Doctor Osier tells us that the cure of tuberculosis is largely a question of nutrition; if one can make the patient grow fat, the local disease may be left to care for itself. As eggs, cream and milk are easily digested, and are rich in fatty matter, we at once turn to these as the all-important foods. It was only a few years ago that tuberculosis patients were sent to the country, where they might drink the milk warm from the cow. There seems to be more virtue and more health-giving qualities in milk with the natural warmth than in milk artificially heated.
The cure of tuberculosis depends upon pure air, both day and night, and correct nutrition. The disease calls for easily-digested fatty matter - cream, butter, olive oil, marrow, the yolks of eggs. I am speaking now of pulmonary tuberculosis. From the first the patient must be impressed that if a cure is to be effected, the given rules must be carefully followed, otherwise the race is not worth the running.
The amount of food and the hours of feeding must be regulated by the condition of the patient. The writer cannot establish rules, as each patient is a law unto himself. Be careful, however, not to overeat. On the other hand the appetite must be kept up by a pleasing, well-served variety of food.
I fully believe that almost any tuberculosis patient, not too far gone, can be cured at home, providing he will follow directions, better than at the average, poorly-managed sanitarium. In many sanitariums too much dependence is placed on climate and air and too little on correct diet. Stay at home, build an outdoor sleeping room, wear warm clothing, not necessarily wool - linen is preferable. Take milk and eggs in large quantities between meals.
To keep up the appetite change the method of serving both the eggs and milk. At one time separate the egg, beat the yolk, add the white and a little powdered sugar; later drink a glass of milk. At another time, take eggnog; or shake the whites of eggs with milk, and use the yolks, hard boiled, grated over toast as a supper dish. Do not give too much meat; it is not as nutritious as eggs and milk, and nourishment is of cardinal importance. Give nut dishes, Brazilian nut butter, cocoanut cream and egg occasionally, in the place of cow's milk. Use now and then for an afternoon luncheon a cup of well-made chocolate, with whipped cream, in place of egg and milk.
At regular meals give puree of beans, lentils or old peas, made with good stock, and thinned with milk or cream; or cream soups, well-roasted beef and mutton, boiled rice or potato, and hard bread that will require mastication, breakfast bacon, with eggs, and fruits.
It is necessary for dispensary nurses, who visit the patients at their homes, to select the most suitable from foods that are accessible and within their price limit. If eggs and cream are expensive, substitute bacon, meat stews, hominy, lentils, peanut and bean soup, cornmeal mush, oatmeal, milk and suet puddings, and the cheaper fruits, stewed prunes and baked bananas.
Arrange the meals for ordinary patients as follows: Early in the morning give a cup of hot milk, flavored with strong coffee, no sugar. The patient may rest a half hour, then bathe, then rest again for half an hour, and breakfast. Give orange juice or other fruit, and a well-cooked cereal with cream, or two shirred eggs with two slices of broiled bacon and a half ounce of butter on a bit of toast. For variety, if the patient is a meat eater, give a couple of broiled chops, or a meat cake, or fish, in the place of eggs.
If breakfast is taken at eight o'clock, at eleven give a glass of milk and egg shaken thoroughly together. At twelve-thirty or one (be careful not to crowd the patient) give puree of lentils, and a slice of zweiback, with a half ounce of butter; or broiled meat and a baked potato, with cream or butter; or meat and boiled rice, or carefully-boiled hominy grits, or mush bread, with a half ounce of butter; followed by a "heart" of lettuce with olive oil and a drop of lemon juice. In the middle of the afternoon, give either a bowl of junket, or koumys, or leban, buttermilk or zoolak, without other food; or eggs and milk. At six o'clock, a bowl of cream soup, with zweiback, well buttered; a little piece of steak or chop; a small dish of carefully-cooked macaroni with cream sauce; a toasted cracker, well buttered, and a bit of cheese. At bedtime, a glass of modified milk, with a double quantity of cream, or plain milk.
If for any reason the patient should have an attack of indigestion, stop all vegetable foods at once and substitute modified milk, albumin and milk, chopped meat cakes, and whole wheat bread only. Large quantities of foods are called for, but if the digestion is upset the whole scheme fails. Avoid too great a variety at a meal.
Do not give preparations to aid digestion; they frequently upset the stomach and cause a "set back." All drugs should be avoided, except those ordered by the physician. Do not give cod liver oil unless ordered. Depend for your fatty foods on cocoanut cream, milk and eggs, olive oil, nut soups, nut milks, especially those made from black walnuts and Brazilian nuts.
The nurse who has charge of tuberculosis patients should study carefully the character and idiosyncrasies of each patient. Recovery usually follows an increase of weight; if the patient loses weight, the road to recovery is difficult. Constipation should not be allowed; foods that do not agree should not be repeated. If egg and milk disagree, give milk and barley water, or milk with cocoa-nut cream. If the taste of milk is disagreeable, change its flavor by adding articles recommended under the heading of "Milk and Milk Preparations," in the Second Part of this book.
The care of the mouth is of great importance. Wash a half pound of water cress carefully, pick the leaves from the stems, chop them fine, and rub them to a pulp; stir them into a pint of water, add two teaspoonfuls of salt, strain, bottle and cork. Use this as a mouth wash once or twice a day. It must be made fresh once a week. If cress is not obtainable, Listerine, Glycothymoline, or salt and water are recommended.
The following list may offer suggestions to the caretaker:
Eggs, raw, in milk
Milk and barley water Milk and rice water Junket cream Koumys Leban Matzoon Zoolak
Meiggs' Food Eskay's Food Whole wheat bread Graham bread Toasted pilot bread Crisp rolls Baked potato Broiled steak Panned steak
Roasted lamb or mutton
Fresh peas pressed through a sieve Lima beans with cocoanut sauce Lettuce heart with cocoanut cream Olive oil
Carefully-cooked spinach Cocoa Chocolate Alkathrepta Racahout Puree of dried peas, beans and lentils A few ground oily nuts (not with meals) Fresh ripe fruits
All bulk foods
Pork; veal; duck; goose
Bananas, unless well cooked
Pastry; sweets in general
All fried foods
Hot breads; white bread