If there is catarrh of the stomach and much mucus in it, this organ should be washed (lavage) before food is put into it. Excellent results have been obtained from this mode of treatment, so far as the addition of flesh and strength is concerned. Cough also often grows less, sweating at night ceases, and expectoration becomes less abundant. Frequently appetite improves for a time so that the use of the esophageal tube can be discontinued or needs to be resorted to only occasionally. Forced feeding has never become popular, for it is disagreeable to patients and usually of little ultimate utility, because, with rare exceptions, it is employed only when the hope of recovery is gone and the prospect of prolonging life is slight.

To a degree, all feeding of tuberculous patients is forced; for it is constantly the aim of the physician, during the periods when the lesions are developing rapidly, to give more food than the patient craves, and even more than is needed in health, if it can be utilized. Nevertheless care is necessary not to overtax the digestive power.

It is my custom to urge all patients who are under weight and whose digestion is unimpaired to eat at regular mealtimes more than they crave: and at ten in the morning and three in the afternoon and at nine in the evening, two raw or soft-cooked eggs or if they can not take them comfortably, a mixture of egg and milk, or milk, or malted milk. Often it is best to vary these lunches by using sometimes egg and sometimes milk or milk mixtures:

During periods of quiescence in the progress of the disease the aim should be to fatten and strengthen the patient so as to make him as resistant as possible to the malady.

Various special diet cures have been much vaunted from time to time. The milk cure consists in the exclusive use of large quantites of milk for a few weeks. If a patient goes from home for the cure, and especially if he has more or less gastritis, he will almost always improve, but the gain is not permanent. It is like the gain so often noticed when a patient changes his residence, his.nurse, or his doctor. His mental state has quite as much to do with his improvement, as his diet. The same can be said of the kumiss cure. The results of the employment of kumiss at home are negative, except as it affords variety and is easily digested by weak stomachs. But when the cure is taken on the steppes of Russia, where it originated, permanent good results are often reached. A change of scene and a favorable climate both play a part in effecting it.

The grape cure also has been recommended for consumptives. It is probable that the climatic conditions and the changed environment have much to do with the seemingly good results of this treatment. The cure is practised at various places in the vineyard districts of Europe. I know of no place in America where it is systematically carried out. One or two pounds of grapes are prescribed to be eaten daily. Moderate amounts are eaten at first, and the quantity is gradually increased. More than two pounds a day cannot safely be eaten, as appetite for other foods will lessen and the bowels will become loose, effects which must be avoided, as they cause loss of flesh and strength. A full mixed diet should be prescribed and the grapes should supplement it. The addition of one or two pounds of easily absorbed grape-sugar solution to an ordinary diet will often increase the weight of phthisical patient. It is believed by Bauer also to stimulate the mucous membrane of the throat which extends to the air-passages, and to assist the expectoration, etc. - in other words, favorably to influence the bronchial catarrh. The raw egg cure consists in administering between the regular meals from six to twelve raw eggs daily. They are so bland as to be unirritating to the stomach and are so nutritious as to insure almost always a rapid gain in weight. They can be taken quickly with little more effort than a dose of medicine. They are swallowed easiest, directly from the broken shell or from a glass after the addition of a little salt, pepper and vinegar or lemon juice. An egg taken in this way is swallowed whole as an oyster might be bolted.