The digestive tract being more or less weakened in all cases of acute illness, patients convalescing from an acute disease may be regarded as dyspeptics for the time being. Great care is therefore necessary in regard to both the quantity and quality of the food. The digestive capacity of convalescents, however, varies widely. There is, for instance, the healthy young adult recovering from some sharp attack of infective fever, in whom the digestive organs are only weakened, not organically affected. His convalescence is rapid, and he is soon capable of eating and digesting everything. In this class of case there is no necessity to try and tempt the appetite; the food can be simply prepared; the danger is that the patient will overeat. On the other hand, the patient may be a delicate child recovering from scarlatina, complicated by nephritis. Here it would be absolutely wrong if we did not limit the quantity, and give very strict injunctions as to the quality of the food. Similarly, after typhoid fever, when convalescence is established, a mass of undigested food, e.g., potatoes or a piece of unmasticated meat, may cause a relapse, by setting up irritation in some recently ulcerated patch.
At first, in all cases, the fever diet should be continued, the milk and beef-tea being gradually reduced, and thickened 292 beef-teas and souos, egg drinks, and various jellies being mainly given. This can be extended to include the more easily digested starches, cither in the form of some invalid food, e.g., a simple, well-cooked gruel, malted gruel, or Benger's or Savory & Moore's invalid food. The next advance would include lightly cooked eggs, either plain boiled, poached, scrambled, or in the form of a custard; or combined, as in milk puddings, with a farinaceous food. For breadstuff's, thin slices of toast, the crusty portion of a Vienna roll, sweetened and unsweetened rusks, toasted sponge, finger biscuits, rice biscuits, and plain biscuits may be recommended. Many of the malted breads now on the market, such as Veda, Hovis, Bermaline, Bipsine, etc., are quite permissible, care being taken that the bread is not new (see Bread).
As the strength of the patient increases a more liberal diet is given, fish, sweetbreads, chicken, game, pigeons, rabbits, being gradually added to the dietary. Then follow mince, beef quenelles, eye of a tender loin chop, a slice of tender beefsteak, or a small piece from the undercut of a lightly cooked sirloin of beef, or a slice from a leg of mutton. The patient should always be reminded of the necessity of eating slowly, and masticating well. Vegetables and fruits must be cautiously added to the dietary.
The following seven days' dietary is sketched to give an indication of what is permissible. Doubtless, in some cases a more rapid return to ordinary diet could be made, while in others the change would require to be more gradually effected. This scheme of dietary is followed by an account of the manner of preparation of farinaceous and other foodstuffs of special value in convalescence.
7 A.M. - If awake early, a small cup of freshly made tea, with cream. 8.30 a.m. - Milk and thick barley-water, half a slice of toast, cut in fingers. 11.30 a.m. - Calfs-foot jelly, about 2 ounces. 1 p.m. - Thick beef-tea (Egg and tapioca grout, p. 77).
A few grapes (juice and pulp only).
4 P.M. Cup of tea, with milk and cream, thin slice of bread and butter. 6.30 P.M. - Cup of Benger's food (or other invalid foods). 11. - Cup of beef-tea (method 1, p. 76).
7 A.M. - A small cup of coffee, with milk.
8.30 a.m. - Malted gruel.
11.30 A.M. - Milk and soda-water, with plain biscuits.
I P.M. - Beef-tea puree (p. 77), with strip of toast.
Blancmange. 4 P.M. - Cup of tea, with milk and cream.
1 slice bread and butter.
1 sponge finger. 6.30 P.M. - Plain egg flip (p. 48), with biscuits. 9 P.M. - Cup of chicken soup or chicken jelly.
7 A.M. - A small cup of freshly-made tea, with cream and small half-slice toast. 8.30 A.M.: Breakfast - Saucerful of oatmeal gruel, with cream and a little piece of Vienna roll (crusty part). 11.30 a.m. - A teacupful of beef-tea (unthickened), either hot or cold. 1 p.m. - Steamed whiting, half-slice of bread. Semolina or ground rice pudding. 4 P.M. - Potash and milk, with rice biscuit or sponge cake.
A little fruit. 6.30 P.M. - An invalid food, in any form (see p. 183). 9 p.m. - Some variety of meat tea or infusion.
8 a.m. - Saucerful of hominy porridge or barley-meal gruel, etc.
A small cup of tea, toast, and a very little butter. 11.30 a.m. - A teacupful of chicken tea, with milk and potash or a little fruit. I.30 P.M. - Baked or steamed fish (p. 306).
Apple cream. 4 P.M. - Potash and milk, or a small cup of fresh tea, bread and butter, and sponge cake. 6.30 P.M. - Peptonised cocoa and milk, or custard.
9 P.M. - Some variety of meat infusion, e.g. veal tea.
8 A.M. - A lightly-boiled egg, toast or roll with butter. A small cup of tea. 11.30 A.M. - Teacupful of soup, or a little fruit, and a drink of milk and potash. 1.30 P.M. - Rabbit, chicken (roast), two slices from breast, or pigeon served with bread sauce. A small helping of vegetable, e.g., stewed vegetable marrow or cauliflower, not potatoes. Pudding - apples cooked in water sago, eaten with cream. 6.30 p.m. - Oysters (p. 305).
9 P.M. - Some variety of soup.
8 A.M. - A piece of boiled or steamed haddock, whiting, or sole Tea, bread or toast and butter. 11 A.M. - Soup, or egg drink. 1.30 P.M. - Sweetbread or tripe.
Vegetable, stewed tomato (pulp only).
Stewed fruit with custard. 4 P.M. - Afternoon tea (avoiding rich cakes and pastry) 6 P.M. - Poached egg on toast or spinach.
Milk and potash.
9 P.M. - Cup of soup.
8 A.M. - A few rolls of well-fried streaky bacon.
Toast and tea. 11.30 a.m. - Egg flip, or soup, or milk and potash.
Fruit. 1.30 P.M. - A small slice of tender roast mutton, or the eye of a tender mutton chop.
Jelly. 4.30 P.M. - Afternoon tea (avoiding rich cakes and pastry). 6.30 P.M. - Fish.
9 P.M. - Cup of soup.