Many suppose that feeding in acute diseases is unimportant, because they are usually of short duration. This is a great error; for who knows the duration of any attack of illness? The patient should be kept in as good a condition as possible to resist disease, and to be able to more quickly resume the duties of life.

A few years ago, a large per cent, of typhoid patients died of exhaustion after three or four weeks' illness. Now it is possible to carry them the same length of time with very little loss of weight. Fever destroys tissue at a high rate. This calls for diet rich in proteids. There are some general principles which apply in nearly all acute diseases. Briefly enumerated, they are as follows:

(1) Foods must be well cooked and easy to digest.

(2) They should be given in fluid, puree, semi-solid or powdered form.

(3) It is generally necessary to give small quantities with greater frequency than in health.

(4) Foods should be given when the body temperature is the lowest.

(5) All foods must be bland and unimitating.

(6) No iced drinks should be given except by advice of attending physician.

The foods most commonly used in acute diseases, except water, are as follows:

Milk holds first place, and can probably be used in some form in all cases. Plain milk may first be tried, either cold or hot, then pasteurized, sterilized or peptonized.

If these do not agree, try milk and barley water, or milk and gelatine, or milk and "slippery elm" water. In diarrhoea use milk and lime water, and in constipation milk and soda water (see "Milk," for methods).

When desirable to use the largest quantity of food, the milk should be thickened with well-cooked starch, either rice, barley flour, arrowroot, sago or corn starch. The fine flour starches should be put to cook in cold water and gradually brought to a boil and kept boiling for an an hour or two. Coarse meals should be kept boiling from three to five hours and then strained. Meat broths are used extensively, but as ordinarily made they contain but little nutriment. Meat may be used in powdered form to better advantage. The most practical way to powder meat is to grind it at least six times, and each time it is run through the grinder, the solid or stringy part should be removed. This will reduce the bulk about one-half, but the refuse may be used for broths. The powder may be macerated in cold water and then gently warmed. If the patient is very feeble, it should be strained.

Eggs may be used with either broths, milk or alcohol, where the latter is prescribed it will usually be desirable to use it as a vehicle for food. They can best be used without cooking, when beaten or stirred into hot broths or milk. Skill in flavoring may save life, because recovery may depend on the strength of the patient, and that in turn on the amount of food that can be taken. Lemon, pineapple, vanilla, nutmeg, cinnamon and fruit flavors generally, may be employed. Some of the prepared infant and invalid foods may be used to great advantage. The use of fruits gives most concern, because of their sugar and acid, which may quickly ferment. Sometimes they seem to exert a restorative power that is marvelous. The sweet fruits seem to ferment too quickly, and the sour ones are incompatible with milk, and sometimes with the medicines administered. If attending physician fails to give any directions about fruits, it would be well to ask whether acids would be incompatible with any of the drugs administered. The sour fruits should be given with the egg or meat broths, and not with milk, and always free from seeds and skins. The juices of stewed fruits should be used for their flavor, rather than the nutriment they contain.

Great care must be exercised not to give fruits that are tainted with decay, or that contain any solid or tough substance. Nothing but the juice should be given, with the possible exception of mellow peaches, baked apples and banana meal.

It is certainly advisable to give daily all the food that can be digested, whether that be a pint or three quarts. We doubt the propriety of giving more .than three pints or two quarts of milk per day' in typhoid cases. More nourishment will be needed, but meat-powder or beaten eggs, with an increased supply of water, will bring best results. It is best to add barley water, well-cooked starch or gelatine to milk to prevent the formation of large-curds. There are no inflexible rules - feeding must be adapted to the patient.

Drinks

Not many generations ago, the sick died of thirst, because the people were so ignorant as to believe that water was a strong ally to fever. Now water is administered inside and outside, and fever is controlled by it when all other remedies are impotent. Patients who are rational will ask for water; but those who are unconscious, should be given water at regular intervals. If milk be used extensively, the need for water will be much less than if smaller quantities of fluid be ingested. Sour lemonade is one of the favorite drinks in fever. If there is any tendency to sour stomach, no sugar should be used. It must not be given with milk or starch gruel, nor with incompatible drugs. Both tea and coffee should be refused, but cereal coffee may be allowed, and very useful by way of variety. Coffee may be used for flavoring milk or other foods. It must not be allowed to boil, and should be steeped only a short time.

If the patient likes chocolate, a little may be added to cereal coffee, but should be strained before using. Grape juice, unfermented fruit juices, and natural mineral waters are usually allowable, and sometimes very beneficial. Cold drinks must be slowly sipped, otherwise they may greatly interfere with digestion.