The most important functional disorder of the nervous system from the point of view of dietetics is neurasthenia, or nervous exhaustion. In the treatment of this disease, complete rest in bed, isolation of the patient from his or her friends, and a special diet are the essential factors of the treatment. In neurasthenia the nervous system is in a state of exhaustion, and practical experience has proved the great value of the administration of a large amount of food of an easily digested nature. This will be further discussed under Neurasthenia. In functional conditions other than neurasthenia, diet does not enter specially into the treatment.
The temperament of children should be carefully studied. This is of practical importance in the management of children. Clouston has given us an admirable description of the nervous child: - "There is the nervous child when the brain is somewhat over-developed, but especially when it is unstable in its action, when sensitiveness is too great, when reactiveness is also exaggerated, and in whom passion and emotion are too exaggeratedly or too easily expressed. Such children are often difficult to manage, are wayward, disobedient, and subject to gusts of apparently causeless passion and sulkiness; they are subject also to whims and groundless fears; they are fidgety, restless, deficient in the elements of control; they are usually thin, often capricious about food, and they are subject to nervous ailments such as chorea and convulsions." The neurotic tendency is further shown by the readiness with which they become delirious under the influence of a trivial catarrh, by the occurrence of night terrors, and by the liability to asthma.
In discussing the management of these children from the dietetic point of view, Clouston sums up the position admirably when he states: - "It may be said generally that the child with a strongly nervous heredity or mental taint in ancestry should be fed on milk, farinaceous diet, and fruits, certainly up to seven, and largely up to twenty-five." Further details of the dietetic management of these cases are given on pp. 201 and 526.
Headache is a symptom, not a disease. Hence the treatment can only be determined after the cause of the condition has been ascertained. Most commonly it is dependent on constipation, gout, renal disease, or neurasthenia, and the dietetic treatment of these diseases is then applicable. The possibility of the headaches being due to eye strain should be kept in mind.
One of the most severe forms of headache - migraine, or sick headache - is a neurosis characterised by pain in the course of the fifth nerve, often accompanied by nausea, vomiting, physical and mental depression, with local vasomotor disorders. The treatment of this condition is further referred to on p. 506.
In adult and elderly subjects insomnia and disturbed sleep are sometimes dependent on dietetic habits. The most common error is the taking of solid food late at night. In such cases the chief meal of the day must be the midday one, the evening meal being taken not later than C.30, and consisting of, at the most, two light, easily digested courses. A hot drink taken at bedtime is frequently of great value as a hypnotic, the best of these being a cup of good beef-tea, or hot milk, which may be malted if desired, e.g. Horlick's malted milk. In elderly and weak subjects a small glass of whisky, or hot toddy, taken the last thing at night, is of value in promoting sleep.
Rest, seclusion, and careful feeding are the essentials for the successful treatment of chorea. In mild cases the diet should be a light, nourishing one. Red meat and rich foods of all kinds should be avoided, the diet consisting of milk, milk foods, eggs, bread, bread foods, and white meats. In more marked cases it is advisable to restrict the diet to milk and milk foods only; this regime diminishes the likelihood of the development of heart complications. In some cases the diet should be liquid, and it may have to be administered by the nasal tube. In these circumstances the daily diet should be - milk, from 2 to 3 pints; beef-tea, 1 pint; and two to three eggs given in the milk. In severe cases where the patients are practically starved through the violence of the movements, it may be necessary to give in addition 1/2 ounce of alcohol with each meal.
With regard to the relationship of diet to epilepsy, the following points may be laid down as established. Over-eating may bring on an attack; an excessive meat diet is prejudicial; rich foods and pastry should be avoided, largely because they foster excesses; and alcohol in all its forms should be avoided. A light, mixed diet is there-fore the ideal one for the epileptic. The meals should be given at regular hours, nothing being taken in the intervals. Great care must be taken to avoid constipation, and this may be attained by the proper use of fruits and the coarser forms of cereals. An appropriate diet sheet is here given.
Lunch (Lacto-vegetarian) - Bread and cheese, celery, glass of milk, fruit (see pp. 520, 526).
Cup of tea with biscuit.
These forms of nervous disease may be due to many causes, the most common being anemia, gastro-intestinal derangement, gout, rheumatism, and artcrio-sclerosis. The dietetic treatment therefore varies with the cause, and this must be determined before a suitable diet can be ordered. In troublesome cases assistance will be obtained from the examination of the stools, which will indicate whether the state of the bowel is satisfactory or not. The following general rules will be found helpful in framing a dietary for these conditions: -
1. Seek to determine whether the condition is a result of insufficient food (malnutrition), or excess of food (over-eating).
2. If dependent on anemia, indigestion, gout, or arteriosclerosis, the dietetic treatment must be regulated accordingly.
3. Aim at giving a light, easily digested, non-stimulating diet, free of alcoholic liquors.
4. Attention to the teeth, careful mastication, and the prevention of constipation, are often important factors in the successful treatment.