Sunday, March 29, 2009

Diet For The Sick

(image from the LOLCats).

By Audrey C. Bullock (Modern Priscilla, January 1915).

THE problems in diet for the sick are two: (1) To keep up the bodily strength by sufficient nourishment. (2) To administer this nourishment in an easily assimilated form so as to tax the energies of the patient as little as possible.

A small amount of unsuitable or indigestible food may mean overfeeding, taxing the strength of the patient to a dangerous degree when he is obliged to eliminate the resulting evils; while, on the other hand, the customary diet of liquids is apt to be a process of slow starvation, containing as it generally does an insufficiency of nutrients. If you wish to succeed in avoiding nausea, vomiting, loss of strength, and even loss of life, you must learn to offer nourishment to the patient in a suitable form, in the quantity and at times suited to his digestive power and so adapt his food to his capabilities. Even when the patient is confined to bed and prevented from taking any kind of voluntary exercise, he still requires heat and energy for the involuntary action of heart, lungs, and the process of living, and this must be procured from his food.

When the temperature is high there is always a demand for a large quantity of easily digested food, usually in liquid form, and water is given to assist in carrying off the waste products. The hours of alternate ebb and flow of vital force should be most carefully watched for in order that you may anticipate the best time to offer nourishment.

By diluting milk, stimulants, gruels to much, or making beef tea too weak, the quantity of the fluid is so great that the patient soon tires of swallowing and stops before enough nourishment has been obtained. When a strictly milk diet is ordered during fever the amount given should never fall below three pints daily, and two quarts is often considered necessary. To make a liquid diet bearable for any length of time without destroying all desire for food, it is necessary to offer as much variety as possible; but do not give solid foods too soon, as they may cause rise in temperature and rapid heart action. The first meat consumed should be in a finely subdivided state, such as scraped beef or minced chicken.

The lack of desire for food on the part of the invalid may be due merely to defective cookery, the serving of meals at inopportune moments, or to the fact that the food selected is not to the patient’s liking. A desire for food may exist, but not for the particular food offered, and you must learn what to give in its place. It is much better to serve small quantities often than too much at one time, and punctuality in serving meals should be observed, for an appetite ready at the accustomed hour may fail if the meal is delayed. There is much unconscious habit in regard to eating.

Overcoming a Poor Appetite

Have the tray covered with a spotless cloth or napkin, and everything about it as dainty, clean, and attractive as possible, remembering that with a sick person appearance counts for a great deal. He may seem to ill to notice these details, whereas he is only too ill to speak of them, for one feeds with the eyes quite as much as with the lips. It often proves pleasing to carry out a color scheme. Nervous patients are apt to be depressed in the early morning, therefore for this reason make the breakfast tray as attractive as possible by using bright flowers, etc. The tray should be of correct size, so that when laid it will not have the appearance of being overcrowded; on the other hand, if a small amount is to be served, use a small tray. Have the dishes so placed that they may be easily reached by the patient. An individual coffee or tea pot will keep the beverage much hotter than it can be kept in a cup, and there is not the same danger of its being spilled while it is being carried on the tray. Have the hot things hot, and the cold things cold, not lukewarm, and taste all foods and drinks before serving, using a separate spoon, to ascertain if they are properly seasoned and at the right temperature. Remove the tray and all traces of the meal as soon as the patient has finished, thus giving him no opportunity to grow weary of looking at the food, and never leave half-emptied cups or glasses in the room.

Beverages are almost as necessary during fever as liquid foods, not only to relieve thirst, but to assist the organs of elimination in carrying off the poison that accumulates in the system. While pure cold water is usually the most acceptable, barley water, rice water, and beverages made from fruits, as lemonade, orangeade, etc., are useful alternates which may be sipped freely between meals. When a large amount of nutriment is required these beverages are sometimes combined with the white of an egg.

In convalescence, when the first part of the meal is hearty, a light and delicate desert properly follows, while in a case where the dishes first served have a comparatively low food value the desired average may be made up by finishing with an especially nourishing dessert. Fresh fruits, nature’s own ready-made desserts, may be prepared in many attractive ways. An orange, for example, may be cut in halves, the pulp and juice removed with a spoon, placed in a sherbet glass and dusted with powdered sugar.

Delicacies That Tempt

The following PINEAPPLE AND BANANA PUREE is especially nice. Press a sound but perfectly ripe banana through a potato-ricer, sweeten and add one tablespoon of orange juice. Pile a little mound of this mixture on a thing round slice of pineapple and place one unhulled strawberry on top.

A GRAPEFRUIT is usually cut in halves, the seeds and tough membrane removed, and the pulp cut loose from the outer skin. Sprinkle with sugar and put a maraschino cherry in the centre.

For convenience the following recipes have been arranged in individual amounts.

RICE WATER. – Wash two tablespoons of rice in several waters. Soak thirty minutes in three cups of cold water, heat gradually to boiling point and let boil until rice is soft. Strain, reheat rice water, season with salt, and if too thick dilute with boiling water. Milk may also be added if desired.

TOAST WATER. – Cut two slices stale bread, one-third-inch thick, and remove crusts. Put in pan and bake in a slow oven until thoroughly dried and well browned. Break in small pieces, add water, cover, let stand one hour. Squeeze through cheesecloth. Season with salt and serve hot or cold. This often proves efficient in extreme cases of nausea.

SYRUP FOR FRUIT BEVERAGES. – Add three-quarters of a cup of sugar to three-quarters of a cup of boiling water, stir until dissolved, then let boil without stirring for twelve minutes. Cool and bottle.

LEMONADE. – Mix together one and one-half tablespoons of syrup, two tablespoons of lemon juice, and three quarters of a cup of cold water. Use a glass lemon-squeezer and strain the juice. Place mixture on ice to cool and serve in a thin glass with a slice of lemon floating on top.

ORANGEADE is made in the same manner as lemonade, substituting orange juice for the lemon juice. Should the orange be very sweet use less sugar or add a little lemon juice.

A delightful invalid drink is made by blending three-quarters of a cup of strong lemonade with one-quarter of a cup of grape juice.

A dainty way of serving raw white of egg is to add two tablespoons of lemon, orange, or grape juice, and two tablespoons of sugar to the well beaten white.


Anonymous said...

I got sick just reading that.. especially the egg white part :)

Shay said...

Yeah, the toast water looks terribly appetizing, too.

Gina said...

What a delightful read! Well, I thought the same about the egg white too until I realized it's just meringue. I wasn't impressed with the toast water either but my mom loved milktoast (dry toast made soggy with milk) and I hated that too. Never tried it as it looked so unappetizing to me but I think it was probably a comfort food to her, something from her childhood.

Shay said...

Well, in the days before Ensure and Metamucil, you had to work with what was on hand. I personally think the toast water would be ghastly but I can see where it might work in cases of extreme diarrhea.