Appetite almost disappears in severe illness, especially when there is fever; and the capacity to digest food is then nearly lost. It is best not to give large quantities, but keep up the nourishment of the body by giving strong, concentrated food, in the liquid form, in small quantities, at short intervals.

A young and robust person may, at the beginning of an illness, be better for a day or two with almost no food. Feeble patients need, as a rule, to be so fed from the start.

The main staple article of diet for the sick is the same as for infants; namely, milk. And for the same reasons; that it contains all that is essential for the system, in a form easy of digestion and appropriation. In typhoid fever, for example, almost from the beginning, a patient may be fed with two tablespoonfuls of milk every two or three hours, day and night. Another concentrated article is beef-tea ; and stronger yet, beef-essence. The mistake has been very often made ofstraining or filtering beef-tea, after it has been subjected to a boiling heat. Its most nourishing part is thus left behind. It ought to be brown with finely, divided particles (not solid pieces, of course) of the meat. The same is true also of essence of beef, made without the addition of water.

Next to these articles of food come broths or teas of other meats; as mutton and chicken soups. They should, for the sick, be made strong, not watery; but should be thoroughly rid of their fat, by skimming. This can be most effectually done when they have stood and become cool; but, except in the warmest weather, they should be heated again to be taken.

Prepared extracts of beef are much in use, to save trouble in getting the fresh article; but try to get those that have not been filtered, as filtering takes out most of the nourishing part of the meat, and leaves rather a nutritive stimulant than a food.

BED TABLE (WITH RACK)

BED-TABLE (WITH RACK)

Any standard beef-juicewhich is prepared without boiling, has the substance of the beef in a very concentrated state. Most people can take this very well. Two teaspoonfuls of it may be added to about a quarter of a tumblerful of water (hot or cold, as preferred), this being given two tablespoonfuls, more or less, at a time.

Johnsons fluid beef is agreeable to some persons, and, when so, answers a very good purpose. To my taste, it is unpleasant. Many physicians recommend it, and use it largely. Beef peptonoids are much used.

fellies *are weak food; good only for variety, or to hold something stronger, as a matter of taste.

Fruits are commonly pleasant during fever, but they are most of them rather too hard to digest. Malaga grapes will almost always agree well. Orange juice (without swallowing the pulp) does so also, and is often very refreshing to the sick. Lemonade is pleasant and cooling, but requires consideration of the condition of the stomach and bowels at the time. One of the best things to clean a foul tongue during fever is half a lemon, passed slowly over it now and then.

Stimulants are often added to the diet of the sick, when patients .are much prostrated or exhausted. Their use requires great caution and judgment. As a rule, they should not be employed with-out the advice of a physician. Wine-whey and whisky-punch are most frequently advised. They are most apt to be appropriate in typhus fever, in the weakest cases of typhoid fever, and in the date stages of severe acute diseases. Also, they may be called for in cholera, and in certain conditions which are met with in advanced or advancing consumption of the lungs.

Convalescence is generally attended by the return of a good appetite and digestive power. The system has to make up for what it has lost during illness. Care is necessary that the patient does not venture too soon upon a varied diet, or the use of things hard of digestion. After typhoid fever, this is particularly necessary. From the special condition of the intestinal canal in that disease, life may be endangered at that time by a single imprudence in diet. Gradually, however, after most diseases, recovery is marked by ability to eat all ordinary wholesome food, and a variety of digestible dishes may be indulged in, always, of course, avoiding excess.

BED REST

BED-REST

We shall now give directions for preparing a number of articles especially suited for the food of the sick; those, that is, who cannot properly take ordinary solid meals.* Different things are required for different cases. Of this the physician must judge, when one is in attendance. In his absence, those in charge must be guided by the symptoms and conditions present.

* To show that fluid food may suffice even for a length of time, I have just read an account of a man who died at the age of eighty-five years, who, when seven years old, swallowed by mistake some strong lye, the effect of which was to contract his oesopHagus (lower gullet) so much, that he never afterwards could swallow solid food.