The diet of people who suffer from intestinal catarrh is of the greatest importance. Everything likely to irritate the mucous membrane should be avoided. All food must be completely masticated, and nothing should be swallowed that is not exceedingly fine and smooth. It is necessary when the case is a very bad one to reduce everything to a pulp before allowing it to be consumed. An average case, however, would be sufficiently protected from irritation by careful selection, preparation, and mastication of the food. The rule of Sir Lauder Brunton for these cases is, "The patient must avoid skins and bones, strings and stones". If this rule is impressed on the memory it will serve as a guide to what the patient may not have and for the preparation of the foods he may have.

What The Patient Is To Avoid

Every particle of skin, gristle, and perceptible fibre should be removed from all kinds of meat, fowl and fish. Scales must be carefully removed from sardines and other fish. The bones of all animals must be religiously avoided. This is not an easy matter with regard to sardines, pilchards, whitebait, sole, and many other fishes. The skins of vegetables and fruit, the seeds of all kinds of fruit, fibrous vegetables, etc., must all be avoided. An exhibition of the various articles recovered from the faeces will show the necessity for carefulness on the part of everybody, more especially those who suffer from catarrh of the alimentary canal. Among those which have been seen by the writer are pieces of bone and wood varying from 1/4 to 1 1/4 inches in length, and from the thickness of a pin to that of the finger; the larger pieces were swallowed in stews, entrees, soups, etc.; gristle and undigested skin from meat, etc.; scales from fish ; skins of fruit - e.g., plums and grapes, currants; seeds of apples, pears, oranges, currants, gooseberries, strawberries ; stones from cherries, damsons, etc.; peas, beans, either skins or undigested legumes ; undigested oatmeal, bran, nuts, raisins, currants, salted or dried meat; last, but not least, tin-tacks, buttons, teeth, etc.

What The Patient May Have

Bread two or three days old, bread and butter, plain biscuits, crackers, rusks, sponge cake, madeira cake.

Soups

Clear or thick, but they must be strained through a sieve. Exception: When diarrhea is a marked feature of the case all soups and meat extracts should be avoided. "French soup" is particularly good for most cases; this can be made without meat. It is practically a consomme of all kinds of vegetables and herbs, rubbed through a sieve, and finally boiled up with milk and a raw egg or two added. Ordinary clear soup with macaroni or vermicelli is suitable when there is no diarrhea.

Flesh

Any kind of meat which has been reduced to a pulp and rubbed through a sieve; scraped raw meat, potted meat, chicken panada or souffle; eggs - raw, poached, scambled or buttered, "egg-snow" and custard; a fillet of sole or plaice, half a whiting, or a small amount of fresh haddock. Meat powders, such as Meatox and Mosquera's beef-meal, are suitable when other forms of meat disagree.

Vegetables

Any vegetable which has been cooked and reduced to a puree or rubbed through a sieve. In addition to these, the patient may have potato, mashed and creamed ; vegetable marrow, boiled lettuce, spinach, and beet-chard. No raw vegetables.

Puddings

Custard, junket, blancmange, jelly of all kinds, and puddings made from farinaceous materials such as Neave's, Savory and Moore's or Mellin's food. Milk is admissible as a beverage, or in puddings and jellies; milk powders are also useful. Rice, sago, and tapioca puddings are exceedingly suitable, but great care must be taken that every grain of the substance is perfectly soft. Such puddings should be cooked for at least four hours; by this means not only will the softening of the cereals be assured, but some of the starch will become dextrinized.

Fruit

Raw fruit is usually forbidden, but if the rule of Brunton be observed several kinds can be allowed; thus a few grapes, a ripe banana, and one or two plums may be taken if the skins and seeds are removed. Strawberries, raspberries, currants, and other fruits can be rubbed through a sieve, and the pulp eaten with sugar and cream. Cooked apples and plums may be taken, also stewed rhubarb.

Drink may consist of milk, whey, buttermilk, China tea, cocoa, coffee, Ovaltine, Hygiama food, Cafe Zylak, etc.

The following recipes may be found useful:-

Vegetable Soup

Boil a carrot, onion, leek, and half a turnip in three pints of water until they are tender; strain the liquor through a wire sieve and rub the vegetables through; season with salt and pepper. Make a custard of the yolks of two eggs and half a pint of milk. Boil up the soup and pour it on the custard while stirring ; finally stir into it the egg-whites, and it is ready to serve. Any vegetables can be used in place of the above, and a small piece of mace, a bay-leaf, a sprig of thyme, or a clove of garlic, a few sorrel leaves, tarragon, or chervil can be used for flavouring.

Carrot Soup

Slice three carrots and boil them in two pints of veal stock until they are tender. Remove the carrots, rub them through a wire sieve, return them to the soup, boil, season, strain again through the sieve, and add some cream just before serving it. Artichoke soup and turnip soup can be made in the same way; chicken stock can be used instead of veal stock.

Chicken Soup

Boil a fowl with vegetables until it is tender. Take out the bird, remove the meat, put the bones back into the soup and continue to boil it with the vegetables and some seasoning. Meanwhile pound the flesh with some boiled rice in a mortar; rub it through a sieve. Pour the soup over it, through the sieve; stir well; finally add two or three ounces of cream and it is ready.

Chestnut Soup

Take a pound of chestnuts, slit the skins with a knife, and drop them into boiling fat for two or three minutes; and, while hot, remove the outer and inner skins. Put the nuts in a pan with three pints of boiling veal or fowl broth and boil them until they are tender. Take out the chestnuts, pound them in a mortar, or put them through a fine-mincing machine, add a pinch of nutmeg, return them to the soup, boil for one hour, strain through a sieve, and add a cupful of cream. The soup should not be boiled after adding the cream.

Barley or Rice Soup is made by boiling pearl barley or rice in veal or fowl broth until it is quite soft; the grain is then pounded in a mortar, rubbed through a sieve, mixed into the soup, seasoned, and enriched with cream and custard as in vegetable soup.

Chicken Panada

Take the flesh from half a boiled fowl and reduce it to a pulp in a mortar. Add half as much crumbs of bread, the white of two eggs, two tablespoonsful of cream, pepper and salt. Put this mixture into a buttered dish and steam it three-quarters of an hour. Meanwhile make a sauce of the yolks of two eggs and some stock from the boiled chicken. Turn out the panada and pour the sauce over it.

When making chicken souffle pounded chicken and breadcrumbs are seasoned with pepper, salt, and a little nutmeg. Finally the white of two eggs is beaten to a stiff froth and mixed thoroughly into the mass. It is then put into a well-buttered dish and baked in an oven fifteen minutes.

Bavarian Cream

Make a custard of two eggs and three egg-yolks, three ounces of powdered sugar, and half a pint of milk. Beat up the eggs and yolks with a whisk; while still beating let the milk be gradually added at a boiling temperature. Put the mixture into a saucepan over a slow fire and continue to stir until the custard is thick enough to coat the spoon. Pour it into a basin until it is quite cold.

Now take half a pint of cream, flavour it with fruit juice and some sugar, and beat it thoroughly with a whisk; immediately afterwards stir into it half a cupful of milk, and next one ounce of melted gelatine or isinglass. Finally, pour the custard into the cream, thoroughly mix it with the whisk, and pour it into a mould to set.

Blancmange Sponge

Take two ounces of cornflour, one pint of milk, two eggs, two ounces of sugar, and a teaspoonful of pure butter. Mix the cornflour to a smooth cream with a little milk; beat up the yolk of the eggs with the sugar, and stir into the cornflour. Boil the rest of the milk in a large saucepan; remove it from the fire, and gradually pour into it the cornflour mixture while stirring; add the butter and a little salt. Boil for ten minutes, stirring all the time. Beat up the egg-whites to a stiff froth and stir lightly and evenly through the mixture; pour it into a mould to cool. It may be eaten with any kind of sauce made from fruit juice.

Fruit-Juice Sauce

Raspberries, currants, cherries, plums, crab-apples, gooseberries, blackberries, bilberries, whortleberries, rhubarb, and other fresh fruits may be eaten when prepared in this way by sufferers from intestinal catarrh. Take a pound of fresh fruit and half a pound of sugar; stew them until the fruit is tender; rub through a sieve; when cold serve round blancmange, sponge, and other moulds.

Fruit Jellies can be made of cornflour and fruit juice. Take one and a half pints of fruit juice and two and a quarter ounces of cornflour. Mix the flour into a smooth cream with a little juice. Boil the rest of the juice, and while boiling pour it slowly into the cornflour, stirring vigorously. Put the mixture into the saucepan, bring to the boil, continue to boil for three minutes; pour it into a mould to cool; serve with cream. The fruit juice must be carefully prepared. Practically any sort can be used - e.g., cherries, currants and raspberries, strawberries and rhubarb, damsons, plums, and apricots ; apples or pears may have a few cranberries mixed with them to give flavour. As a general rule a pound of fruit, if not fully ripe, requires half a pound of sugar; when quite ripe perhaps not more than a quarter of a pound of sugar. Wash the fruit, put it into a saucepan with the sugar, and only enough water to cover them. Stew until the fruit is quite soft. Strain through a flannel cloth or fine sieve, pouring over the fruit enough water to make a pint and a half. It is now ready for use. Isinglass or gelatine might be used to form the jelly, but cornflour or arrowroot is more nutritious.