Liquid Diet In Typhoid Fever

In the ordinary case, two and a half pints of milk and a pint and a half of beef, mutton or chicken broth will be a fair average supply, given in divided quantities, alternately.

Give ten ounces at a time, every three hours; the broths will come in after every second supply of milk. The amount of meat broths must be governed by the state of the bowels. If diarrhoea, then broths must not be given, or should be given in very small quantities.

Broths tend to increase diarrhoea. In some eases meat jelly iced or extract of meat may be taken in place of broths, a teaspoon being given at a time.

The chief guide in the matter of food in typhoid must be found in the condition of the stools. The physician in charge of the case should himself see the feces daily. If any signs of undigested food appear, there is something regarding the dietary that is wrong. If masses of hard curd appear in the motion, there is probably too much milk given in the twenty-four hours, or it is being given in too large quantities at a time.

It may be that the quantities are not wrong, and that dilution of the milk, or the addition of an alkali, or of some farinaceous material in powder well cooked in milk will answer the purpose by preventing the formation of the firm curd.

Milk, if not retained or digested, should be peptonised.

The chill may be taken from milk by adding a little hot water, and twenty drops of the saccharated solution of lime in each supply will secure alkalinity. Farinaceous substances to use in milk are arrowroot and baked flour, to aid in subdivision of the curd. Food should not be given as the nurse sees fit, but definite directions should be laid down as to the quantity to be given at a time and the mode of its administration.

Indication for the use of alcohol lies in the condition of the heart. A small, frequent, easily compressed pulse, especially if associated with feebleness of the first sound of the heart, is a clear indication that alcohol is required. The amount given should be small - from a teaspoon to a tablespoon, or one ounce of wine.

Alcohol, on account of effect only lasting for a short time, should be given every two hours, so that stimulation is kept up. In giving alcohol, you get an effect first of stimulation, then depression.

The use of alcohol is not advocated by some physicians.

Typhoid Fluid Diet Of Presbyterian Hospital

Milk, broth, egg albumin.

Typhoid Fluid Diet Of Gloversville Hospital

Milk, strained broths of chicken, mutton, beef, clam broth, barley water, farina, arrowroot and other gruels, custards, egg-nog, weak tea, bouillon, junket, cream, egg albumin, gelatin.

Diet In Convalescence From Typhoid Thompson

As the fever subsides, it becomes an important question how soon to allow a return to solid food. Relapses are very easily induced by indiscretion in this regard.

The patient's appetite is always a dangerous guide to follow in this disease. After four or five weeks of an exclusive milk or milk and broth diet, when the temperature subsides, and often before it has become normal, he becomes ravenous. Like a long-starved man, he thinks of nothing but food, and demands something new to eat every day. A hospital ward containing a dozen convalescing typhoid fever patients, is difficult to manage, as a bread riot is constantly menaced. Ill-advised but sympathetic friends attempt to smuggle in all manner of forbidden fruits, and the patient just arrived at the hungry state is tempted to steal solid food from his more advanced neighbors.

In the milder cases it is undoubtedly both safe and wise to allow a strengthening diet at an early date, and it will greatly prolong convalescence to forbid it. Light farinaceous diet - tapioca, rice, vermicelli, cream-toast, a cracker soaked in cream, etc.- may be given with impunity in cases which have run a mild course, as soon as the temperature remains normal. Meat broth may be thickened with rice, sago, or vermicelli. In a day or two more, the soft part of oysters or a chop are permissible in cases which have presented no need of prolonging a fluid diet for fear of intestinal injury. The following is a list of fluids suitable for the different days of convalescence, commencing a day or two after disappearance of all fever. Milk should still be given, until gradually wholly replaced by solid food:

1 Diet used at the Presbyterian Hospital, New York. 2 Diet used at the Nathan Littauer Hospital, Gloversville, N. Y. 3 W. Gilman Thompson, M.D.: "Practical Dietetics." New York. D. Appleton & Co.