In these maladies appetite is diminished, digestion impaired, and general strength much lessened. It is essential, therefore, that as much food be given as possible to overcome loss of strength and to restore vigor, that it be as easily digested as possible, and sufficiently varied and dainty to tempt the appetite. These general dietetic principles are especially applicable in the chronic or prolonged cases.

Anorexia, as well as great feebleness, makes feeding difficult in the severest cases. Such easily digested and assimilated food as milk, broths, gruels, and egg-nog, should be given in as large quantities as the patient can take and utilize. Often, however, food must also be given by the rectum. As in all other maladies in which mental hebetude exists at times, water should be given regularly and in sufficient amounts to keep the kidneys acting well. If enough fluid cannot be given by the mouth, it should be given by the rectum or beneath the skin. It is especially in these cases that hypodermoclysis has proved most useful. Physiologic salt solution introduced beneath the skin in considerable quantities provokes a copious flow of urine, which is often followed by the mitigation of all symptoms. As much as two or three pints of water may be introduced gradually in this manner. Less frequently, in cases of extreme danger, a vein is opened and an intravenous injection of physiologic salt solution is made. In a large majority of cases a pronounced fall of the temperature follows the copious diuresis that is thus produced. All the other general symptoms are also mitigated. Unfortunately, this improvement is often but transitory.

In proportion as the malady is chronic, the necessity for forcing food increases. It must be given often. When, as happens in many cases, considerable remissions of temperature occur, food should be crowded upon the patient, but during the hours of pyrexia it should be given in small amounts and in forms that make it very easy to digest and to assimilate.

If nephritis complicates a septic or pyemic malady, the diet must be modified accordingly. Traces of albumin in the urine or a few granular casts with or without albumin point to a pathologic state of the kidneys. The diet should then be confined to milk and gruels, with an abundance of water and a little fruit or fruit-juice. In all other ways care should be taken to avert nephritis. For instance, the bowels must be emptied regularly and those foods eaten which will not tax the liver and kidneys to eliminate them after digestion and absorption. Patients must be protected also from the ill effects of cold or dampness.

During convalescence the diet must be that usually prescribed for patients recovering from infections, and for those who are much enfeebled. It should be more varied than in the earlier stage of the disease; at first solids that are finely divided are the best to use, but soon the simplest kinds may be given without being divided before mastication.