distinguish between a dietary suitable for acute disease, when we have to wait and tide over difficulties, and one that may be better adapted to restore a convalescent or weakly patient. The highest nutritive value may not be (I think it is not) the most essential point to have regard to in selecting a dietary in acute diseases.[1]
In most cases of acute disease, beef tea, freshly prepared, can well be taken and digested. It is now often peptonized, and I believe for clinical purposes this is generally unnecessary, unless there is manifest failure of secretion of gastric juice. This remark applies equally to milk, which is also too often given peptonized. I feel sure that we do best to administer nutriment in the most natural and unaltered forms when possible—that is, with as little of culinary or medicinal interference as may be; to give it, in fact, fresh from Nature's laboratory.
In many illnesses it is well to vary the broths given, changing from beef to mutton, veal, or chicken, and so providing variety for the patient. Milk and veal broth may often be given together Alcoholized liquids are best not administered with animal broths. These are better given separately, but brandy, rum, or whisky may be given with milk.
It is, unfortunately, a good rule to boil milk before using it, especially in the case of children and young persons. This no doubt averts many of the evils of milk diet, and may also prevent some specific diseases. I say unfortunately, because I suspect boiling much damages the nutritive value of a secretion such as milk. Dilution with barley water, lime water, or the addition of sodium bicarbonate, certainly aids its digestibility in children and adults, both in health and disease; the bicarbonate being preferable if there is constipation. Whey is of considerable value for many dyspeptics, and also in enteritis, typhlitis, and intestinal obstruction, and may be freely given. Isinglass boiled in milk is very useful, and children readily take this in the form of blanc-mange when not too firm in consistence. Alum whey is of much avail in diarrhœa, and in cases of enteric fever with hæmorrhage. One drachm of powdered alum is added to a pint of hot milk, and the whey strained off. Cream with an equal volume of hot water can often be taken when milk disagrees.
Koumiss has considerable value in cases of great irritability of the gastric mucous surface. Koumiss one week old I find the most useful, and I have often known troublesome vomiting checked by it. Few plans are better than that of employing milk with one
- ↑ Thus alcohol, which is by some denied to have any nutrient property whatever, will, with water, maintain life for days in some cases of acute illness, to the exclusion of any other articles of diet I consider alcoholized liquids as food, for both ordinary and clinical purposes
