This section is from the book "Practical Dietetics: With Reference To Diet In Disease", by Alida Frances Pattee. Also available from Amazon: Practical Dietetics: With Reference to Diet in Disease.
(Left Half) | ||||||||||||||
No. | Name | Present Address | Permanent Address | |||||||||||
Vol. | Sp. Gr. | Reac. | Alb. | Acetone | Diacetic Acid | B-oxy bu'ric Acid | Ammonia | Fehl-ing's | Fer'ta-tion | Rotation | ||||
Total | % of Nitrogen | Before | After | |||||||||||
Fermentation | ||||||||||||||
(Right Half) | ||||||||||
Laevu-lose | Pentose | Urine Total Sugar | DIET | NaHCO3 | Carbohydrate Balance | Weight of Patient | REMARKS | |||
Total Carb. | Protein | Calories | ||||||||
Opposite side of Chart | |||||||
Date | Orders | Breakfast | Forenoon | Dinner | Afternoon | Supper | Night |
Meat, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee and tea, and for variety, tongue, sweetbreads, tripe, kidneys, pig's feet, brains, bone marrow, anchovies, caviar, lobster, crabs, sardines, shrimps, bologna sausage, smoked or pickled meat, or fish.
Per Cent, of Carbohydrates in 5% or Less.
Lettuce.
Sauerkraut.
String Beans.
Celery.
Cucumbers.
Brussels Sprouts.
Sorrel.
Endive.
Rhubarb.
Egg Plant.
Leeks.
Beet Greens.
Watercress.
Butternuts.
Unsweetened and Unspiced Pickle.
Ripe Olives Grape Fruit.
Clams Scallops Fish Roe.
6% or Less.
Cabbage Radishes Pumpkin Kohl-rabi.
Oysters Liver.
10% + Onions Squash Turnip Carrots Okra Beets Mushrooms.
Lemons.
Cranberries.
Strawberries.
Blackberries.
Gooseberries.
Watermelon.
Musk Melon.
Brazil Nuts.
15% + Green Peas Artichokes Parsnips.
Canned Lima Beans Apples Pears Apricots Cherries Currants Raspberries Huckleberries.
Pecans.
Filberts.
Walnuts.
Pistachios.
Beechnuts.
20% + Potatoes.
Shell Beans Baked Beans Green Corn Boiled Rice Boiled Macaroni.
Plums Bananas.
Almonds.
 
Continue to: