"Alimentation occupies the first place in the general treatment" (Trousseau). Throughout the active stage of the disease, while the fever lasts, there is difficulty in swallowing. All food must be given in fluid form, of which milk is the best, or if, as sometimes happens, semi-solid material is more easily swallowed, the food must be thickened with cream, gelatin, eggs, or farinaceous articles; or Dry Peptonoids Soluble, malted milk, etc., may be added for this purpose to other foods. The use of pineapple juice is recommended because it contains an enzyme which belongs to the proteolytic group.

The diet should consist chiefly of nutritious beef or chicken broth and beef tea, egg albumin, egg-nog, milk, and milk punch. Plain vanilla ice cream is nutritious, and if not too sweet, it is well borne, and is frequently very grateful to the inflamed throat. Simple farinaceous foods, such as arrowroot, thoroughly cooked rice, soft cream toast, and gruels, may be taken. Continued disgust for food is a very bad prognostic sign, and every effort must be made to counteract it by offering variety. When the child is unable to swallow on account of pain in accumulation of membrane in the throat, forced feeding with a nasal or stomach tube may be better than nutrient enemata.

1W. Gilman Thompson, M.D.: "Practical Dietetics." New York. D. Appleton & Co.