SELECTION OF FOODS FOR THE SICK.—Methods of preparation of food for the sick differ somewhat from methods of preparation of food for those in health. The chief difference is in the selection of the foods to be prepared. In severe illness the physician prescribes definitely the diet of the patient. In the absence of a trained nurse, it is the home-keeper's work to follow the physician's directions and to prepare such foods as can readily be digested.

Often the home-keeper not only prepares, but selects the foods for the indisposed members of the household. In any case of feeding the sick, the following suggestions should be kept in mind:

(a) Choose easily digested foods and prepare them in such a way that they will be easily digested. Liquid or easily liquefied foods are digested with the least effort, hence the use of milk, broths, soups, and gruels in sick-room diet. Such semisolid foods as eggs (uncooked or soft cooked), cereals, softened toast, etc., are also easily digested. Avoid foods that are digested with difficulty, as pastry, fried foods, "rich" sauces, pork, veal, lobster, and baked beans.

(b) Give special attention to the selection of foods that appeal to the appetite. When foods are served, even though they are selected according to the physician's directions, likes and dislikes of the patient should be observed. If food suitable for the patient is distasteful to him, substitutions should be made or distasteful foods should be disguised. Eggs, for example, are most valuable foods for the sick. If disliked by the patient they may be slipped into such foods as cocoa or gruels. Appeal to the appetite can be made by changing the methods of preparing foods. The selection and preparation of food for the sick call for ingenuity and resourcefulness on the part of the homekeeper.

(c) Prepare less food for the sick than for those in health. Sometimes a lessened quantity of easily digested food is all that is needed to effect recovery from an indisposed condition. Some energy is needed to carry on the involuntary activities of the body, such as the beating of the heart, and the movements of the lungs (see Table of Energy Requirements). For the very sick patient, food served in small quantities, but served often, is necessary.

SELECTION OF FOODS FOR THE CONVALESCENT.—In recovery from severe illness, there is often the problem of building up an emaciated body. Knowledge of the proper quantity and the kind of food aids greatly in solving this problem.

The basic principles of the selection of food to increase weight were discussed previously (see Daily Carbohydrate and Fat Requirement). The use of concentrated foods, i.e. those whose fuel value is high, such as eggs, cream or top milk, and butter, is usually advisable. These foods can be added to foods of less fuel value such as vegetables. A generous use of whole milk is also effective in gaining weight. This can be used to advantage not only at meal times but between meals and at bed time. Milk is one of the few foods which can be used effectively between meals. Because it is bland in flavor, it does not "spoil the appetite" for the following meal. Bread and other grain foods and starch-rich vegetables are useful foods for gaining weight.

Many of the suggestions for the selection of foods for the sick apply to the selection of foods for the convalescent.

PREPARATION OF SPECIAL FOODS FOR THE SICK AND FOR THE CONVALESCENT.—(1) Milk.—Milk is one of the most important foods for an invalid because it is a liquid containing valuable nutrients. It is used in a partially predigested condition in Junket "Custard", peptonized milk, and malted milk. Buttermilk, kumiss, and matzoon are often agreeable and beneficial to the sick; by some, they are more easily digested than whole milk. Frozen desserts made of milk or cream are popular foods for the sick.

(2) Eggs.—Since eggs are both high in nutrients and easily digested, they serve as a most important article of diet for the sick. The variety of ways in which eggs can be cooked and served also adds to their value as a sick-room food. Eggs combined with milk (egg-nog, custards), with cereals (rice pudding, gruels), and with toast make suitable foods for the sick and convalescent. The principles used in the preparation of custards (see Lesson LI) should be applied in combining eggs with hot liquids.

(3) Gruels.—The principle of preparing breakfast cereals may be applied to the preparation of gruels. In the making of gruels less cereal and more liquid are used, i.e. mix 1 tablespoonful of cereal with 1 cupful of liquid. The finished product is strained. A gruel may be prepared by diluting a cooked cereal and straining. Gruels should be of the consistency of cream soups. Corn-meal, oatmeal, barley, rice, flour— especially graham, whole wheat, and gluten—arrowroot, and crushed crackers—especially graham and oatmeal—are suitable cereals for gruels. Water or a combination of water and milk is used for the liquid. When both water and milk are used, the method of cooking Rice Pudding should be followed.

The seasoning and flavoring of gruels are most important. Distaste for gruels is often due to improper seasoning. "High" seasoning is not desirable for the sick or convalescent. Usually a patient does not care for highly seasoned food. But some seasoning is necessary to make a tasty gruel. Gruels may be flavored with whole spices, meat extract, fruits, such as raisins, cranberries, etc., and lemon peel. The flavor of whole spices and fruits is extracted by cooking them with the gruel. If nutmeg is used, it is grated over the surface of the cooked food. The identity of this spice can thus be recognized. Sugar is used sparingly for the sick.

(4) Broth and Meat.—Although there is little nourishment contained in meat broths (see Protein in Meat), beef tea is often used as food for the sick, especially when liquid diet is necessary. It is appetizing and tasty.

To make beef tea, soak chopped meat in water for at least one hour. (Use 1 pint of water to 1 pound of lean beef.) Then cook the mixture slightly, over hot water (until it becomes reddish brown in color), and stir constantly. Strain through a coarse strainer, season, and serve at once.

Sometimes the juice of beef without any dilution with water is served to the sick. The meat is cut into pieces and heated slightly; then by means of a lemon "squeezer" or a meat press the juice is extracted.

Meats such as chicken (white meat preferably), lamb, broiled or roasted beef, can be used for convalescents. Scraped meat, i.e. meat from which the tough tissue is removed (see Experiment 50), can often be given to an invalid when solid meats are denied. The scraped meat contains more nutriment than beef juice (see Protein in Meat). It should be made into balls and pan-broiled (see Pan-broiling).

PREPARING THE TRAY.—Attractive serving of foods may make a stronger appeal to the appetite than choice selection or skilful preparation of foods. It should be remembered that the foods are to be carried from the kitchen to the sick room. For this reason, it is well to place foods, especially liquids, in deep dishes suitable for transit. All hot foods should be placed in covered dishes, that they may be hot when the bedside is reached.

For serving sick-room foods, the daintiest china available should be used. The tray should be spread with a clean napkin or doily. In the case of a contagious disease, a paper napkin or doily may be used. It should be destroyed at once after using.

A bedside stand which supports the tray without any effort of the patient is a comfort.

For contagious diseases, burn any remaining bits of food and sterilize the dishes,—cover with cold water, heat, and boil.

QUESTIONS

Keeping in mind that the requisite for food for the sick is ease of digestion, make a list of liquid, semisolid, and solid foods suitable for the sick room.

Explain why it is that liquid foods are invariably prescribed for the sick.

Give a variety of ways of cooking and serving eggs for the sick.

Keeping in mind the suggestions given in the chapter on Menu-making and in the present chapter, write several menus for an indisposed or convalescent patient.