The nurse should serve everything in the most cleanly and appetizing way if it is only a cup of tea; and all waste, soiled dishes, napkins, and excreta must be removed as delicately as possible.

Diet for Pregnancy.—Fresh fish, boiled, broiled or baked; and shell-fish raw or cooked,—any way but fried.

Meat, once or twice a day, except when contraindicated by condition of the kidneys. Veal is best omitted.

All farinaceous foods and vegetables may be eaten freely.

Desserts should be plain, but tempting.

No alcohol is taken without direct permission from the doctor, and coffee and tea should be limited.

Diet for Puerperium.—First two days, milk, buttermilk, soup, gruel, cocoa, toast and tea, chicken, oyster and clam broth.

In the next two days, under ordinary conditions, the diet is increased and made somewhat heavier.

Semisolids are added like milk-toast, eggs, poached or boiled soft, oysters, clams and boiled fish.

After the milk comes in, the woman is put on a general diet as fast as she can digest it.

Farinaceous diet—melons and oranges.—

Breakfast.—Cereal, coffee with milk and sugar, if desired, bread and butter, corn bread, rolls, toast, muffins, hominy, cereal with cream.

Lunch.—Vegetable soups, bread, butter, potatoes, beans, rice, macaroni and cereal, peas, buttermilk, pudding, such as rice, tapioca, bread cornstarch, jellies, fruit juices, pumpkin, squash, turnips, tomatoes, etc.

Dinner.—Bread, butter, milk-toast, hominy, rice, celery, fruit salads, lettuce, apples, pears, prunes, stewed fruits or fresh melons, etc.

The following diets are routine at many hospitals:

General Diet.—Full tray of food in season as furnished by the hospital. Three meals daily.

Light Diet.—Foods from the following list may be selected, and served three or five times daily, as desired:

Soups of all kinds. When leguminous foods are employed, their outer coverings must be removed by rubbing them through a sieve or colander.

Vegetables of all kinds, except green vegetables (provided they have been reduced to a pasty consistency). Those with excess of fiber or cellulose, such as turnips, celery, asparagus, and cabbage, should be chopped after thorough boiling, then mashed, while those having tunics should be sieved or colandered.

Grain foods of all kinds thoroughly cooked, excepting corn preparations containing much cover, as hulled corn.

Prepared foods such as tapioca, macaroni, and vermicelli, require prolonged cooking.

Meats, scraped beef.

Eggs, soft boiled, raw or soft poached.

Bread of all kinds, stale, home-made.

Puddings, ices.

Beverages, all kinds unless otherwise ordered.

Forced Diet.—This includes the general diet with the addition of one quart of whole milk and four eggs. The milk may be given plain or as an eggnog at seven, ten, three, and eight o’clock. The eggs may be given raw or cooked soft in any form.

Milk Diet.—Twelve ounces of whole milk (375 c.c.) may be given every two hours; i. e., at six, eight, ten, twelve, two, four, five, and eight o’clock, or the patient may sip it at her pleasure.

The milk may be given raw, boiled, diluted with plain water, lime water, Vichy, seltzer, or Apollinaris to taste. The daily amount should include three quarts of whole milk. Koumiss, buttermilk and milk soups are sometimes allowed. Note the exact amount taken, and give reasons for failure. Watch the stools for undigested milk.

Liquid Diet.—Whole milk, buttermilk, koumiss, beef tea, or beef, chicken, mutton, oyster, or clam broth, in eight ounce portions, or two ounces of beef juice, every two hours. Lemonade, orangeade, ice cream, or fruit ices, at intervals and amounts as desired.

Ulcer Diet.—Whole milk and cream, equal parts, three ounces every two hours. Sodium bicarbonate, thirty grains, in a small amount of water, to be given before and thirty minutes after feeding. Albumin water, soft boiled eggs, scraped beef, custard, and cream soups to be added later by direction of the physician. No seasoning except salt is allowed.

Prochownik Diet.—This diet is advised where some necessity exists for preventing a large child. It is administered in the last six weeks of pregnancy only.

Breakfast.—Small cup of coffee, two slices of toast (1 ounce).

Lunch.—Small piece of meat, fish or an egg, a little sauce. A vegetable prepared with fat, lettuce, a small piece of cheese.

Dinner.—Same as lunch with three slices of bread and butter, and a little milk.

A pint of water daily is allowed; taken in sips it lasts longer.

Soup, water, beer (all fluids) and sugar, pastry, and potatoes are forbidden.

Skimmed Milk Diet (Karell).—Skimmed milk, to which a pinch of salt is added, 3 to 6 ounces, three or four times daily, increasing the amount gradually, taken slowly to allow thorough mixture with saliva, warmed in winter, room temperature in summer.

Acute Nephritis Diet.—Whole milk, 1000 c.c.; cream, 250 c.c.; water, 150 c.c.; stewed fruit, well sweetened, 50 c.c.

Bread, well buttered, may be toasted, 150 gm. (equal to three slices).

Green salad of lettuce, celery, apple, pear or grape fruit, and served either with olive oil, or with a mayonnaise dressing made from olive oil, egg and lemon juice, with salt (but no pepper or condiments) may be given in two small portions daily.

Cooked cereals (cream of wheat, etc.) with cream and sugar, one portion equal to about two ounces, once daily.

The above represents a daily fluid intake of about 1500 c.c. The diet is to be given in “three meals,” at eight, one, and six o’clock, with fluid nourishment at eleven, three, and nine o’clock.

RECTAL FEEDING

Nutrient enemas should be given every six hours, unless otherwise ordered. It is necessary to cleanse the lower bowel with a saline or soapsuds enema at least once a day. The cleansing enema should be given one hour before the nutrient enema is to be given. The proper quantity for the nutrient enema is four to six ounces for an adult, and one to three ounces for a child. Nutrient enemas should be given slowly at very low pressure, the level of the fluid in the can being not over eight to ten inches above the level of the rectum. If the injected material is thick, a piston syringe may be required. The patient should be placed upon the left side with the hips well elevated and should be kept in that position for fifteen to twenty minutes after the enema has been given. The tube should be oiled and not be inserted more than three or four inches. The temperature of the enema should be about 98 degrees. If there is a strong tendency to evacuate the enema, pressure should be made against the rectum with a pad.

The following nutrient enemas may be ordered by name.

Glucose Enema.—Glucose (dextrose, grape sugar) 1 ounce, normal salt solution 5 ounces.

The glucose should first be dissolved in hot water. The amount of glucose may be increased, upon order, if no irritation is produced.

Pancreatinized Milk Enema.—Add 1 tube of peptonizing powder, or 1 to 2 drams of “Pancreatic solution” to 1 pint of skimmed milk. Stir well and place in a warm water bath for one-half hour. Add 1 dram of salt.

Milk and Egg Enema.—Thoroughly beat the whites of 2 eggs, add ? dram of salt, and 6 ounces of skimmed milk. Add one tube of peptonizing powder, or 1 to 2 drams of “pancreatic solution,” stir well, and place in a warm water bath for one-half hour.

Milk, Egg, and Beef Juice Enema.—Mix the beaten whites of 2 eggs, 2 ounces of fresh beef juice, 6 ounces of skimmed milk, and ? dram of salt. Add 1 tube of peptonizing powder, or 1 to 2 drams of “pancreatic solution,” stir well, place in a warm water bath for one-half hour.

Milk and Glucose Enema.—Add 1 tube of peptonizing powder to 6 ounces of skimmed milk, stir well, place in a warm water bath for one-half hour. Add 3 drams of glucose and ? dram of salt.

ELIMINATIVE ENEMAS

Impaction Enema.—

Castor oil or olive oil, 1 ounce.

Soapsuds (100° F.), 1 quart.

Mix as thoroughly as possible, add one dram of spirits of turpentine beaten up with the yoke of one raw egg.

S. S. and G. Enema.—

Soapsuds, 1 quart.

Glycerine, 1 ounce.

Asafoetida Enema.—

Milk of asafoetida, 8 ounces.

Water, 8 ounces.

1–2–3 Enema.—

Magnesium sulphate, 1 ounce.

Glycerine, 2 ounces.

Water, 3 ounces.

Milk and Molasses Enema.—

Milk, ordinary cooking molasses in equal parts, possibly 8 ounces of each. Heat, but do not boil.

Turpentine Enema.—

Soapsuds, 1 pint.

Turpentine, 1 dram.

It acts quickly and effectively.

All enemas should be given through a colon tube. The patient should be on the left side and the temperature of the injection should be about 100° F.

Albumin Water.—Take white of 1 egg, stir until separated. Add a little lemon juice and 1 pint of water. Ice and serve. Sugar or salt may be used.

Barley Water.—Wash 2 ounces of barley with cold water. Boil for 5 minutes in fresh water. Strain. Then cover with 2 quarts of water and cook slowly down to 1 quart. Flavor with thinly cut lemon rind and sugar. Do not strain unless patient requests.

Beef Juice.—Cut into cubes 1½ inches each, 1 pound round steak. Place in a clean, ungreased pan, and fry one and one-half minutes on each side. Pour into hot meat press and apply pressure. In absence of a press, a potato ricer may be used. Season with salt and pepper. May be served iced or heated by putting in double boiler and stirred all the time. Do not allow to curdle.

Beef Tea.—Put 1 pound of finely chopped round steak into a quart glass jar, fill with cold water. Place jar in kettle of warm water. Leave over slow fire for four hours. Strain, season with salt and pepper.

Champagne Whey.—Boil 8 ounces milk for fifteen minutes. Strain through cheesecloth. Add 1½ ounces champagne.

Chicken Broth.—Skin and chop in small pieces one small or one-half large fowl. Boil bones and all with one blade of mace, a sprig of parsley, and 1 tablespoonful of rice, 1 crust of bread and 1 quart of water, for one hour. Skim from time to time. Strain through coarse colander and season to taste.

Cinnamon Water.—One-half ounce stick cinnamon, 2 cups boiling water.

Break sticks in small pieces. Add water, boil twenty minutes. Strain and serve hot or cold.

Clam Broth.—Wash thoroughly 6 large clams in shell. Put in kettle with 1 cup of cold water, bring slowly to boil, and keep temperature for one minute. Pour off broth and serve hot. Add salt and pepper.

Eggnog.—Beat an egg, white and yolk separately. Add to the yolk 1 dram of vanilla extract, a pinch of salt and 4 oz. fresh milk, and 1 dram of sugar. Add ½ dram of sugar to white of egg, stir a portion into the glass and heap remainder upon top of glass.

Egg Cordial.—One egg white, 1 teaspoon sugar, 1 tablespoon brandy, 2 grains salt, 2 tablespoons cream.

Beat white until stiff. Add cream, continue beating, add other ingredients, and serve cold.

Egg Lemonade.—Beat 1 egg and 1 teaspoonful of sugar until very light, add ¼ cake of yeast dissolved in one-fourth cup of water, two tablespoonfuls of sugar, pour into bottles with patent stopper, fill bottles only two-thirds full, cork tightly. Shake well. Allow to stand on ice twenty-four hours.

Flaxseed Tea.—One ounce of whole flaxseed, 1 ounce powdered sugar, ½ ounce licorice root, 1 ounce lemon juice. Pour over these materials 1 quart of boiling water and allow to stand four hours. Strain off liquor.

Gum Arabic Water.—Dissolve 1 ounce of gum arabic in 1 pint boiling water. Add ½ ounce sugar, a wineglassful of sherry, and juice of one lemon. Serve with ice.

Junket.—Take ½ pint of fresh milk in a saucepan. Add 1 teaspoonful of essence of pepsin, stir just enough to mix. Pour into custard cups. Let stand until firmly curded. Serve plain or with grated nutmeg. Sherry may be added.

Koumiss.—Heat four cups of milk, then cool; when lukewarm, add ¼ cake of yeast dissolved in one-fourth cup of water, two tablespoonfuls of sugar, pour into bottles with patent stopper, fill bottles only two-thirds full, cork tightly. Shake well, allow to stand on ice twenty-four hours.

Milk Shake.—White of 1 egg, 1 ounce sugar, 1 ounce chipped ice, 1 ounce cream. Shake in milk shaker two minutes. Add milk to fill glass. Flavor with vanilla and lemon.

Mutton Broth.—Boil slowly 1½ pounds of lean loin mutton, including the bone. Add a little salt and ½ onion. Pour broth into a basin. Skim off fat when cool. Warm as used.

Oatmeal Gruel.—One teacup oatmeal flakes, cover with 1 quart cold water. Place on slow fire and soak three hours. Strain, add 4 teaspoonfuls of sugar and 1 teaspoonful of salt.

Oatmeal Water.—Cover 1 teacupful oatmeal with 1 quart cold water. Let it stand two hours. Stir often. Strain. Serve with salt, sugar and ice.

Peptonized Milk. Warm Process.—Dissolve the contents of Fairchild’s peptonizing tube in 4 tablespoonfuls cold water. Add to 1 pint of milk. Put in glass jar, and place jar in vessel of warm water. Heat slowly to 115° F. Stir slowly and allow it to remain thirty minutes. Place on ice at once to check further digestion.

Peptonized Milk. Cold Process.—In a clean quart bottle, put one peptonizing powder (Fairchild). Add 1 teacupful of cold water. Shake. Add 1 pint fresh cold milk. Shake well. Place on ice. Do not heat before using.

Rice Water.—Pick over and wash 2 tablespoonfuls of rice. Put in a saucepan with 1 quart of boiling water; simmer two hours. When rice is dissolved, strain. Add teaspoonful salt. Serve warm or cold. Sherry may be added.

Rum Punch.—Two teaspoonfuls powdered sugar, 1 egg well beaten, warm milk, 1 large wineglassful; 4 ounces Jamaica rum. Flavor with nutmeg.

Scraped Beef.—Place on breadboard a round steak. Scrape with table-knife but do not take any shreds of muscle. Salt and pepper. Spread on thin slices of bread. Place in toaster until seared.

Toast Water.—Three slices of stale bread well browned, but do not burn. Put in a pitcher, pour over them 1 quart boiling water. Cover closely, and allow to stand until very cold. Strain. Wine and sugar may be added, to stimulate.

Wine Whey.—Put 1 quart new milk in a saucepan and place over fire. Stir until nearly boiling. Add 2 ounces of sherry wine. Boil slowly for fifteen minutes. Skim off curds as they arise. Add 1 tablespoonful sherry. Skim again, then strain through gauze.