The following diet-list will be found useful for those patients with good digestion who need to have food crowded upon them, in order to gain in weight and strength:

On awakening: A cup of hot milk or of tea, coffee, or cocoa well diluted with cream or milk, or of beef tea, or of gruel. The hot milk is the best. The hot liquid food not only gives strength but makes coughing easier and the expectorate thinner and move easily dislodged.

Breakfast, one to three hours later, at from seven to nine: Weak tea, coffee, or milk. One of the cereal food; with rich cream and sugar. Bacon, fried hard, and a poached or boiled egg. Bread or toast and fruit or marmalade. This meal is preferably taken immediately after the morning coughing, unless the patient falls to sleep for an hour or so, when it will follow the sleep.

Bacon should form a staple breakfast dish if possible. Fish, sweetbreads, or minced meats may be taken instead of eggs.

Luncheon at about eleven: A glass of milk, gruel, malted milk, Mellin's food, or a dish of Robinson's barley or of soft-boiled rice with cream. Milk is usually the best, for it is easily prepared and quickly taken.

Dinner at from one to two: Soup, meat such as beef, mutton, lamb, or fowl. A variety of simply prepared and easily digested vegetables, like baked potatoes, peas, string- and wax-beans, corn, spinach, asparagus, and similar garden products. Salads with oil dressing are grateful to many patients, and the oil is a most useful food. Desserts should be simple. Those made or eaten with cream are especially good. Fruits are among the best.

Luncheon at about four: A cup of broth, an egg lemonade, a dish of ice-cream, or a glass of milk. Bread or crackers may be eaten with these if desired.

Tea at from six to seven: Fruits, fresh or preserved; bread and butter; some cereal food with cream, or cream or milktoast. A small portion of meat. Milk or tea or cocoa weakened with milk if preferred.

At bedtime: A glass of milk, hot or cold, as the patient prefers.

Water may be taken as it is wanted. The easily digested fats, such as butter, cream, bacon, and olive oil, are especially to be recommended. The frequent use of foods on which they are freely eaten should be urged. Necessarily this regimen must be greatly modified for patients who have much fever or gastritis.

The following is the dietary recommended by Dr. Weber:

"At 7 o'clock or earlier, while still in bed, a cup of milk with a dessert or tablespoonful of cognac or with lime-water or with a small quantity of tea or cocoa, and a small piece of bread and butter.

"At half past eight or nine o'clock, after dressing, breakfast of milk, with some stimulating addition, as tea, coffee, or cocoa, bread and butter or bacon, ham ,or fish.

"At 11, a tumblerful of milk or kumiss, or sometimes a cup of broth or beef-tea, or a sandwich and a glass of wine.

"At 1 or 1.30 a substantial meal of meat, poultry, fish, or game, with fresh vegetables, some light pudding or cooked fruit, and a glass of wine.

"At 4 o'clock, a glass of milk or kumiss, or a cup of tea or coffee with much milk, and some bread and butter, or plain biscuit.

"At 7 p. m., another substantial meal similar to that in the middle of the day.

"At 9.30 or 10 p. m., on going to bed, a cup of milk, or bread and milk, or milk with some farinaceous food, as Hart's or Liebig's, or Nestle's, or Mellin's. At this time, if there be night-sweats, a tablespoonful of brandy is very useful."

At Dr. Brehmer's sanatorium at Gorbersdorf the following is a sample menu for one day:

"Breakfast between 7 and 8 a. m., consisting of coffee, cocoa, tea, white or brown bread and butter, and a glass of milk. At ten o'clock luncheon, consisting of from one to two glasses of milk and bread and butter, or perhaps broth, egg, etc., and a glass of wine to finish with. At one o'clock, dinner of soup and three other courses, two of meat with vegetables, and one of pudding, with one or two glasses of wine. About 7 p. m., supper of one or two courses, one cold and one hot, with vegetables and one glass of wine; at 9 p. m., a glass of milk with two or three teaspoonfuls of cognac."1

At Nordrach three meals are given in the day:

1 "Sanatoria for Consumptives," von Jaruntowsky, translated by E. Clifford Beale.

"Breakfast at 8 a. m., consists of coffee, bread and butter, and cold meat, such as ham, tongue, sausage, etc., and a half liter of milk. This after a time is reduced to a quarter liter, according to the patient's capacity and need for putting on flesh. Dinner at one o'clock consists of two hot courses of meat, or fish and meat, about six ounces being served to each patient, with plenty of potatoes and green vegetables, and sauces in which butter is the main ingredient. The third course may be pastry or farinaceous pudding, fruit, and ice-cream, with coffee and a half liter of milk. Supper at seven usually consists of one hot meat course, as at dinner, and one cold, as at breakfast, tea, and a half liter of milk. The last two meals must be taken under the supervision of the resident physician, and servants may not take away the plates until everything has been eaten. Roughly speaking, the patient eats about double the amount of food he desires."1

It is interesting to contrast with these menus that recommended by H. P. Loomis:

"On awakening: Eight ounces of equal parts of milk and Seltzer, taken slowly through half an hour.

"Breakfast: Oatmeal or cracked wheat with a little sugar and an abundance of cream, rare steak or loin chop with fat, soft-boiled or poached egg, cream toast, half pint of milk, small cup of coffee.

"Lunch, 10 a. m.: Half pint of milk or small teacup of squeezed beef-juice with stale bread; 12 noon: Rest or sleep.

"Midday meal, 12.30: Fish, broiled or stewed chicken, scraped meat ball, stale bread, and plenty of butter, baked apples and cream, two glasses of milk.

"Lunch, 4 p. m.: Bottle kumiss, raw scraped beef sandwich, or goblet of milk; 5.30 p. m.: Rest or sleep.

"Dinner, 6 p. m.: Substantial meat or fish soup, rare roast beef, or mutton, game, slice of stale bread, spinach, cauliflower, fresh vegetables in season (sparingly)."

At the Loomis Sanitarium at Liberty, New York, the stronger patients are given the foods usually found upon the menu of a good hotel. For special cases, particularly if their ability to digest food is impaired, such a diet as the following is prescribed:

"7 a. m.: Two eggs, soft boiled; two slices of buttered toast; one cup of coffee with milk, cream, and sugar.

"9.30 a. m.: Kumiss, about ten ounces, and two slices of bread and butter.

"12 noon: Lamb chops, steak, or chicken, mashed or baked potatoes, boiled rice in milk, toasted bread and butter.

"3 p. m.: Same as at 9.30.

"5.30 p. m.: Meat soup, with farina or the like in it; squab or other

1 Fowler and Goodlee, " Diseases of the Lungs." meat; thickened rice or some other pudding (custard); spinach, asparagus, or green peas; Bass ale or stout, half a tumblerful.

"8.30 p. M.: Kumiss, crackers and butter, or oysters, or ale and crackers, or a sandwich and stout."

Cod-liver oil must be regarded both as a food and a medicine. It is an important adjuvant to the diet of consumptives. When it is well tolerated, it should be used very steadily in tablespoonful doses three or four times daily. If it lessens appetite for other food, it should not be used, or should be taken in smaller amounts. It is best to begin its administration with teaspoonful doses and to increase the amount gradually. Only the clear and comparatively tasteless oils should be employed. When patients are especially fastidious in regard to its taste, it may be given as an emulsion, or, better still, in capsules. A pinch of salt or a bite of dry cracker will often remove its taste from the mouth.

Alcoholic beverages are medicines rather than foods and must be prescribed as such. They are not now used with the same freedom as formerly. Fowler writes of them: "There is no evidence that the admittedly injurious effects of alcohol taken apart from food are not experienced in this disease, and we have frequently observed that patients who have previously been addicted to alcoholic excess suffer when attached by tuberculosis far more severely, chiefly from loss of appetite, inability to digest food, and a very irritable cough, than those who have led temperate lives." The routine use of alcoholics is not advisable and is not recommended by most of the recent writers on the subject. When they are used, they are prescribed as medicines to meet certain indications, such as a weak heart or enfeebled digestion with fever.

Change of climate and of scene produces good effects which have already been referred to and are as notable in improvement of general nutrition as in improvement of the condition of the lungs. Living in a well-conducted sanitarium increases a patient's weight and strength because of good care, regular eating and sufficient food, and the hope inspired by seeing fellow patients who are recovering. These important aids in treating tuberculosis must not be forgotten.

What has been said in the foregoing pages while it is espedaily applicable to those having pulmonary tuberculosis is applicable also to those having tuberculosis elsewhere.