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 http://www.archive.org/details/cu31924059209688 
 
THE 
 
 BOOK OF DIET 
 
 BY 
 
 CHALMERS WATSON, M.D., F.R.CP.E. 
 
 ASSISTANT PHYSICIAN, ROYAL INFIRMARY, EDINBURGH ; EDITOR 
 
 OP THB "eNCYCLOPjSDIA MEDICA ; " AUTHOR OF "FOOD 
 
 AND FEEDING IN HEALTH AND DISEASE : A 
 
 MANUAL OF PRACTICAL DIETETICS*' 
 
 THOMAS NELSON AND SONS 
 
 LONDON, EDINBURGH, DUBLIN, LEEDS, PARIS 
 LEIPZIG, MELBOURNE, AND NEW YORK 
 
CONTENTS. 
 
 m 
 
 I, The Chemistry and Physiology of Nutri- 
 tion . 9 
 
 II. Animal Foods . . -33 
 
 III. Vegetable Foods 73 
 
 IV. Beverages and Stimulants. . . .107 
 V. Concerning Meals 131 
 
 VI. Patent and Proprietary Foods . . 141 
 
 VII. Predigested Foods 153 
 
 VIII. Food Preservatives, Food Adulteration, 
 
 and Diseases caused by Food . .165 
 
 IX. Infant Feeding ... . . 177 
 
 X. Diet at Different Periods of Life. . 211 
 
 XI. Vegetarianism 237 
 
 XII. Nutritious Meals at Small Cost . . 249 
 
 XIII. How does Diet cause Disease?. . . 267 
 
 XIV. Diet in Fevers 275 
 
 XV, Light Diets 285 
 
CONTENTS. 
 XVI. Indigestion . . ... 303 
 
 XVII. Gout and Rheumatism . . , .311 
 
 XVIII. Diabetes -331 
 
 XIX. Obesity 347 
 
 XX. Tuberculosis 357 
 
 XXI. Cookery and the Preparation of Foods 371 
 
 XXII. Recipes 397 
 
 Appendix . 437 
 
 Index 441 
 
THE CHEMISTRY AND PHYSIOLOGY 
 OF NUTRITION. 
 
 THE CONSTITUENTS OF 
 FOOD. 
 
 I. — Protein. 
 Protein. 
 Casein. 
 Myosin. 
 Albumin. 
 
 Glaten and Legumin. 
 Gelatine, 
 
 II. — Carbohydrates. 
 III.— Fats. 
 
 IV. — Mineral Salts. 
 Calcium. 
 
 Sodium and Potassium. 
 Iron. 
 Phosphorus. 
 
 V. — Water. 
 
 NUTRITIVE Value of 
 
 FOODS. 
 Chemical Composition of Food. 
 The Heat Value of a Food. 
 
 DIGESTION AND ABSORP- 
 TION OF FOOD. 
 
 Time Occupied by Digestion in the 
 Stomach. 
 
 AMOUNT OF FOOD 
 REQUIRED. 
 
 THE INFLUENCE OF VARI- 
 OUS CONDITIONS UPON 
 THE AMOUNT OF FOOD 
 REQUIRED. 
 
 Influence of Age and Sex. 
 Rest and Exercise. 
 Climate and Seasons, 
 Personal Idiosyncrasy. 
 
 INFLUENCE OF VARIOUS 
 FACTORS ON DIGESTION. 
 
 Appetite, Hunger, and Thirst. 
 Sleep in Relation to Meals. 
 
THE BOOK OF DIET. 
 
 Chapter I, 
 
 THE CHEMISTRY AND PHYSIOLOGY 
 OF NUTRITION. 
 
 Food Constituents — Digestion and Absorption of 
 Food — Food Requirements and Factors modify- 
 ing Them. 
 
 Introduction. — All animate nature, both animal and 
 vegetable, is constantly changing. The tissues of plants and 
 animals are continuously built up and at the same time 
 gradually broken down by a process of wasting. The wasted 
 tissues have to be replaced, and this is effected through the 
 food we eat. Constant chemical changes are involved in 
 these processes, these chemical changes supplying a large 
 amount of energy, which produces both body heat and work. 
 In the human body the rate of change varies in the 
 different organs and tissues according to age and activity. 
 Thus the rate of growth from infancy to youth and on to 
 manhood is enormous ; in adult life, growth and repair take 
 place much more slowly. The liver and other digestive glands 
 are in a chronic state of rapid change, as they are intimately 
 concerned in the chemical processes involved in breaking 
 down the food-stuffs. The muscles of the body are also 
 9 la 
 
10 THE BOOK OF DIET. 
 
 rapidly changing, as they are so much concerned in muscular 
 exercise. The changes in some of the bodily structures can 
 readily be observed, notably in the nails and hair, which 
 require to be cut on account of their growth. The super- 
 ficial layers of the skin are continually being shed in the 
 form of fine branny scales; similarly, the teeth develop, 
 remain for a time, and then decay. 
 
 The existence of chemical changes is furtha- shown by 
 the waste products. Every human being gives off a large 
 amount of carbonic acid and water from the lungs by 
 respiration ; a large amount of water containing waste prod- 
 ucts (urea) in solution is daily excreted by the kidneys, and 
 other waste products are discharged along with the indigest- 
 ible food residue in the faeces. The chemical changes 
 involved in the processes of growth and repair go on 
 incessantly, and food is essential for this growth and repair. 
 If no food be taken, the chemical changes still go on, the 
 tissues of the body being drawn on by the blood for its 
 nutritive material, with the result that emaciation sets in and 
 death results from starvation. 
 
 The question therefore arises as to the best means of supply- 
 ing the materials necessary for the growth and repair of the 
 tissues, and this involves the study of food and feeding. A food 
 may be defined as anything which when taken into the body is 
 able (i) either to build up or repair the tissues ; or (2) to supply 
 the material for the production of heat and muscular work. 
 
 A true food must be either a tissue builder or a source 
 of potential energy. There are other substances used as 
 food which are, strictly speaking, not true foods, although 
 they are useful in nutrition — for example, tea, coffee, alcohol, 
 and condiments. 
 
 All foods are chemically complex substances, and have to 
 be subjected to digestive processes in order to break up the 
 
THE CONSTITUENTS OF FOODS. ii 
 
 complex substances into simple elements capable of being 
 absorbed by the blood and tissues. These simple elements 
 are in turn abstracted from the blood by the tissue, each 
 tissue taking from the blood the particular element which it 
 requires. At the same time the waste products from each 
 tissue pass into the blood stream, and are excreted by the 
 kidneys. If not excreted as rapidly as they are formed, these 
 waste products accumulate in the tissues and act as toxins 
 (poisons). See p. 269. 
 
 As stated above, all foods are chemical substances. They 
 contain, in addition to the nutritive elements proper, a more 
 or less non-nutritive or indigestible material, which is of no 
 value as a food and is at once eliminated. The white of 
 eggs, for instance, is an example of a food which can be 
 almost completely digested and utilized as food, whereas 
 the fibrous parts of many vegetables are very imperfectly 
 digested, and the indigestible residue is at once excreted by 
 the bowels in the fseces. This indigestible material is of 
 value as ballast in promoting evacuation of the bowels. 
 
 THE CONSTITUENTS OF FOODS. 
 
 All foods are built up of the following five nutritive con- 
 stituents in different proportions. These are spoken of as 
 aliments or nutritive principles. 
 
 •( 
 
 Casein of milk and myosin of 
 
 Proteins— for example, -j Albuminoid— for example, gela- 
 O-^a"": i [ tine. 
 
 Carbohydrates — for example, sugar and starch. 
 Fats — for example, butter and cream. 
 
 {Mineral matter — for example, sodium, potassium, calcium, 
 magnesium, iron, phosphorus, sulphur, chlorides. 
 Water. 
 
12 THE BOOK OF DIET. 
 
 The proteins contain nitrogen, carbon, hydrogen, oxygen, 
 and a small amount of sulphur. The carbohydrates and 
 fats differ from the proteins in containing no nitrogen ; they 
 contain carbon, hydrogen, and oxygen only. All foods, 
 therefore, are composed of these nutritive constituents in 
 different proportions. Some contain all the five aliments, 
 others contain two or three only. For example, lean flesh 
 meats contain a very large proportion of proteins or nitroge- 
 nous elements and only a very small proportion of carbo- 
 hydrates and fats ; potatoes, sugar, and arrowroot consist almost 
 entirely of carbohydrates and water; butter and cream consist 
 almost entirely of fat. Some foods, such as milk, eggs, and 
 bread contain all five nutritive principles in fair amount, 
 carbohydrates however largely predominating in the case of 
 bread. Careful observation and experiment have shown that 
 for growth and the preservation of health the three food-stuffs 
 — ^protein, fat, and carbohydrates — must be taken in certain 
 relative amounts. There is, however, no food that contains 
 them in the necessary proportion, hence the necessity of 
 having recourse to a mixed diet. Milk is a perfect food in 
 infancy, but in adult life the enormous bulk of milk required 
 makes it an unpracticable food. 
 
 Each food-stuff has a particular value in nutrition : the 
 building material is supplied by the proteins, mineral salts 
 and water, which are spoken of as tissue builders. Fats, 
 carbohydrates and albuminoids are not tissue builders, but 
 are sources of heat and energy. The second great function 
 of the food, the supply of heat and energy, is shared by all 
 the organic food-stuffs, such as proteins, fats, and carbo- 
 hydrates. These substances are able to supply heat and 
 energy in virtue of their capability of undergoing oxidation 
 in the tissues. In the body the proteins, fats, and carbo- 
 hydrates undergo oxidation, the oxygen necessary for their 
 
PROTEIN. 13 
 
 combustion being taken in with the inspired air. The 
 oxidation processes are attended by the liberation of energy, 
 which may take the form of heat or work. Fats require the 
 greatest amount of oxidation, and are thus the most im- 
 portant fuel food. It is owing to its great value as a heat 
 producer that fat forms such a prominent article of food in 
 the dietaries of the inhabitants of the Arctic regions. 
 
 A short detailed survey of the five nutritive priijciples may 
 now be made. 
 
 I. — Protein. 
 
 Protein is the term applied to the nitrogenous element in 
 the food. There are various varieties of this substance — for 
 example, in meats, eggs, and milk from the animal kingdom, 
 and in beans and peas from the vegetable kingdom. Analyses 
 show that they all contain much the same amount of nitrogen, 
 carbon, hydrogen, salts, and water. The all-important point 
 regarding proteins is that they perform the same function 
 in nutrition by supplying building material, and after the 
 growing period is over it is largely a matter of indifference 
 whether animal or vegetable protein is taken. The chief 
 proteins are : — 
 
 Casein is the chief protein in milk ; when separated from 
 the milk by the addition of rennet it constitutes the curd of 
 milk from which curds are made. 
 
 Myosin is the chief protein in meat. 
 
 Albumin is found in its purest form in white of egg, but is 
 also present combined in many animal and vegetable foods. 
 Albumin is a fluid substance that solidifies when heated to 
 160" F. This property of albumin is exemplified in a hard- 
 boiled egg, also in the skin that forms on the surface of 
 boiled milk, and in the granular portion that forms the 
 lower layer in a cup of beef-tea. 
 
14 THE BOOK OF DIET. 
 
 Oluten and Legiimin are the best known vegetable pro- 
 teins; gluten is the chief protein in wheat; legumin is a 
 protein derived chiefly from peas, beans, and lentils. 
 
 Gelatine is a nitrogenous substance closely allied to albu- 
 min. It differs from other proteins, however, in not being able 
 to build up the tissues. If gelatine be given along with albumin 
 it is utilized by the tissues and less albumin is needed ; and 
 on this account gelatine is spoken of as a protein sparer. 
 This property is of value in the feeding of fevers and other 
 conditions. 
 
 n. — Carbohydrates. 
 
 This class of food-stuff includes all forms of starches and 
 sugars and some gummy substances. They are found very 
 abundantly in potato, rice, corn-flour, sago, barley, and 
 wheaten flour. Sugars are present in fruits, honey, sugar-cane 
 and beetroot. The special r61e of carbohydrates in nutrition 
 is to act as a source of heat and energy. 
 
 m.— Pats. 
 
 This class contains all the fatty and oily foods. They 
 may be derived either from the animal kingdom (cream, 
 butter, suet), or from the vegetable kingdom (olive oil). 
 The edible fats are composed of stearin, palmitin, and olein. 
 These differ from one another in their melting point, olein 
 being liquid at ordinary temperature and stearin solid. Beef 
 and mutton suet are a mixture, chiefly composed of stearin, 
 while olive oil consists almost entirely of olein. 
 
 The chief use of fat is to generate heat at the time of 
 consumption or to form a reserve store in the body. If 
 just a sufficient amount is taken for the needs of the body it 
 is converted into carbonic acid gas and water, in which form 
 
FATS. 15 
 
 it leaves the body. An excessive consumption of it in the 
 food invariably leads to the accumuktion of fat in the body. 
 The amount of fat required by the body is dependent upon 
 (i) muscular exercise. If a sufficient amount of fat is not 
 taken, heat production during muscular exercise takes place 
 mainly at the expense of the albuminous tissues, with the 
 result that the muscles waste and a loss of weight results. 
 The combustion of fat is also dependent on (2) the external 
 temperature. With a low temperature more fat is oxidized 
 and more heat is evolved. In winter there is more rapid loss 
 of heat from the surface and there is more active internal 
 heat production than in the summer, when the external tem- 
 perature is higher. In cold climates more fet must be con- 
 sumed than in warmer zones ; this explains why the Eskimos 
 eat enormous quantities of fat. Fat is also stored in the 
 body and is available for future use. 
 
 If it is desired to increase the amount of fat in the body, 
 a fair amount must be taken in the food, together with a 
 plentiful supply of carbohydrates. In young children the 
 fat supply is more essential, deficiency of fat in the food 
 being a fault often met with in the artificial feeding of 
 infants. The uses of fat may be summarized as follows : — 
 
 (i) Supplies muscular energy ; (2) supplies heat; (3) forms 
 a reserve store ; (4) prevents waste of tissue. 
 
 rV. — Mineral Salts. 
 
 Mineral salts are of very great importance in nutrition. 
 This will be readily understood if we bear in mind that the 
 tissues, on analysis, yield 5 per cent, of ash. Death occurs 
 in a few weeks if salts are cut out of the diet. The two 
 most important salts are calcium phosphate, which enters 
 largely into the composition of bones ; and sodium chloride, 
 
lb THE BOOK OF DIET. 
 
 which occurs in all the tissues and fluids of the body. 
 Mineral substances are of great value as tissue builders, and 
 indirectly are also sources of energy. We have no very 
 precise knowledge as to the exact amount required daily, but 
 we know that an ordinary mixed diet contains sufficient for 
 the body requirements. Salts pass into the blood, as a rule, 
 unchanged by digestion. The chief mineral constituents are 
 calcium, sodium, potassium, magnesium, and iron; phosphorus, 
 chlorine, and sulphur ; traces of silica, iodine, fluorine. The 
 chief uses of the salts may be summarized as follows : — 
 
 1. They enter into the composition of the tissues — for 
 
 example, the bones and teeth. 
 
 2. They subserve special functions, such as the iron in 
 
 haemoglobin, the colouring matter of the blood, 
 and sodium chloride in the production of hydro- 
 chloric acid of the gastric juice. 
 
 The order in which food stands as regards richness in 
 salts is as follows : — 
 
 (i) Pulses and cereals; (2) vegetables; (3) meat; and 
 (4) fruits and nuts. 
 
 Calcium. — Foods rich in lime are milk, eggs, cereals 
 (especially rice), vegetables (especially asparagus and 
 spinach), and drinking water, when that is of the hard 
 variety. Foods poor in hme are meat, fish, potatoes, and 
 fruits. An adequate supply of foods rich in lime is essen- 
 tial, more especially in the growing period. Deficiency of 
 lime leads to softness of the bones and rickets. Reference 
 may here be made to oxalic acid, which is present in food as 
 oxalate of lime. It occurs specially in tea, coffee, rhubarb, 
 spinach, and pepper ; cereal foods contain little calcium. 
 
 Sodium and Potassium. — Salts of sodium are specially 
 required for the fluids of the body, salts of potassium for the 
 
SODIUM AND POTASSIUM. 17 
 
 cellular constituents, notably the red blood corpuscles and 
 muscles. 
 
 Vegetable foods are, as a rule, rich in potassium salts; 
 animal foods, on the other hand, have a larger proportion of 
 sodium salts. Green vegetables and fruits are the chief 
 sources of these salts, these foods being valuable on account 
 of their containing vegetable acids with which the minerals 
 are combined to form salts known as citrates, tartrates, and 
 acetates, these salts tending to maintain a proper degree of 
 alkalinity of the blood. A deficiency of alkaline salts in 
 foods leads to scurvy. Sodium chloride is the most im- 
 portant salt. It supplies chlorine for the production of the 
 hydrochloric acid of the gastric juice ; it stimulates appetite ; 
 it promotes renal secretion ; and it induces thirst, which is of 
 value in encouraging the drinking of fluid. On an average 
 more than ten grams of salt are taken in the daily dietary, 
 this representing an amount which is far in excess of the 
 body requirements. This excess of salt above the real 
 requirements is more particularly observed in people who 
 live largely on vegetarian foods. There is an ample supply 
 of salt in a mixed diet without adding salt as an extra. 
 
 Iron. — Beef, eggs, oatmeal, and lentils have a relatively 
 large amount of iron ; milk and its derivatives are poor 
 in iron. A prolonged milk regime leads to anaemia. 
 
 Phosphorus. — Meat and vegetables are rich in phosphorus. 
 It occurs usually in organic form, and to a less extent in 
 inorganic form, as phosphates of the alkalis and earths. It 
 is especially valuable for growing children. 
 
 v.— Water. 
 
 Water is indispensable to life. Seventy-five per cent, of 
 the tissues consists of water. It is required (i) to act as a 
 
i8 THE BOOK OF DIET. 
 
 medium for taking the food elements to the tissues, and 
 (2) as a solvent for the waste products of the tissues which 
 are excreted in solution by the kidneys (see p. 272). 
 
 NUTRITIVE VALUE OF FOODS. 
 
 A word may be said as to the methods of determining the 
 nutritive value of foods. This is done : — 
 
 1. By a study of its chemical composition. 
 
 2. By ascertaining its heat value. 
 
 3. By reference to its physiological properties — the ease 
 
 with which it is digested and absorbed. 
 
 Chemical Composition of Food, — Chemical analysis of a 
 food tells us the proportion of protein, fat, carbohydrates, 
 salts, and water present in its composition. The results of 
 chemical analysis, therefore, give us some information as to 
 the value of food, both as a tissue builder and as a source of 
 energy or heat production. 
 
 The Heat Value of a Food. Physical and Physiological 
 Heat Values. — The heat value of different foods may be 
 determined experimentally by the use of an instrument 
 known as the Bomb calorimeter, a special form of heat 
 chamber, the result being expressed in calories. The 
 standard of heat production is the calorie, which means 
 the amount of heat required to raise the temperature of 
 I kilogram of water 1° centigrade. The amount of heat 
 evolved by the combustion in a calorimeter of i gram of 
 the different food-stuffs is as follows : — 
 
 I gram protein produces 4 calories. 
 
 I „ carbohydrate produces 4 calories. 
 
 I ,, fat produces 8.9 calories. 
 
 These figures represent the amount of energy set free by 
 
NUTRITIVE VALUE OF FOODS. 19 
 
 I gram of the food-stuff combining with oxygen to form 
 the end-products of its combustion. This constitutes the 
 physical heat value of the food — that is, the amount of heat 
 produced by complete combustion of the food in a special 
 calorimeter chamber. The physiological heat value of the 
 food is the amount of heat produced by the complete com- 
 bustion of the food in the living tissues. Carbohydrates and 
 fats are completely oxidized in the tissues; their physio- 
 logical and physical heat values are therefore the same. 
 Proteins, on the other hand, are not completely burnt up; 
 urea, the end-product of nitrogenous metabolism in the 
 tissues, being an incompletely oxidized product. The physio- 
 logical heat value of protein is, therefore, less than the 
 physical heat value by the extent to which urea is capable of 
 further oxidation outside the body. 
 
 On referring to p. 23 it will be found that the heat value 
 of an ordinary mixed diet for a man not engaged in severe 
 muscular work is 3,000 calories. This method of gauging 
 the amount of food required is, however, not of very great 
 value in practice. The diet has to be adjusted in each 
 instance from a knowledge of the digestive and absorptive 
 power of the patient, special reference being paid to the 
 influence of the food on fermentative and putrefactive pro- 
 cesses 'n the bowel, under the influence of intestinal bacteria. 
 
 DIGESTION AND ABSORPTION OF FOOD. 
 
 All foods have to be digested — that is, they have to be sub- 
 jected to the action of certain juices secreted by the digestive 
 organs. This is done in order to convert the complex food 
 ingredients into simpler substances capable of being absorbed 
 into the blood stream and distributed to the tissues. The 
 process of digestion begins in the mouth and ends at the 
 
20 THE BOOK OF DIET. 
 
 lower part of the small intestine. In the mouth the processes 
 to which the food is submitted are partly mechanical and 
 partly chemical. The mechanical part consists in maceration 
 of the food, whereby the harder portions are broken down, 
 so that the whole is reduced to a more or less soft uniform 
 mass. This is effected by mastication, which if thorough is 
 of the greatest value to the whole digestive process, by 
 allowing the digestive juices to become thoroughly mixed 
 with every portion of the food, and thus to act upon it more 
 quickly and thoroughly. The chemical part of the oral 
 digestion consists in the partial digestion of the starches of 
 the food under the influence of a ferment contained in the 
 saliva (ptyalin). This converts starch into dextrines and 
 then into sugar, and the longer the stay in the mouth the 
 more complete the action. Under ordinary circumstances 
 the digestion of starch is not complete in the mouth. 
 Salivary digestion continues for some time after the food has 
 entered the stomach, and is only terminated when the whole 
 contents of the stomach become acid in reaction. 
 
 The stomach has a narrow opening through which food 
 enters, and a similar narrow opening (the pylorus) through 
 which it leaves after being digested more or less completely 
 by the gastric juice. The gastric juice contains two chief 
 ingredients, a ferment pepsin and an acid — ^hydrochloric acid. 
 The ferment can only act in the presence of the free acid. 
 Under the action of the gastric juice the greater part of the 
 proteins of the food is dissolved and converted into more 
 soluble simpler substances, some of which — peptones — are 
 absorbed from the stomach. About half an hour after a 
 meal is taken the pylorus relaxes at intervals to allow the 
 passage of the fluid parts of the gastric contents, which are 
 now spoken of as chyme, and this passage of dissolved and 
 partially digested food from the stomach to the small intes- 
 
DIGESTION AND ABSORPTION OF FOOD. 21 
 
 tines goes on at intervals for six or eight hours after the 
 ingestion of food. When the food reaches the small intes- 
 tines it is then acted on by three secretions : — 
 
 1. Ferments secreted by the lining membrane of the 
 
 bowel (the intestinal juice). 
 
 2. The pancreatic secretion, which contains a number of 
 
 ferments. 
 
 3. The bile. 
 
 Under their influence the whole of the proteins of the 
 food are completely dissolved and converted into simpler 
 bodies capable of being absorbed into the blood stream 
 and distributed to the tissue. Under the influence of the 
 pancreatic ferments the starches are further changed into 
 dextrine, and maltose, and under the further agency of the 
 intestinal juice into dextrose (sugar), in which form the 
 starches are absorbed into the system. Here also the fats 
 are split up under the influence of the pancreatic secretion, 
 aided by the bile, into a form capable of absorption by 
 the vessels. The salts and water) of the food are absorbed 
 unchanged. 
 
 Throughout the whole of the small intestines active secre- 
 tion and absorption are taking place, so that the amount of 
 water in the intestinal contents in the lower part of the small 
 intestine is about the same as in the upper part. The con- 
 tents of the lower part acquire a distinct faecal odour from 
 putrefactive products produced by the action of bacteria on 
 the proteins of the food. In the large intestine the process 
 of absorption predominates over those of secretion ; hence 
 that part of the intestinal contents which has not been 
 absorbed becomes less and less watery, and acquires the 
 character of faeces, in which form it is periodically expelled 
 from the body. The faeces consist mainly of the indigestible 
 
22 
 
 THE BOOK OF DIET. 
 
 residue of the food, and of substances which have been 
 taken in too large quantities to be digested ; they also contain 
 various forms of bacteria. 
 
 Time Occupied by Digestion in the Stomach. — An ordi- 
 nary meal requires from four to six hours' digestion in the 
 stomach, but the time required varies with — 
 
 1. The nature and amount of the food. 
 
 2. The digestive capacity of the individual. 
 
 3. The amount of fluid taken with the meal. An excess 
 
 of fluid will over-dilute the gastric juice and impede 
 its action. 
 
 4. The interval since the previous meal. Some foods are 
 
 more easily digested than others. 
 The following table gives the result of some standard 
 observations on the rate of digestion of some common 
 foods : — 
 
 I. One to Two Hours. 
 
 7 oz. boiled milk. 
 
 7 oz. beef-tea. 
 
 Whites of 3 eggs. 
 
 7 oz. water, tea, coffee, or cocoa. 
 
 5 oz. white fish. 
 
 7 oz. cauliflower or asparagus. 
 
 2} oz. toast, rusk, biscuits. 
 
 2. Two TO Three Hours. 
 
 5 raw or poached eggs. 
 3j oz. raw meat. 
 9 oz. sweetbread. 
 
 2^ oz. oysters. 
 
 ii oz. bread or biscuits. 
 
 5i oz. rice, spinach, apples, carrots. 
 
 3. Thrik to Four Hours. 
 8 oz. stewed or roast chicken. | 3} oz. beef steak. 
 
 4. Four to Five Hours. 
 Roast beef, goose, or duck. | Mashed lentils, peas, French beans. 
 
AMOUNT OF FOOD REQUIRED. 23 
 
 AMOUNT OF FOOD REQUIRED. 
 
 The amount of food required varies under different con- 
 ditions. Thus, the growing child requires relatively more 
 than the adult ; old people need less than the middle-aged; 
 and the food requirements of a stout, muscular subject engaged 
 in active physical work are greater than those of a thin 
 weakly subject leading a sedentary life. We will here con- 
 sider the minimum diet required for a man of average build 
 and weight doing a moderate amount of muscular work — in 
 other words, the standard amount of the different con- 
 stituents required daily. 
 
 A healthy man of average weight, and doing a moderate 
 amount of muscular work, excretes from 16 to 20 grams 
 of nitrogen and about 320 grams of carbon daily. The 
 investigations of Atwater, Rubner, Voit, and others, until 
 lately regarded as classical, established the standard amounts 
 of the nutritive constituents required to make this loss daily, 
 as follows : — 
 
 Protein 125 grams, or 41^ ounces. 
 
 Carbohydrate 500 „ 18 ,, 
 
 Fat SO „ It „ 
 
 These yield the following amount of heat in calories : — 
 
 Protein 125x4.1- 512.5 calories. 
 
 Carbohydrate 500x4.1 2050.0 „ 
 
 Fat 50x9-3 465 '. 
 
 3027-5 .. 
 No single article of food contains these elements in a 
 proper proportion, and for this reason a mixed diet is neces- 
 sary, as by that means only can we avoid taking too largely 
 of one or other ingredient. 
 
24 THE BOOK OF DIET. 
 
 Expressed in terms of ordinary foods, the above dietary is 
 approximately as follows : — 
 
 
 
 Carbon. 
 
 NiTROGBH. 
 
 
 
 Grams. 
 
 Grams. 
 
 I lb. bread, 
 
 containing 
 
 . ... 117 
 
 5-S 
 
 i lb. meat. 
 
 
 • -. 34 
 
 
 J lb. fet, 
 
 
 . ... 84 
 
 — 
 
 I lb. potatoes, 
 
 
 . ... 45 
 
 '•3 
 
 1 pint milk, 
 
 
 . ... 20 
 
 1-7 
 
 i lb. eggs (2 eggs). 
 
 » 
 
 . ... IS 
 
 
 i lb. cheese, 
 
 „ .» ... 20 
 
 
 
 
 335 
 
 21. 1 
 
 Or, if expressed in meals : — 
 
 Breakfast — 
 
 2 slices of thick bread and butter. 
 
 2 eggs. 
 Dinner — 
 
 I platefiil of potato soup. 
 
 Large helping of meat with fat (about 6 oz. of cooked meat). 
 
 4 moderate-sized potatoes (J lb.). 
 
 1 thick slice of bread and butter. 
 7>o— 
 
 Glass of milk and 2 thick slices of bread and butter. 
 Supper— 
 
 2 thick slices of bread and butter and 2 oz. of cheese. 
 
 In the case of subjects engaged in severe muscular work, 
 it has long been taught that the amount of food required is 
 greater than the above, the increase being shared by all three 
 food constituents so as to furnish an energy value of 4,500 to 
 5,000 calories. 
 
 In recent years the researches of Chittenden on protein 
 requirements have thrown considerable doubt on the correct- 
 ness of these views. Chittenden's observations were made 
 on three classes of subjects — ■ 
 
 1. Men engaged in mental work ; 
 
 2. Soldiers engaged in moderate exercises ; and 
 
 3. Highly skilled athletes — 
 
AMOUNT OF FOOD REQUIRED. 25 
 
 his experiments being conducted with great care and over 
 long periods. Chittenden's work has rightly attracted a very 
 large amount of attention because of the very large number 
 of persons simultaneously experimented upon, and the com- 
 pleteness of the experiment from the point of view of 
 chemical analysis. Chittenden found that a state of good 
 bodily health was maintained on a diet which contained from 
 one-half to one-third of the protein in the standard diet. 
 
 It will be seen that Chittenden's results throw much doubt 
 on the correctness of the teaching as to protein requirements, 
 hitherto regarded as well established. There is no question 
 that the ideal diet consists in the smallest amount of protein 
 food, together with non-nitrogenous food, that will keep the 
 body in a state of vigour. The question is whether it is right 
 to accept as correct, for protein consumption — 
 
 1. The minimum of 100 to 120 grams of the com- 
 
 monly accepted standard dietary ; or 
 
 2. The minimum of 50 to 70 grams of the Chittenden 
 
 standard. 
 Chittenden's explanation of the advantages of a low 
 protein is, that the protein food when metabolized yields a 
 number of crystalline nitrogenous products which are ex- 
 creted through the kidneys. If proteins are taken in excess 
 the kidneys are overworked, and the end-products of protein 
 metabolism either surcharge the blood or are deposited in 
 the tissues, giving rise to various diseased states. There is, 
 in the author's opinion, no doubt whatever as to the correct- 
 ness of Chittenden's main contention that the amount of 
 protein required daily to maintain the body in a satisfactory 
 state of health is less than the amount hitherto regarded as 
 essential ; and secondly, that some at least of the excess is 
 injurious to health. This view is now very largely held by 
 medical men. 
 
26 THE BOOK OF DIET. 
 
 THE INFLUENCE OF VARIOUS CONDITIONS UPON 
 THE AMOUNT OF FOOD REQUIEED. 
 
 Influence of Age and Sex. — The age of the individual 
 not only modifies the absolute amount of food required, but 
 also the relative quantity in proportion to body weight. The 
 rapid growth of children in early life necessitates a relatively 
 larger consumption of food than at any other period of 
 life ; more especially it calls for a large supply of building 
 material — that is, proteins. Fats are also of particular value 
 in the growing period. 
 
 The standard of increase usually adopted may be roughly 
 indicated as follows : — 
 
 A child under z 
 
 requires 
 
 0.3 
 
 the food of a man 
 
 doing 
 
 moderate work 
 
 A child of 3 to 5 
 
 
 0.4 
 
 
 1* 
 
 
 A child of 6 to 9 
 
 
 o-S 
 
 
 »i 
 
 
 A child of lo to 13 
 
 
 0.6 
 
 
 1* 
 
 
 A girl of 14 to 16 
 
 
 0.7 
 
 
 If 
 
 
 A boy of 14 to 16 
 
 
 0.8 
 
 
 ff 
 
 
 In old age the processes of assimilation are less active, 
 and the bodily activities are restricted ; hence less food is 
 required. Over-feeding is a fruitful cause of serious trouble 
 in elderly subjects. (See p. 268.) 
 
 Under similar conditions women require less food than 
 men, for the reason that they are usually smaller and do less 
 muscular work. Given precisely similar conditions as to the 
 weight of subject and amount of physical work performed, 
 there is probably no difference in the amount of food re- 
 quired. The diet in pregnancy should be liberal, but not 
 excessive. During lactation the amount of food must be 
 increased, more especially in protein and fat, in order to 
 make good the nutritive elements lost in the milk. 
 
REST AND EXERCISE. 27 
 
 Rest and Exercise. — Much less food is required during 
 rest than during exercise. The following is the generally 
 accepted statement of the number of calories which must 
 be supplied for the work of different degrees of severity 
 (Rubner) : — 
 
 Calories^ 
 
 Rest — for example, a clerk at a desk 2500 
 
 Moderate muscular work — for example, house-painter... 3121 
 
 Severe muscular work — for example, shoemaker 3659 
 
 Hard labour — for example, blacksmith 5213 
 
 The researches of Chittenden, however, already alluded to, 
 throw great doubt on the correctness of this teaching. 
 
 In the present state of our knowledge it is not possible 
 to be too dogmatic on the subject. It is probable that an 
 increase of food by one-fourth or one-third of the normal is 
 all that is necessary for subjects engaged in severe muscular 
 work. 
 
 The question arises as to whether the increase of food un- 
 doubtedly necessaryfor subjects engaged in hard physical work 
 should come mainly from the proteins, fats, or carbohydrates. 
 There are no data by which this can be precisely determined. 
 By those engaged in training for athletics, proteins are largely 
 relied on to supply the extra energy ; but for ordinary pur- 
 poses it is certainly advisable that the increase should be 
 equally distributed among the proteins, fats, and carbo- 
 hydrates of a mixed dietary, sugar being specially advan- 
 tageous. 
 
 CUmate and Seasons. — Climate and temperature influence 
 the quantity and quality of food required. In tropical 
 countries the natives live largely on vegetable foods and 
 fruits, and consume less animal food and fat. The explana- 
 tion of this is to some extent to be found in the fact that the 
 natives of any country eat what they can most easily obtain. 
 At the same time we must recognize the necessity for supply- 
 
38 THE BOOK OF DIET. 
 
 ing the body with a large proportion of combustible food, 
 such as carbohydrates and fats, when the external tempera- 
 ture is very low. It is also clear that less food of this kind 
 is required when the external temperature is high. In this 
 country common experience has shown the advisability of 
 modifying the diet in the heat of summer, less animal food 
 being taken, vegetable substances and fruits entering then 
 more largely into the dietary. 
 
 Personal Idiosyncrasy. — It is a matter of common ob- 
 servation that some people habitually eat much less than 
 others, although living under the same general conditions. 
 This is, in all probability, to some extent a result of habit 
 and general training. At the same time there is no doubt 
 that some tissues work more economically than others, with 
 corresponding advantage to the individual. Many special 
 idiosyncrasies with regard to diet have to be considered. 
 Some persons cannot take eggs in any form ; others cannot 
 take milk ; some are made ill by certain kinds of fruit or 
 meat. These may be the result of inherited tendencies, or 
 may be the growth of habit. 
 
 INFLUENCE OF VABIOUS FACTORS ON DIGESTION. 
 
 Appetite, Hunger, and Thirst. — Appetite means the en- 
 joyment of food and drink; hunger and thirst mean a 
 longing for food and drink. The stimulus created by food is 
 more or less specific. By that we mean that each kind of 
 food calls forth a supply of the special juices that are par- 
 ticularly required for its digestion. This no doubt explains 
 how it is that sudden changes of diet are not well tolerated. 
 
 Reference must be made to the various conditions which 
 interfere with normal digestion. One of the commonest is 
 unduly hurried meals. The bolting of imperfectly masticated 
 
DIGESTION. 29 
 
 food is a fruitful cause of indigestion. Irregularity in meals 
 is another factor which may derange digestion. This irregu- 
 larity may take the form of unequal and irregular hours 
 between meals, as, for instance, allowing six hours to elapse 
 between the first and the second meal of the day, and three 
 hours between the second and last ; or it may take the form 
 of want of regularity in the size and nature of the meals, as 
 the partaking of a heavy midday meal by a person who has 
 accustomed himself to a light luncheon in the middle of 
 the day. Constipation interferes with healthy digestion, more 
 especially if it be associated with auto-intoxication (self- 
 poisoning), such as frequently arises from altered bacterial 
 activity in the digestive tract, the result of a septic condition 
 of the teeth {oral sepsis). Lack of appetite may lead to a 
 weakening of the digestive powers, but in this connection we 
 have to note that in some people the introduction of food 
 into the stomach seems to induce an appetite. A sudden 
 change in diet may adversely affect digestion. The researches 
 of Pawlow have shown that| the digestive juices adapt them- 
 selves in a remarkable manner to the kind of food — a protein 
 diet leading to the development of juices specially adapted 
 for the digestion of proteins, a carbohydrate diet similarly 
 inducing secretions specially adapted to digest carbohydrates. 
 It is, therefore, easy to understand that any sudden and 
 complete change of diet may for the time being interfere 
 with normal digestion. The digestive powers may also be 
 modified by the nature of the food. For example, an over- 
 fatty diet mterferes with the action of the gastric juice; 
 excess of fluid may lead to an impairment of its action 
 through over-dilution ; or new bread, new potatoes, and the 
 like may throw a strain on the gastric secretion which it is 
 unable adequately to deal with. The temperature of the food 
 is of some importance, hot food stimulating the flow of the 
 
30 THE BOOK OF DIET. 
 
 salivary and gastric secretions, iced foods sometimes arresting 
 the digestive process, especially when taken immediately after 
 hot foods. Lastly, active, physical, or mental work should be 
 avoided during the earlier stages of digestion, as the blood is 
 then primarily required for the digestive processes. 
 
 Sleep in Eelation to Meals. — Sleep is affected by the 
 quantity and kind of food taken. A heavy meal taken 
 shortly before going to bed may be followed by a disturbed 
 and restless night and by sleep of an unrefreshing character. 
 As it ordinarily takes three hours to complete gastric 
 digestion, that time at least should elapse between the last 
 regular meal of the day and bedtime. Many patients find 
 that their sleep is disturbed after taking certain articles of 
 food or drink in the afternoon or evening — for example, 
 strong tea or coffee, new scones, and the like. On the other 
 hand, sleeplessness is often observed in elderly subjects who 
 have taken only a light evening meal, and may be promoted 
 by taking a little fluid food at bedtime — for example, a cup 
 of hot beef-tea, malted milk, or thin gruel. 
 
11. 
 
 ANIMAL FOODS. 
 
 MILK. 
 Chemical Composition. 
 
 Cow's Milk. 
 Clotting of Milk, and its Effect on 
 
 the Digestibility. 
 Nutritive Value. 
 Cream. 
 
 Varieties of Cream. 
 Whey. 
 Butter. 
 
 Margarine and Butterine. 
 Cheese. 
 Buttermilk. 
 Koumiss. 
 Kepbir. 
 
 Foods Prepared from Cow's 
 
 Milk. 
 Condensed Milk. 
 
 Advantages and Disadvan- 
 tages OF Condensed Milks. 
 Dried Milk Preparations. 
 
 EGGS. 
 Raw Eggs. 
 
 MEATS. 
 Composition of Flesh. 
 
 Varieties of Meats. 
 Beef. 
 
 Names of the Various Joints. 
 Veal. 
 Mutton. 
 
 Foreign Mutton. 
 Lamb. 
 Hare. 
 Rabbits. 
 Poultry. 
 Game. 
 
 Pig- 
 
 Hams. 
 
 Sausages. 
 
 FISH, INCLUDING CRUSTA 
 
 CEA AND MOLLUSCA. 
 Varieties. 
 Crustacea. 
 
Chapter 11. 
 ANIMAL FOODS. 
 
 Milk and its Products — Eggs — Meats, etc. — Fish. 
 
 MILE. 
 
 Milk is the type of a complete food provided by Nature. In 
 early life it forms the exclusive food of all young mammals. 
 
 It is in the highest degree important for the well-being of 
 young children to have milk which is of excellent quality at 
 its source, and it is equally necessary that it should not be 
 adulterated or infected in the process of transit and distribu- 
 tion. Since the sources of contamination are numerous, the 
 task of obtaining an absolutely pure supply is a difficult one, 
 and in recent years the question of the milk-supply of our 
 large towns has engaged more and more the attention of the 
 medical profession and of civic authorities. 
 
 Chemical Composition. — The milk of all animals contains 
 the elementary substances — proteins, fats, carbohydrates, 
 salts, and water — combined in such proportions as are best 
 adapted for the period during which growth is most active. 
 
 Milk is an emulsion consisting of fine oil globules sus- 
 pended in a colourless liquid or plasma. 
 
 When freshly drawn, the reaction of milk varies in different 
 animals. Human milk is alkaline; cow's milk is neutral; 
 
 2 
 
34 THE BOOK OF DIET. 
 
 the milk of carnivora is acid in reaction. On standing, all 
 milk becomes acid, owing to the formation of lactic acid, 
 through the action of bacteria normally present in milk. 
 The average proportions of the chief ingredients in cow's 
 milk and human milk are here given for comparison : — 
 
 Human Milk. 
 
 
 Cow's Milk. 
 
 Proteins — Casein ... . 
 
 : =S}- 
 
 „ Lactalbumin 
 
 Fat 
 
 3-S 
 
 Sugar 
 
 4-0 
 
 Salts 
 
 7 
 
 Water 
 
 87.8 
 
 1.4/ 
 
 3-S 
 
 7.0 
 
 0.2 
 
 87-3 
 
 It will be ■ seen that the chief differences in composition 
 are the much larger amount of protein and the smaller pro- 
 portion of sugar present in cow's milk. There is further an 
 important difference in the nature of the proteins, for while 
 in cow's milk they consist chiefly of casein, the proportion of 
 casein to lactalbumin being 4.1, in human milk lactalbumin 
 is the chief protein, the proportion of casein to lactalbumin 
 being approximately 1.2. The practical importance of this 
 is readily appreciated if samples of the two milks are treated 
 by the addition of weak hydrochloric acid. Large masses of 
 curd are at once formed in the cow's milk, while the human 
 milk shows a fine flocculent precipitate. Similar changes 
 occur in the stomach. Another important difference is the 
 sterility of human milk in contrast with the large number 
 of bacteria normally present in cow's milk as it reaches 
 the consumer. We will now consider cow's milk and its 
 derivatives. 
 
 Govt's Milk. 
 The composition of milk varies within wide limits, so that 
 it is impossible to gauge within 20 per cent, the amount of 
 
cows MILK. 35 
 
 nutritive materials contained in a given quantity. The main 
 variations are in the amount of fat and protein present. The 
 composition, quality, and quantity of milk are influenced by 
 a variety of circumstances, such as the breed of the cow, the 
 nature and quality of the food supplied to the cows, and the 
 degree to which the milk has been adulterated by the addi- 
 tion of water, sugar, or other preservatives, such as formalin, 
 etc. (See p. i68.) 
 
 The specific gravity of milk is from 1,026 to 1,035. This 
 is, however, of no value as a test of its quality, because 
 skimming milk raises the specific gravity, since fat is lighter 
 than water. Hence, milk can be skimmed and water added 
 to keep the specific gravity the same. An estimation of the 
 fat is essential for determining the nutritive value of milk. 
 Good milk should contain 4 per cent, of fat. 
 
 The proteins of milk consist of casein and a small amount 
 of lactalbumin. Casein is the principal protein, and is kept 
 in a state of solution by the phosphate of lime present in 
 milk. This substance can be extracted and dried, and is 
 the basis of many useful preparatory foods (see p. 50). These 
 preparations of casein are used to increase the nutritive 
 value of gruels, soups, teas, and puddings. Lactalbumin is 
 present only in very small quantity in milk; it coagulates 
 slowly when boiled, and forms the " skin " on boiled milk. 
 
 The carbohydrate of milk is in the form of lactose or milk 
 sugar. This is less soluble than ordinary sugar, from which 
 it also differs in having no sweet taste. It is readily split up 
 by certain micro-organisms, with the production of lactic 
 acid, a process which occurs in the souring of milk. Many 
 cases of diarrhoea in infancy are due to the irritation of lactic 
 acid produced in this manner. 
 
 The fat of milk (cream) is in the form of an exceedingly 
 fine emulsion, being suspended in the plasma of milk in the 
 
36 THE BOOK OF DIET. 
 
 form of globules, which impart to milk its white, opaque 
 appearance. The proportion of fat should not be less than 
 3.5 per cent. When the cream is removed, skimmed milk is 
 left ; this, however, may still contain from ^ to 1 per cent, of 
 fat. If the cream be removed by a separator, the fat is 
 much more completely abstracted, and the milk so prepared 
 is known as separated milk. 
 
 The mineral matters are of great importance, the most 
 important salts being the phosphate of lime and phosphate of 
 potassium. The one important mineral constituent that milk 
 lacks is iron, and this has to be borne in mind when giving a 
 prolonged course of strict milk diet. Citric acid is present 
 in milk, chiefly combined with lime as calcium citrate. It 
 has been suggested that this is the antiscorbutic element of 
 milk. 
 
 The remaining ingredient is water. This keeps the solid 
 constituents in solution, but makes milk a dilute and bulky 
 food. 
 
 Clotting of Milk, and its Effect on the Digestibility. — 
 Milk is not truly a fluid food, for whenever milk enters the 
 stomach the ferment rennin and the acid of the gastric juice 
 change the milk into a solid curd. This coagulation or clot- 
 ting of milk must be distinguished from the curdling of milk. 
 Curdling is due to the casein separating out of the milk in 
 the form of a fine precipitate of unaltered casein, this taking 
 place under the influence of lactic acid fermentation, which 
 removies the casein from its combination with lime salts. In 
 the process of clotting, on the other hand, the casein is 
 profoundly changed, and acquires new and distinctive char- 
 acters. The clot consists of the solidified casein with fat 
 entangled in its meshes. The clot gradually shrinks and 
 becomes more tough and less easily digested. Under normal 
 conditions this clot redissolves in the alimentary tract ; but 
 
CLOTTING OF MILK. 37 
 
 in pathological conditions, such as enfeebled states of the 
 digestive ferments, a hard, firm, indigestible mass forms in 
 the stomach, which may prove an irritant to the whole in- 
 testinal tract, inducing pain, flatulence, diarrhoea, or con- 
 stipation, and may be recognized unchanged in the faeces. 
 
 Various methods are adopted to control the density of the 
 curd, and so improve the digestibility of milk. 
 
 1. By reducing the proportion of casein ; this is done by 
 diluting the milk. The diluent may be simply plain water ; 
 a mixture of half and half will materially lessen the clotting. 
 The addition of an aerated mineral water acts in two ways : 
 firstly, by dilution ; and secondly, the aeration makes the clot 
 more friable ; potash, seltzer, soda, or salutaris may be used. 
 The admixture of barley-water, toast, rice, or oatmeal water 
 is also useful (see ch. xxii. ) ; the thickened fluid hinders the 
 formation of large curds and makes the clot more friable. 
 Gelatine jelly (ch. xxii.), used in the proportion of i teaspoon- 
 ful to 2 ounces milk and 2 ounces of water, is also useful. 
 
 2. By reducing the toughness of the clot, the addition of 
 lime-water in the proportion of one in three acts on the milk 
 in several ways. It dilutes it ; the addition of lime renders 
 some of the soluble lime salts insoluble, and so neutralizes 
 the acidity of the milk ; this effects the desired result of 
 lessening the toughness of the clot. Lime-water causes con- 
 stipation, and if the patient is suffering from diarrhoea, this 
 may be an advantage, but in other cases it is prejudicial. 
 The addition of sodium citrate produces a smaller and softer 
 curd. One grain of citrate of soda added to one ounce of 
 pure milk serves partially to prevent the clotting, while two 
 grains added prevents it entirely. This is specially useful 
 in infant feeding. Sodium bicarbonate in solution (4 drams 
 to 1 ounce) can be used in the same proportion as lime-water 
 (i in 3), and does not produce constipation. 
 
38 THE BOOK OF DIET. 
 
 Nutritive Value. — With regard to its nutritive value as a 
 food for adults, milk cannot be recommended as the sole 
 article of food, for the following reasons: In order to get 
 sufficient carbohydrates, a very large quantity of milk is 
 required (8 pints). This means that the body is supplied 
 with more fat, protein, and fluid than is necessary, or than 
 can readily be digested. Further, although milk is bulky it 
 does not supply sufficient residue to set up peristalsis, and 
 it is therefore constipating. If combined with a carbo- 
 hydrate, that element in which it is defective, milk is an 
 excellent food, and if taken with bread, a smaller quantity 
 of milk would suffice. In states of illness or during 
 convalescence these objections to a milk dietary largely 
 disappear, and milk at once takes its place as the most 
 useful food. 
 
 The chief clinical use of milk may be summarized as 
 follows : — 
 
 1. In fever, milk acts as a quencher of thirst as well as a 
 
 food. 
 
 2. Milk, from the large amount of fluid present, acts as a 
 
 diuretic ; it is the main article of food in inflamma- 
 tory conditions of the kidney. 
 
 3. In patients requiring extra nourishment, milk may be 
 
 taken with meals in the place of other non-nutritive 
 fluids. 
 
 4. The digestibility of milk is increased by the addition of 
 
 substances which tend to make a finer clot, such as 
 barley-water ; also the administration of some solid 
 food, such as bread. 
 
 5. Milk is of special value in cases of " acidity " of the 
 
 stomach and other gastric disorders. Skimmed milk 
 is here of very special value. 
 
NUTRITIVE VALUE OF MILK. 39 
 
 6. Owing to the lack of residue from this food, milk is of 
 
 great value in states of catarrh and ulceration of the 
 gastro-intestinal tract. 
 
 7. In patients at rest in bed the bulkiness of milk is no 
 
 drawback, as not more than three or four pints are 
 required. 
 
 To vary the monotony of a milk flavour, some recipes are 
 given on pp. 397-399. 
 
 Milk is frequently adulterated or contaminated. An ac- 
 count of the more common adulterations is given on p. 168. 
 Milk may be contaminated by the cow's disease germs — for 
 example, tuberculosis and diphtheria. Extraneous disease 
 germs may find their way into milk through contact with 
 unclean hands, or from polluted water used for dilution or 
 for washing cans and pans. Examples of diseases so in- 
 duced are typhoid fever, scarlet fever, gastro - enteritis, 
 diarrhoea, etc The milk is often tainted with excremen- 
 titious matter from the cowshed. 
 
 Professor Silvanus Thompson describes the ideal system of 
 cleanliness which provides a " guaranteed milk " : — 
 
 " Each milkman, before milking, is required to cleanse his 
 hands in hot water with soap and a nail-brush ; he then dons 
 a clean white linen suit from the sterilizing chamber, and 
 takes a clean towel and milking stool ; he is not allowed to 
 moisten his hands with the milk in milking, and he must 
 wash his hands each time before milking another cow. All 
 cows must have given a negative tuberculin test, and all are 
 groomed twice a day before milking. The milk is drawn 
 into pails with small openings, which exclude droppings from 
 the animal's belly. The milk is strained through sterilized 
 absorbent cotton, and placed in a cooler, which reduces the 
 temperature to 40° F. within twenty minutes after leaving the 
 
40 THE BOOK OF DIET. 
 
 udder. It is then bottled and stored in ice water ready for 
 shipment." 
 
 Good, clean, uncontaminated milk should keep fresh, 
 exposed in a clean room at ordinary temperature of 68° F., 
 for forty-eight hours, without souring and coagulating. But 
 if the air is warmer, or if the milk be in any way contami- 
 nated, it will sour in a few hours. Boiled milk will keep fresh 
 about half as long again as fresh milk. A large number of 
 bacteria are capable of inducing lactic acid fermentation of 
 the milk sugar, and some of them carry the decomposition 
 further, to the development of carbonic acid and alcohol. 
 This latter interferes with the normal digestion of milk 
 Lastly, it is important to bear in mind the absorbent power 
 of milk : it may acquire a flavour or odour from substances 
 in its vicinity. It should not, therefore, be kept in a pantry 
 beside such food-stuffs as stale cheese or onions, and it 
 should not be left exposed in a sick-room or anywhere near 
 a waste-pipe. The effects of heat on milk (Pasteurization, 
 sterilization, etc.) are described on chapter on " Infant Feed- 
 ing," p. 190. 
 
 Cream. — Cream consists mainly of milk. It, however, 
 also contains protein and sugar in the same proportion as 
 milk. The real difference between cream and milk is that 
 cream contains less water. 
 
 The percentage of fat in cream may be from 10 to 20 per 
 cent., as in cream obtained by skimming milk ; cream pro- 
 duced by centrifuge may contain from 40 to 60 per cent. ; 
 and the clotted Devonshire cream may contain as much as 
 70 per cent or more. A legal standard for cream would 
 be advantageous. 
 
 Varieties of Cream. — Tea cream, as sold in the dairy, is 
 generally a thin cream produced by skimming milk in the 
 ordinary way. 
 
VARIETIES OF CREAM. 41 
 
 Double cream, or sefarator cream, is obtained from the 
 milk by centrifugal force. A small and large drum are 
 placed one within the other, leaving a space of a few inches 
 between. The inner drum is made of porous material. It 
 is filled with milk and set in rapid revolution. The lighter 
 portion, the cream, remains in the inner drum, while the 
 other ingredients are forced through it into the outer drum. 
 
 This method of obtaining cream is far more rapid than when 
 it is allowed to rise by standing, and also it obtains almost all 
 the fat from the milk. Cream procured in this manner does 
 not remain fresh so long as ordinary cream, for it is separated 
 at a temperature favourable to the growth of bacteria. 
 
 Condensed ox evaporated cream consists of one-fourth cream 
 and three-fourths other ingredients of milk, the whole milk 
 having been evaporated. It is, therefore, a natural product, 
 and is not artificially sweetened. 
 
 Clotted or Devonshire cream is a special variety prepared 
 by heating the milk in deep pans over a slow fire not above 
 150° F. This causes a rapid and complete separation of 
 fat. The proportion of fat in such cream is from 60 to 70 
 per cent. Devonshire cream contains only about half as 
 much sugar as ordinary cream, and it is peculiarly suited to 
 be a source of fat in the dietary of diabetics. 
 
 Cream is one of the most wholesome and agreeable forms 
 of fat. It is often eaten too rich, and may disagree on that 
 account, but if diluted with an equal amount of water or 
 lime-water it can be easily digested. 
 
 Where there is difficulty in digesting milk, three or four 
 tablespoonfuls of cream in a tumblerful of Vichy makes a 
 nourishing and digestible beverage. The nutritive value 
 may be increased, if desired, by the addition of half an ounce 
 of sugar of milk. It may be used along with or to replace 
 cod-liver oil in pulmonary tuberculosis, and it is an admi- 
 
 1a 
 
42 THE BOOK OF DIET. 
 
 rable food in any case of long-continued suppurative disease 
 — for example, hip joint disease or empyema. It must be 
 avoided in cases of flatulent indigestion, in most forms of 
 gastric disorder, in obesity, and in gall-stones. 
 
 The addition of strong liquors to cream lessens its digest- 
 ibility — the alcohol coagulates and toughens the envelopes 
 of the fat globules. 
 
 Ice cream is a frozen mixture of cream, sugar, and flavour- 
 ing agent. When very simply made it is nutritious, and may 
 be allowed to many patients. It is soothing to inflamed 
 throats, and is enjoyed by convalescents from fevers. The 
 nutritional value of ice cream can be increased by the addition 
 of egg or plasmon. 
 
 Whey. — ^When milk has been standing for some time, a spon- 
 taneous coagulation occurs, and whey is squeezed out of the con- 
 tracting clot. Whey so prepared has a sourish taste, and is less 
 palatable than the artificially prepared varieties. Whey is also 
 artificially prepared by the addition of rennet, lemon juice, or 
 wine, in the manner described on p. 197 ; also ch. xxii. It 
 is practically an aqueous solution of milk-sugar. It can be 
 added to beef-tea, or beaten up with yolk of egg in hot water. 
 
 Whey makes a palatable drink, with slightly diuretic and 
 laxative properties. Whey cures, where up to five pints of 
 whey are taken in twenty-four hours, have been estabhshed for 
 the treatment of renal and dropsical affections. 
 
 Butter. — Butter is made from the cream of milk by 
 churning. It consists of about 80 per cent, of fat, 15 
 per cent, of water, with a little casein and sugar. A certain 
 amount of common salt is added to increase its keeping 
 qualities and to improve its taste. Pure cultures of certain 
 organisms are made use of to ripen butter, and so impart a 
 constant flavour. Butter is easily digested and absorbed. 
 Most persons eat about an ounce a day of butter, but two or 
 
CHEESE. 43 
 
 three times that amount may be taken by some people. The 
 adulterations of butter are given on p. 1 69. 
 
 Margarine and Butterine. — These are purified animal fats 
 made up so as to closely resemble butter. They are made by 
 melting down and clarifying various animal fats. The melted 
 fat is allowed slowly to cool, and in the process the various 
 fats solidify at dififerent temperatures. After the stearin 
 and palmitin have solidified, the olein is removed by 
 pressure, churned up with a little milk, and tinted with a 
 vegetable dye, and is then ready for use. They are admi- 
 rable substitutes for butter, and they could with advantage be 
 made more use of, especially in cooking. The legal control 
 of their sale is mainly intended to prevent them from being 
 fraudulently offered as butter. A useful and cheaper variety 
 of margarine is made from the oil of nuts. 
 
 Cheese is another milk derivative, consisting of casein of 
 the milk, separated by rennet, with some of the fats or oils. 
 Cheese, as a food-stuff, presents a large amount of nutriment 
 in small bulk, one pound of cheese containing as much 
 nitrogenous food as two pounds of meat. In countries where 
 meat is scarce and dear, the country people consume large 
 quantities of the heavier, less highly flavoured cheeses. The 
 wealthy classes eat cheese more as an extra taken after meals, 
 and employ the higher flavoured varieties. 
 The varieties of cheese depend upon — 
 
 I. The quantity of water they contain; this chiefly 
 
 determines the hardness or softness. 
 3. The quantity of fat present, this being small in 
 
 amount in cheese made from skimmed milk, and 
 
 large in amount in cheese made from milk fortified 
 
 with cream. 
 3. The kind and degree of the fermentation processes, 
 
 upon which the flavour largely depends. 
 
44 THE BOOK OF DIET. 
 
 The nutritive value of cheese depends largely on the pro- 
 portion of fat present in its composition. There are three 
 leading varieties — soft, hard, and skimmed milk. A fair 
 average for the fat and nitrogen present in these three types, 
 whenfresh, is as follows (Fleischman) : — 
 
 Soft. Hard. Skimmed Milk. 
 
 Fat 31 to 44 29 2 to 3 
 
 Nitrogen 131024 28 19 to 33 
 
 Such cheeses as Stilton, Gloucester, Gorgonzola, Edam, 
 Cheshire, Roquefort, and Imperial, are examples of rich 
 cheese made from milk fortified with cream ; while skimmed 
 milk is chiefly used in the manufacture of Single Gloucester, 
 American, Dutch, Suffolk, and Parmesan. The fat present 
 in the " rich cheeses " makes the -cheese soft and friable, 
 and they decompose more rapidly. This process is called 
 " ripening." 
 
 Cheese cannot be regarded as an article of diet suitable 
 for patients with a weak digestion. This is specially true of 
 the richer cheeses, in which the large amount of fat interferes 
 with the ready digestion of the casein. It is advisable for those 
 with weak digestions, who are very fond of cheese, to partake 
 of one of the softer varieties, as, although less digestible, they 
 are much less likely to be taken to excess. The addition of an 
 alkali (for example, bicarbonate of potash) makes it more easily 
 digested, the alkali forming a soluble compound with the 
 casein. This is best done by adding a pinch of the salt to 
 \ lb. of grated cheese, which may then be mixed with 
 another food-stuff, such as milk or eggs. The large number 
 of bacteria in ripe cheese is another factor which makes 
 cheese an unsuitable article of diet for invalids. The 
 recently introduced lactic St. Ivel cheese is a very palatable 
 cheese, rich in lacto-bacilli. It has undoubted advantages 
 over other cheeses for patients not endowed with a robust 
 
BUTTERMILK— KOUMISS— KEPHIR. 45 
 
 digestion. Some good recipes for cheese dishes are given 
 on pp. 402, 403. 
 
 Buttermilk. — Buttermilk is the milk left after churning 
 and removing the fat. Its sourness is due to the presence of 
 lactic acid, derived from the conversion of sugar. The casein 
 is present in a flocculent form, and on this account buttermilk 
 is a readily digested food. It is a cheap food, since it is a 
 good source of protein. A pint of it contains as much nourish- 
 ment as two ounces of bread. It is a wholesome drink, with 
 diuretic and special medicinal properties. Further reference 
 to buttermilk and soured milk is given on p. 288. 
 " Eoumiss. — Koumiss is a fermented milk, prepared by 
 both lactic acid and alcholic fermentation. It is made from 
 the milk of a certain breed of mares in South-eastern Russia ; 
 it is also made from cow's milk, to which an artificial ferment 
 has been added. The milk is mixed with a koumiss ferment, 
 the lactic acid ferment changing some of the sugar into lactic 
 acid, while another part of the sugar is converted into alcohol 
 and carbonic acid. Koumiss is an acid effervescing drink, with 
 an agreeable bitter taste, and contains from one to two per cent, 
 of alcohol. The strength of koumiss varies with the duration 
 of fermentation. It is very sensitive to temperature changes, 
 and its composition is always changing, unless the fermentation 
 is controlled by extreme cold. It is very easily digested, being 
 much more digestible than milk. 
 
 ' Kephir. — Kephir is another form of fermented milk 
 resembling koumiss. It is made from cow's milk, alcohol, 
 lactic acid, and albumin being formed as a result of the 
 fermentative process. The casein is partly digested. Tablets 
 of the kephir ferment are sold for the home manufacture of 
 the milk j it may also be made as follows : — 
 
 Boil fresh milk, and when nearly cold put into quart bottles, leaving 
 loom to shake. Add half an ounce of crushed lump sugar and a piece 
 
46 
 
 THE BOOK OF DIET. 
 
 of Vienna yeast the size of a hazel nut (that is, 20 grams), cork with 
 new corks, tie down, keep cool ; lay the bottles horizontal, but shake 
 twice daily. It will be ready to drink about the sixth day, or earlier in 
 hot weather and later in cold weather. It can be made with skimmed 
 milk. 
 
 Foods Prepared from Cow's Milk. 
 
 Condensed Milk. — Condensed milks are all made from 
 cow's milk, either whole or skimmed. It is prepared by 
 slowly evaporating the water off the milk to the consistence 
 of honey. As a rule, the milk is only reduced to one-third 
 of its original volume. Most brands of condensed milk 
 have cane sugar added to help it in its preservation. We 
 have thus three types of condensed milk, as follows : — 
 
 I. Whole Milks, Condensed and Unsweetened. — The 
 following are the chief brands : Ideal, First Swiss, Peacock, 
 Viking, Hollandia. Their composition is as follows : — 
 
 
 Water. 
 
 Protein. 
 
 Fat. 
 
 Lactose. 
 
 Ideal 
 
 62.00 
 
 8.3 
 
 12.4' 
 
 16.00 
 
 First Swiss 
 
 62.15 
 
 9-9 
 
 "•33 
 
 14.44 
 
 Peacock 
 
 64.05 
 
 
 10.04 
 
 I.2S 
 
 Viking 
 
 
 8.9 
 
 9-9 
 
 
 Hollandia 
 
 57.00 
 
 "•3 
 
 9.8 
 
 3-4 
 
 These are prepared by evaporation by heat sufficiently 
 strong to render the milk sterile, or nearly so, so that no 
 preservative materials are added. The milk is open to 
 the same objections as the use of sterilized milk, but is 
 better for infants than those forms of condensed milk in 
 which preservation is secured by the addition of too large a 
 proportion of cane sugar. A dilution of two parts of water 
 makes the mixture approximate more or less closely to cow's 
 
CONDENSED MILK. 
 
 47 
 
 milk. Further dilution and the addition of cream and sugar 
 are necessary to make the fluid at all similar in composition 
 to human milk. 
 
 The unsweetened milks tend to go bad quickly when 
 opened. For this reason they should be kept in a cool 
 place after being opened, and the smallest size of tin should 
 be purchased. 
 
 2. Whole Milks, Condensed and Sweetened. — These are 
 made from whole milk, with the addition of cane sugar to 
 such an extent that the cane sugar added is greater than the 
 solids of the milk, and its function is to act as a preservative. 
 The following is the composition of some of the best-known 
 brands :— 
 
 
 Solids. 
 
 Protein. 
 
 Fat. 
 
 Milk 
 Sugar, 
 
 Cane 
 Sugar. 
 
 Nestl^ 
 
 77-2 
 
 9-7 
 
 i3-7i 
 
 iS-o 
 
 37-2 
 
 Rose 
 
 76.6 
 
 8-3 
 
 12.4 
 
 17.6 
 
 36.1 
 
 Milkmaid 
 
 76.3 
 
 9-7 
 
 II. 
 
 14.6 
 
 38.7 
 
 Full weight 
 
 76- S 
 
 12.3 
 
 II. 
 
 13-5 
 
 37-2 
 
 Anglo-Swiss 
 
 74-4 
 
 8.8 
 
 10.8 
 
 16.0 
 
 37-1 
 
 On account of the large amount of sugar present in these 
 preparations, in order to make the milk palatable, a degree of 
 dilution is required which makes it impossible for the resulting 
 mixture to be at all like cow's milk in its proportion of 
 protein and fat. 
 
 Humanized condensed milk is prepared by the addition of 
 cream and lactose, before condensation, in such quantities as 
 to form a solution when suitably diluted equivalent to human 
 milk in percentage composition. 
 
 3. Sweetened and Condensed Skimmed Milk. — Under the 
 Sale of Food and Drugs Act, 1899, there is a section 
 which prohibits the importation or sale of condensed. 
 
48 THE BOOK OF DIET. 
 
 separated, or skimmed milk except in tins or other receptacles 
 which bear a label, wherein the words " machine skimmed 
 milk" or "skimmed milk," as the case may require, are 
 printed in large and legible type. Recent investigations 
 made by the Local Government Board have shown that 
 there is evidence from nearly all parts that this preparation 
 is largely used, and that in some districts its employment is 
 probably extending. If we ask how it is that mothers feed 
 their babies from tins bearing the words " machine skimmed 
 milk" plainly printed on the labels, the cause in all probability 
 is poverty and ignorance. There are many mothers who 
 would not think of using ordinary fresh skimmed milk for 
 their babies, but the presence of sugar in, and the viscosity 
 of, the condensed variety gives a fallacious appearance of 
 richness, and renders the food more satisfying to the baby. 
 The chief characteristic of the condensed separated milks is 
 its poverty in fat — as a rule, not exceeding 1.5 per cent. 
 When suitably diluted, these milks are very deficient both in 
 protein and fat, and are thus not foods adapted for infant 
 feeding. Such brands may be useful as food for culinary 
 purposes and for addition to tea, but should certainly never 
 be given to infants. 
 
 Advantages and Disadvantages of Condensed Milks. 
 
 Condensed milks are more easily digested than cow's milk. 
 For this reason, condensed milk is occasionally of much 
 value in the treatment of infants who are unable to digest 
 ordinary milk. The great popularity of condensed milk is 
 chiefly due to the ease with which the infant's meal is 
 prepared. The disadvantages are marked. They contain, 
 as a rule, too little fat. The unsweetened milks are alone 
 satisfactory in this respect. In suitable cases this can be 
 
DRIED MILK PREPARATIONS. 49 
 
 remedied by the addition of cod-liver oil to the diet. In 
 the dilution recommended they are usually deficient in 
 protein — this holds good very specially in the skimmed milk 
 preparation. This deficiency may be remedied by the 
 administration of protein in other forms — for example, egg 
 albumin. Further, they are not fresh foods. They all lack 
 the important " antiscorbutic " element present in fresh milk. 
 This can to some extent be counteracted by adding to the 
 dietary a little fruit juice every second day. The nutritive 
 value of any preparation depends on the quality of the milk, 
 the degree of condensation, the addition of cream (if any), 
 and the amount of cane sugar added. It need hardly be 
 added that only the best brands should be used. It should 
 also be noted that condensed milks are expensive in com- 
 parison with ordinary milk. As a rough computation, it 
 may be said that the price of the milk diluted and ready for 
 use works out at 4d. per pint. 
 
 Dried Milk Preparations. — There are a large number of 
 preparations of dried milk in the market; they belong to 
 various groups : — 
 
 1. Milk powders, composed of milk modified by the abstrac- 
 tion of casein or addition of sugar, or both. AUenbury No. i 
 food is a food of this sort : it is made from cow's milk from 
 which the excess of casein has been removed and the deficiency 
 of sugar and fat corrected. It is free from starch, and is often 
 very useful during the first three months of infant life, when a 
 temporary change from fresh cow's milk mixture is indicated. 
 
 2. Dried milk, made from whole or skimmed milks. 
 Whole milk dried is sold as glaxo (Nalhan and Co.), and 
 lacvitan (Prideaux), at is. to is. 3d. per pound. Albulactin 
 is a guaranteed pure soluble milk albumin, which does not 
 contain casein ; it is an admirable preparation. Dried 
 skimmed milk is sold as lacumen, at sd. to gd. per pound. 
 
50 THE BOOK OF DIET. 
 
 3. Casein Preparations. — There are a large number of 
 these preparations. The nutritive value is high, containing 
 as a rule over 90 per cent, of pure protein. Their great 
 value consists in that they can be added to other foods, thus 
 "fortifying" them with the nitrogenous element. The 
 preparations are tasteless, compact, easily digested, and 
 soluble. Their solubility enables them to be added to other 
 food — such as soups, jellies, milk puddings — greatly raising 
 the nutritive value of the diet. 
 
 Dried casein is a product of the Protene Company, and 
 forms the basis of many of the patented preparations. It is 
 in the market as protene flour. Casein is purin-free (p. 295), 
 does not clot, and is easily digested and absorbed. Casein 
 combined with ammonia is sold as eucasin, and with sodium 
 as nutrose. Sanose is a mixture of casein (80 per cent.) and 
 egg albumin (20 per cent.). Sanatogen is a valuable casein 
 preparation, with 5 per cent, sodium glycero-phosphate 
 added. 
 
 -^Plasmon is a tasteless, odourless, white powder, entirely 
 soluble in water. It is casein of milk made into a readily 
 soluble powder by the addition of an alkali, and it contains 
 phosphorus in organic form. It is one of the cheapest and 
 best of the dried milk preparations. 
 
 One teaspoonful of plasm on is equivalent to the protein 
 value of about 2 pints of milk. Plasmon is best added to 
 soups, milk gravy, etc., after it has been dissolved. 
 
 Plasmon, 3 teaspoonfuls. 
 
 Plasmon, 3 teaspoonfuls. 1^ p^pared pla 
 Water (tepid) \ pint. ^ v r 
 
 Add 3 teaspoonfuls of tepid water to the plasmon, stir 
 and rub into a paste, then gradually add the tepid water, 
 place on the fire, bring to the boil, stirring well all the time, 
 and boil for two minutes. This can now be added to milk 
 
DRIED MILK PREPARATIONS— EGGS. 51 
 
 or other liquid beverage. When cold, the prepared plasmon 
 will form into a jelly, which when whisked will turn into a 
 thick cream. The jelly or cream can be added to all food — 
 liquid or solid. Plasmon may be added to milk, butter, 
 porridge, and puddings, recipes for which are given on pp. 
 408, 410, 426. It can also be bought combined with cocoa, 
 arrowroot, tea, biscuits, chocolate, oats, and blancmange 
 custard. Certain infant foods — for example, AUenbury Nos. 
 I and 2, and Horlick's malted milk — are also dried milk 
 preparations. 
 
 Casumen (Prideaux) is a white, flake-like powder, odour- 
 less, tasteless and soluble, and miscible with ordinary food 
 and drink. It is free from starch and sugar, and keeps in- 
 definitely. It is combined with other foods in much the 
 same way as plasmon is. A diabetic milk can be made from 
 it by the addition of water, a pinch of baking soda, and 
 saccharin. 
 
 Protein and tilia are also similar preparations. 
 
 EGGS. 
 
 Eggs contain all the ingredients necessary to support life 
 and develop the organism. 
 
 From their chemical composition it is readily understood 
 how they are such valuable articles of food in the dietetic 
 treatment of disease, especially in some ailments occurring 
 in childhood and youth. 
 
 Comparing the composition of the edible part of the whole 
 egg with that of moderately lean meat, we find as follows : — 
 
 Egg. Lean Meat. 
 
 Water 73-7 73-o 
 
 Protein 14-8 21.0 
 
 Fat 10.5 S-S 
 
 Ash i.o i.o 
 
52 THE BOOK OF DIET. 
 
 The nutritive matter is thus seen to be almost the same as 
 meat, eggs being poorer in protein but much richer in fat. . 
 
 m)i& white of egg contains its protein in a solution enclosed 
 in numberless little cells. When white of egg is beaten up, 
 the walls of the cells are ruptured and the protein is set free. 
 The result of beating is to increase the digestibility of egg- 
 white, the protein being more easily broken up when released 
 from the cell. 
 
 The yolk of the egg is much the more nourishing portion. 
 It contains a greater proportion of fat, and in its ash there 
 are some very important mineral constituents, such as 
 phosphoric acid, lime, and iron. The phosphorus and iron 
 are almost entirely present as organic compounds. As 
 mineral matters are most easily absorbed when combined 
 with an organic substance, it follows that yolk of egg is a 
 useful adjunct in the treatment of several forms of nutritional 
 and blood diseases. In chlorosis and some other forms of 
 anaemia, and also in rickets, the great richness of the yolk in 
 lime, phosphorus, and iron makes it most valuable. 
 
 The fats present are the same as those present in butter. 
 They appear in emulsion form, and are thus very easily 
 digested. Eggs, from their chemical composition, should be 
 used with a carbohydrate diet. The usual custom of pre- 
 paring rice and starchy preparations — such as arrowroot, 
 tapioca, cornflour — with eggs in the making of milk puddings 
 is a perfectly right one, the result being a perfect food. The 
 nutrient value of an egg corresponds approximately to a full 
 half-tumblerful of milk, or to i.\ ounces of fairly fat meat. 
 
 The digestibility of eggs varies, depending on the form in 
 which they are taken. A raw egg takes longer to leave the 
 stomach than a lightly boiled one; a raw egg is hardly 
 digested by the stomach, being passed into the duodenum 
 almost unchanged. A raw egg, therefore, is probably the 
 
EGGS. 53 
 
 better article of diet for a stomach requiring rest. Hard-boiled 
 eggs are much more indigestible than those lightly boiled. 
 
 Eggs are very constipating for some people. This is partly 
 due to the large amount of lime present, and partly to the 
 fact that absorption in the intestine goes on to such an extent 
 that only a very small residue remains. 
 
 Some patients show a remarkable idiosyncrasy in the case 
 of eggs, being unable to take any without acute symptoms of 
 gastro-intestinal derangement supervening. Others are un- 
 able to take eggs in a plain form, but can take them in the 
 form of a pudding or cake. If the absorption of eggs from 
 the intestine is delayed, decomposition ensues, with pro- 
 duction of sulphuretted hydrogen and ammonia with 
 accompanying intestinal derangement. 
 
 Raw Eggs are of special value in the treatment of tuber- 
 culosis. They are given in the following ways : — 
 
 1. Albumin Water. 
 
 Take the white of a fresh egg, cut it in several pieces with a pair 
 of clean scissors, add twice its volume of water, pour into a broad- 
 necked hottle, shake thoroughly well together, and strain through muslin. 
 This gives about 3 ounces of a clear solution, etc. 
 
 This fluid added to a beef extract — either home-made beef-tea or to 
 one of the many beef extracts in the market (Lemco, etc. ), just dissolved 
 in hot water — makes a very nutritive solution almost indistinguishable 
 from beef juice, and at a fraction of the cost. Egg-white water added 
 to any of the beverages (see p. 107) makes them at once possess a decided 
 nutritive value, and is useful especially in pyrexial conditions. 
 
 2. Prairie Oyster. 
 
 Raw eggs can be very easily swallowed by breaking the egg into a 
 coffee cup and swallowing it at once. If this method is found difficult, 
 a tablespoonfiil of white vinegar may be placed at the bottom of the coffee 
 cup; the egg is then broken on the top of the vinegar, and a little 
 pepper added. In this form it is known as prairie oyster, and can by 
 
54 THE BOOK OF DIET. 
 
 many people be more easily swallowed. Kggs taken in this form are 
 very easily digested, and this is the best method of taking large numbers 
 of eggs as recommended for tuberculosis. 
 
 3. Egg Flip (without wine). 
 
 White of egg ; i pint of hot milk ; sugar and flavouring to taste. 
 
 Beat the white of egg to a stiff froth. Pour the hot milk over the egg, 
 stirring all the time ; add flavouring — for example, sugar, cinnamon, 
 lemon juice. 
 
 4. Egg Flip (with wine). 
 
 I egg ; I glass of port, sherry, or brandy ; I tablespoonful of sugar. 
 
 Separate the yolk and white. Mix the yolk and sugar well together, 
 and beat up the white to a stiff froth. Mix the yolk with the wine, and 
 stir in the white lightly, and serve. 
 
 5. Egg Drink (with milk or with soda water). 
 
 I egg i 2 pints of milk or soda water ; i teaspoonful of sugar ; 
 I tablespoonful of sherry or brandy. 
 
 Beat up the egg, wine, and sugar, and strain into a cup. Over this 
 pour J pint of almost boiling milk, and serve hot. If soda water is used, 
 serve cold. 
 
 6. Egg Nogg. 
 
 I white of egg ; i tablespoonful of cream ; i tablespoonful of sherry ; 
 castor sugar to taste. 
 
 Mix the wine, cream, and castor thoroughly. Beat the white of egg 
 to a stiff froth, stir into the mixture, and serve. 
 
 7. Caudle. 
 
 I egg ; I glass of sherry or brandy ; J pint oatmeal gruel ; flavouring- 
 lemon peel, nutmeg, and sugar. 
 
 Flavour the gruel by cooking it with the lemon peel. Beat up the 
 egg with the brandy, sugar, and nutmeg, and pour over it the hot gruel. 
 
 Cooked eggs appear as the main basis in custards, soufH&, and 
 omelets. They are also used with carbohydrates in the making of 
 puddings, and for the thickening of soups and sauces. 
 
MEATS. 55 
 
 MEATS. 
 
 Composition of Flesh. — The flesh of animals comprises 
 muscle, with the connective tissue, fat, nerves, and blood- 
 vessels supplying the muscle. The length of the fibre varies 
 in different varieties of animal flesh — for example, very short 
 fibres are present in the breast of a chicken, and very long 
 fibres in the limbs. For this reason the former are more 
 easily digested. 
 
 The fibres are held together by connective tissue ; this con- 
 nective tissue yields gelatine on boiling. The amount of 
 connective tissue is proportionate to the age of the animal, 
 being large in amount in old animals. 
 
 The composition of meat is affected by various factors, 
 such as the age of the animal, breed, condition, and feeding ; 
 and whether the blood has been drained off, as in veal, or 
 retained, as in beef. 
 
 In young animals the muscles are not fully formed, and are 
 more watery, so that young meat (lamb and veal) loses half 
 to three-quarters of its weight in cooking ; the muscle albumin 
 is replaced by gelatine-forming substances, and the fats and 
 salts are also smaller in amount. Veal is known to be very 
 indigestible to some people, but it is useful for making soup, 
 as the protein-forming gelatine, on boiling, produces good 
 jelly stock. 
 
 The best beef is obtained from a two-year-old ox, and the 
 best mutton from a two-year-old sheep. In addition to being 
 more digestible, the flesh of full-grown animals is richer in 
 extractives and has more flavour than the flesh of an 
 immature animal ; this explains why lamb is eaten with mint 
 sauce and veal with mixed herbs. 
 
 The influence of feeding on the flavour of the flesh is 
 illustrated in the difference between the flavour of mutton 
 
56 
 
 THE BOOK OF DIET. 
 
 from hill-fed sheep and from sheep fed on turnips. Wild 
 rabbits are much more palatable than tame ones — probably 
 on account of the aromatic herbs, such as thyme, in their 
 diet Seabirds have a fishy flavour, and are not easily 
 digested. 
 
 The chemical composition of the meat is greatly influenced 
 by the breed, the condition, and general health of the animal 
 — that is, the degree to which the animal has been fattened, 
 and also by the particular part from which the cut is made. 
 The flank contains 43 per cent, of water, and the round of 
 beef 60 per cent, (see fig., p. 58). 
 
 The average composition of meat is given in the following 
 table : — 
 
 Beef. 
 
 Water. 
 
 Nitrogenous 
 Matter. 
 
 Fat 
 
 Ash. 
 
 Lean 
 
 Medium 
 
 Fat 
 
 76. s 
 
 73 
 S3 
 
 21 
 
 20.S 
 
 17 
 
 i-S 
 
 29 
 
 I 
 
 1 
 I 
 
 The nitrogenous part of flesh consists chiefly of the protein 
 myosin. This coagulates after death, this condition being 
 known as rigor mortis. Meat in this state is tough and in- 
 digestible; on this account meat should either be eaten 
 immediately after killing, before rigor mortis has had time to 
 supervene, or it should hang until the stiffening has passed 
 oflF. In hot climates, where decomposition sets in rapidly, 
 flesh is cooked immediately on being killed. 
 
 The serum albumin of muscle is one of the most soluble 
 of the muscle proteins, and this albumin can be extracted 
 by water; this extract, amounting to 5 or 6 per cent, 
 represents the maximum strength of an aqueous extract of 
 beef-tea. The remaining 14 or 15 per cent of proteins are 
 insoluble in water, though dissolved by the digestive juices. 
 
MEATS. 57 
 
 It should be noted that a large number of persons who call 
 themselves vegetarians are vegetarians only in name. They 
 take animal foods in the form of milk, eggs, and in many 
 instances white meats, such as fish and game: Their 
 "vegetarianism" consists solely in abstinence from animal 
 flesh, especially red meats. 
 
 The chief mineral substances present in meat are salts of 
 phosphoric acid and potassium. Iron is present in the red 
 colouring matter. These mineral substances are of great 
 importance in nutrition. 
 
 The extractives in meat are substances which can be 
 extracted by boiling water. They have no direct nutritive 
 value, but are important since they impart the characteristic 
 flavour to meat. These are more fully considered in the 
 section on Beef-teas and Extracts on pp. 142, 382. 
 
 Fat is embedded in the connective tissue between the 
 fibres in mutton and beef. Fat is almost entirely absent in 
 game, and in the breast of chicken, and in most varieties of 
 white fish. In pork, duck, goose, herring, mackerel, and 
 salmon the fat is abundant. The fat lessens the digestibility 
 of the meat, possibly by forming a coating round the fibres. 
 
 Meat should be cut or carved at right angles to the long 
 axis of the fibre. It is then more easily chewed, the flavour 
 is better, and the digestive juices reach the fibres more 
 easily. 
 
 The acids which develop in meat while hanging improve 
 the flavour, and also help to increase the digestibility. This 
 efiiect can be brought about by various devices, such as the 
 addition of vinegar to boiling meat, the rubbing over veal 
 with lemon juice before frying or stewing, and by eating 
 vinegar with crab and lobster. 
 
58 
 
 THE BOOK OF DIET, 
 
 Varieties of Meats. 
 
 Beef is at its best when got from an ox of two years of age. 
 Foreign beef is now imported in large quantities, and, 
 although it is not considered so good in flavour or quality as 
 English meat, it is excellent, and can be obtained at a lower 
 price. The best parts only are sent to this country; the 
 carcasses, frozen, chilled, or refrigerated, arrive in excellent 
 
 The usual Scotch Mode of cutting up an Ox. 
 (More economical than the English mode.) 
 
 condition, and are cut up and sold in the same manner as 
 home-grown beef, thus placing good meat within the reach of 
 all. Argentina, Australia, and the United States are the 
 chief sources of the foreign beef 
 
 The method of cutting up a side of beef varies in different 
 parts of the country, and the accompanying diagram gives 
 the usual Scotch mode, which is more economical than the 
 English. 
 
NAMES OF VARIOUS JOINTS. 59 
 
 Names of the Various Joints, with suggestions for the best 
 method of using, and the average English and American 
 price per lb. : — 
 
 The best parts are the rump, sirloin, and ribs ; ox fat is softer than 
 mutton fat on account of the larger proportion of olein in it. 
 
 Chip (10) and Neck (2). — These parts often suit if soup meat is 
 ordered. It makes a good economical stew, and good pies and puddings 
 if first stewed. Cost: Eng., sd. ; Amer., 3jd. 
 
 Spare Ribs (3 and 4). — Generally stewed. Cost : Eng., 8d. ; 
 Amer., 6d. 
 
 Ribs (s). — Roasting. It is generally thought most economical to 
 have the bones taken out and the meat rolled ; the bones are then 
 used for soup. Cost: Eng., SJd. ; Amer., yjd. 
 
 Runners (6, 7, and 8). — Cut close by the shoulder-bone ; is used for 
 boiling and stewing. The thin end is sometimes salted. Cost : Eng., 
 9id. ; Amer., 6|d. 
 
 Nitte Holes (9). — Used chiefly for pickling, sometimes boiled or 
 stewed, not so fat as the brisket (10). Cost, 6^d. 
 
 Brisket or Breast (lo). — Used for stewing or salting ; rather a fat 
 portion, but excellent cold. Cost: Eng., $\t. ; Amer., 4jd. 
 
 Marrow Bone (il). — Very valuable for the fat it contains. Methods 
 of preparation, see p. 420. 
 
 Hough or Shin (12). — Best for making soup, and makes a good, eco- 
 nomical stew. Cost : Eng., 4d. ; Amer., not sent to this country. 
 
 Sirloin (13). — Cut generally into three parts, called double side, 
 middle cut, and the thin end. It is almost invariably roasted, and is 
 considered the best joint for this purpose. The undercut is sometimes 
 cooked separately, and is the best part for entries, as it is so tender. 
 Cost: Eng., gd. ; Amer., 8d. 
 
 Flank, — Thin (14); thick (15). Thin flank: May be stewed, but 
 is rather fat. The best way is to salt or pickle it and eat it cold. An 
 economical part ; low priced. Thick flank : Coarse in fibre, but well- 
 flavoured and tender. Economical part to buy; contains no bone or 
 fat ; can be stewed, made into puddings or pies, or used for steak, or 
 roasted. Cost: Eng., 5id. ; Amer., 4d. 
 
 Rump (16 and 17). — Gridiron steaks should be cut from here. 
 Excellent roasted. For stewing, steak from a cheaper part does as 
 well. Cost: Eng., is. id. ; Amer., iid. 
 
6o THE BOOK OF DIET. 
 
 The ^»«»rf(i8).— Weighs from 30 to 40 lbs., and contains little fat ; 
 the upper part is sometimes cut into steaks. Sometimes the whole is 
 cut into two rounds — known as Topside of Bullock — which cuts into 
 steaks and joints for roasting; and Silverside, generally salted and 
 boiled. It makes an economical joint if roasted, but is better boiled, 
 stewed, or pickled and boiled. 
 
 Cheek. — Too bony to be a very cheap joint. Sold cheap, and can be 
 made very palatable by long stewing, or is good for soup. Cost : Eng., 
 IS. 3d. 
 
 Ox-tail. — For soups and stews. Expensive, being considered a 
 delicacy. Cost : Eng., is. 9d. each. 
 
 Cow-heel. — The feet are boiled and the neat's-foot oil extracted. 
 These are sold by butchers ; they make excellent jelly in the same way 
 as calves' feet, or can be used for soup. Cost, 6d. each. 
 
 Veal is much less nutritious than beef, containing more 
 gelatinous and fewer albuminous substances. In spite of its 
 fibres being softer, experience and experiment show that it 
 is not so easily digested as beef. When the same quantity of 
 beef and veal are taken, it is found that the former takes two 
 hours, while the latter takes two and a half hours to digest. 
 
 The whiteness of veal is considered a sign of good quality, 
 and the animals are bled to make the flesh white. Veal is 
 best when taken from an animal of eight or ten weeks old. 
 
 Veal is usually cut up by dividing the carcass into four 
 quarters, with eleven ribs to each fore-quarter. They are 
 used in the following way : — 
 
 Loin. — Excellent roasting joint, and also for chops. Cost, SJd. per lb. 
 
 Fillet. — Used for braising, or for cutlets ; can also be roasted. Very 
 little bone present. Cost, is. 
 
 Knuckle. — Excellent for stock ; can be stewed. Low priced. Cost, 6d. 
 
 Neck. — Best end gives a small roasting joint, or chops; too much 
 bone to be economical. Scrag end is only suitable for stewing. 
 
 Breast. — Best braised or stewed. Veal tendons served as an entr^ 
 are cot from this part. Cost, 8d. 
 
 Head. — Boiled ; eaten hot and cold, and dressed in a variety of ways 
 as a delicacy. Cost, 5s. 
 
MUTTON. 
 
 6i 
 
 Mutton is generally considered to be more easy of 
 digestion than beef; this may be due to the finer fibres 
 and looser connective tissue. The flesh of the sheep is 
 usually much fatter than beef, and the fat is hard and solid, 
 owing to the greater proportion of stearin. There is no 
 doubt that hot mutton fat is irritating to some digestions. 
 Mutton differs very greatly in quality and flavour ; when of 
 the best quality, it is a most excellent form of animal food. 
 
 The usual Scotch Mode of cutting up a Shbep. 
 
 Foreign Mutton. — New Zealand mutton and Canterbury 
 lamb are now sold everywhere at prices much below English- 
 grown meat; the quality of the meat is excellent, but the 
 result of the freezing causes more shrinkage in the cooking. 
 
 The sheep is divided into hind-quarters (consisting of 
 gigot or leg, and loin), and fore-quarters (consisting of 
 shoulder, scrap of neck, best end of neck, and breast). 
 
 Leg or Gigot (l). — This is the most economical joint for a family. 
 Legs car be bought of all weights from about 3 lbs. Mutton steaks are 
 cut from the leg. It is best roasted, and can be boiled. Cost : Eng., 
 9id. ; New Zeal., 6id. 
 
62 THE BOOK OF DIET. 
 
 A leg of mutton improves by hanging. It shoald not be in contact 
 with other food. Before cooking, the meat can be made more tender 
 by being smacked (beaten with a wooden roller). The probable 
 explanation is that some of the fibres are broken. 
 
 Loin (2). — This is the best for chops and for grilling or broiUng, or 
 can be roasted entire; it is rather too fat in this way. Two loins 
 together make a saddle — a very excellent joint, but wasteful. Cost : 
 Eng., 9id. ; New Zeal., 5id. 
 
 Shoulder (6). — If a large shoulder is wanted, cut it off close to the 
 bone ; if, on the other hand, the meat below is required for chops, the 
 shoulder should be taken off by the seam. This is a good joint for 
 roasting, but it is not so economical as the leg, and is fatter. If the 
 shoulder is boned and rolled it is very good stewed with vegetables. 
 Cost : Eng., 8d. ; New Zeal., 6d. 
 
 Flank (3). Brisket or Breast (5). — Very cheap, but fat; used for 
 soup and cheap stews. Cost : Eng., 4d. ; New Zeal., i\i.. 
 
 Back Ribs and Neck (4). — The best part, used for cutlets or for 
 boiling. Cost : Eng., gd. ; New Zeal., sJd. The scrag end is used for 
 broth and stews or boiling. Low-priced, not very fat, bony, and 
 wasteful; not to be recommended. Costl Eng., 6d. ; New Zeal., 4d. 
 
 Head (7). — Used for broth, or can be braised. One head gives 
 a large quantity of excellent broth, and the meat on the head is enough 
 to give good helpings for two persons. Cost, 6d. each. 
 
 Shank (8). — Used for soup ; sometimes stewed. 
 
 Trotters or Feet (9). — Only used by the very poor ; but can be boiled 
 with head to make more soup. Sold at id. or \&. each. 
 
 Mutton suet is better for frying than beef, but it is not so good for 
 puddings. 
 
 Lamb greatly exceeds mutton in its proportion of fat, and 
 is correspondingly less digestible. The flesh is more watery 
 than that of the mature animal ; it does not keep well. 
 
 Home-grown lamb can be had from Christmas until the 
 end of October. A good deal of lamb is imported from 
 New Zealand, and is known as "Canterbury" and "hill" 
 lamb ; these are excellent. 
 
 When lamb is small it is sold in quarters. The hind-quarter, con- 
 sisting of the leg and loin, costs 2 approximately, Eng. iid.. 
 
ox, SHEEP. AND PIG. 63 
 
 New Zeal., SJd. ; the shoulder, breast and neck, and the fore-quarter, 
 Eng., 9d., New Zeal., 7d. 
 
 The fore-quarter of lamb is preferred by many, but the leg is the much 
 more economical part. 
 
 Tongue. — The tongue of the ox, sheep, and pig is eaten both fresh 
 and pickled. It is very tender, and is quite suitable for invalids and 
 children if the tender central part is used ; the base contains much fat, 
 and the fibre is indigestible. It is considered a delicacy, and is conse- 
 quently expensive. 
 
 Tripe. — This is the name applied to the stomach and intestines 
 of the ox or sheep ; the mucous lining is scraped off, leaving con- 
 nective tissue, fat, and muscle. The latter is very easy of digestion, 
 and the large proportion of fat in it makes tripe one of the most 
 nutritive diets, and most suitable for those with a weak diges&n. 
 It is rather deficient in flavour, owing to the want of extractives. 
 The special points to be noted in the preparation of tripe will be 
 found on p. 427. 
 
 Sweetbreads. — Under this term two distinct organs are referred to — 
 the thymus or "throat sweetbread," and the pancreas or "stomach 
 sweetbread." Both glands are cellular organs, held together by a 
 loose connective tissue. They are very rapidly digested by the 
 stomach, nine ounces being digested completely in two and three- 
 quarter hours, while a similar quantity of beefsteak demands four and 
 a half hours. Sweetbreads require great care in the preparation for 
 cooking, so as to rid them of the masses of fat mixed in the connective 
 tissue. 
 
 Liver and Kidneys. — These are compact, solid organs containing little 
 connective tissue. They are not very digestible. The livers of the calf 
 and lamb are the most tender. 
 
 Bones. — All the connective tissues, including bones and cartilages, 
 yield gelatine on boiling. It is specially useful in soup-making and for 
 making jellies. 
 
 In order to get the maximum amount of gelatine, the bones are 
 broken up into small pieces, and cooked in the oven with a. high- 
 pressure pot. 
 
 Bones are a really cheap source of gelatine, as they contain gelatine 
 to the extent of from 15 to JO per cent. 
 
 The marrow of bone has much nutritive value. It is an easily digested 
 fat. It can be used in the form of marrow bones or marrow toast, and 
 has the advantage of being a very cheap food (see p. 420). 
 
64 
 
 THE BOOK OF DIET. 
 
 Heart. — The heart of an ox or sheep is denser in structure than 
 ordinary beef, but forms an admirable diet for the healthy individual. 
 It has the merit of cheapness. 
 
 Blood. — Blood is sometimes used in the form of black-puddings. It 
 is not an easily digested food, nor is it at all palatable. 
 
 Hare, when young, is very tender, and possesses an 
 excellent flavour. The fibres are short, and the flesh is 
 very digestible ; it is greatly esteemed for soup-making. 
 
 Rabbits, when young and cooked with plenty of gravy, are 
 very digestible ; they are the better of the addition of a little 
 fat in the form of streaky bacon. 
 
 Poultry. — These are characterized by short, muscular fibres 
 and a small amount of fat. The common fowl and turkey, 
 which have a white flesh, are the most easy of digestion, 
 being tender and of a delicate flavour. A young, well-fed 
 chicken is the most digestible of all animal foods. Short- 
 
 Game. 
 
 Average Price. 
 
 Season. 
 
 Cheapest. 
 
 Blackcock ... 
 
 2/6 to 3/6, brace. 
 
 Aug. to Nov. 
 
 Sept. and Oct. 
 
 Ducks, wild ... 
 
 2/- .. 3/- >. 
 
 Oct. „ Sept. 
 
 Nov. „ Dec. 
 
 Grouse 
 
 2/6 „ s/- „ 
 
 Aug. ,, Nov. 
 
 Sept. 
 
 Partridges 
 
 3/- .. 5/- ,. 
 
 Sept. „ Feb. 
 
 Oct. and Nov. 
 
 Pheasants 
 
 6/- „ 10/- „ 
 
 Oct. „ Feb. 
 
 Sept 
 
 Ptarmigan . . . 
 
 I/- „ 1/6 ,, 
 
 Sept. „ Apr. 
 
 Oct. and Nov. 
 
 Snipe 
 
 2/6 „ 3/- ., 
 
 Oct. „ Feb. 
 
 Oct. „ Nov. 
 
 Woodcock ... 
 
 3/6 „ S/- ., 
 
 Oct. „ Feb. 
 
 
 legged fowls are more delicate in flavour ; a one-year-old cock 
 will be found too tough for roasting or braising, and only 
 edible when stewed for soups. Bain-door fowls are less fat 
 than, but far superior in flavour to, fowls fed in close coops. 
 The flavour and tenderness of the flesh is also greatly 
 increased by removal of the sexual organs — the capon is 
 the term for this. Ducks and geese have more fat, are 
 
GAME— PIG. 65 
 
 generally richer, and have a stronger flavour than fowls. 
 Their flesh is darker in colour, and is more difficult of 
 digestion. 
 
 Game. — Partridges and pheasants, when young, are very 
 delicate in flavour; pigeons less so. Grouse, woodcock, 
 snipe, quail, ptarmigan, and wild duck have muscles with 
 a very firm, close fibre, and on this account are generally 
 "hung," to impart tenderness and develop flavour. The 
 most easily digested portion is the breast. 
 
 Pig. — In use in many forms ; in its uncured form it is 
 known as pork. Pork can be produced at less cost than 
 other meat, and consequently can be sold more cheaply. 
 
 The flesh of the pig is a cheap and nourishing food. In 
 its uncured form it is known as " pork," in its cured form as 
 " bacon." Pork is relatively indigestible on account of the 
 large amount of fat present. The fat in bacon is friable, 
 and on that account is more readily acted on by the digestive 
 juices. Bacon is an admirable food for delicate children. 
 
 The cheaper parts of bacon range from 5d. to gd. per 
 pound, but on account of the bone present these are not 
 so economical as they appear. 
 
 Hams. — Hams cost from 7d. to is. per pound according to 
 the type of ham, some small English hams commanding the 
 largest prices. The shoulder can be purchased boned and 
 rolled, and often does duty for a ham ; it is not so fine in 
 fibre, but is much more economical, and costs from 7d. to 
 lod. per pound. 
 
 Sausages. — In this country these are made of uncooked 
 meat, and various carbohydrate substances such as bread 
 are frequently added; the vegetable matter is not infre- 
 quently disguised by the addition of colouring material. 
 Seasonings of various sorts also enter into their composition. 
 As sources of protein they are not more economical than 
 
 3 
 
66 THE BOOK OF DIET. 
 
 ordinary meat, and their uncertain composition makes theni 
 unsuitable for invalids. 
 
 FISH, INOLUDINa CRUSTACEA AND MOLLUSCA. 
 
 There is no doubt that a large proportion of our town 
 population would profit by exchanging some of their meat as 
 an article of daily diet for fish. 
 
 Its greater richness in gelatine-yielding substances causes 
 fish to lose more in boiling than meat does, and on this 
 account boiled fish is an insipid and unattractive article of 
 diet. The cheapest fish are cod, ling, herring, mackerel, and 
 sprats, the cost, of course, varying with the supply. 
 
 Fish as a food-stuff contains a large proportion of water, 
 and a varying amount of fat and protein. The latter belongs 
 chiefly to the gelatine-forming order. Isinglass, the finest 
 form of gelatine, is obtained from fish bones, but more 
 especially from cartilaginous fish, like the skate and sturgeon. 
 According to the proportion of protein and fat in fish, they 
 may be divided into two groups of " fat " and " lean." 
 
 With more than 5 per cent, of fat — eel, salmon, turbot, 
 herring. 
 
 With from 2 to 5 per cent, of fat — halibut, mackerel, 
 mullet. 
 
 With less than 2 per cent, of fat — cod, whiting, haddock. 
 
 Fish are at their best just before spawning, when they are 
 said to be in season ; later they become poor and flabby. 
 
 The perfection of fish-cooking is obtained when the fish is 
 transferred immediately from the water to the pot. Keeping 
 in ice deteriorates the flavour. Skate and sturgeon are ex- 
 ceptions ; they improve by being " hung," the muscular fibre 
 becoming softer. Smoked, salted, and pickled fish are much 
 less digestible than when fresh, and in this form they are 
 
FISH. 67 
 
 better avoided by dyspeptics. The fish best suited for 
 smoking are firm, oily fish, like the salmon and herring. 
 
 In selecting fish, the following are the main indications of 
 freshness : The flesh is stiff and firm, the animal being in a 
 state of rigor mortis ; the skin should be well covered with 
 scales, and there should be no disagreeable smell. A most 
 important point is that the eyes and gills are bright, while 
 the tail is firm and not drooping. Cod, haddock, and 
 whiting keep best, then flat fish ; mackerel and herrings very 
 rapidly get soft. 
 
 Varieties. — The edible fishes fall into two groups — 
 " white " and " oily " — the difference being as to whether they 
 have the fat stored in the liver or distributed throughout the 
 body. 
 
 The white fishes are the most digestible ; they comprise 
 the whiting, haddock, cod, brill, sole, plaice, flounder. 
 
 The whiting has been termed "the chicken of the sea.'' It is 
 very light, easily digested, and when fresh possesses a very delicate 
 flavour. 
 
 Haddock, when fresh, possesses a very delicate flavour ; the flesh is 
 firmer and harder than whiting. It is best to select one of medium size ; 
 when large, their flesh is coarse. Smoked haddocks are very well 
 known, and vary greatly in digestibility. The small sort, known as the 
 "Aberdeen Findon," are quite tender ; they are smoked with peat smoke. 
 The Arbroath smokies are also easily digested. The larger forms, 
 smoked with petroleum, are tough, and have not nearly so fine a flavour. 
 In season August to January. 
 
 CodKi the toughest of the white fish. Its quality varies at the different 
 seasons ; sometimes the flesh is hard and full of fibre. The tail portion 
 is the most digestible, but has least flavour. In season September to 
 April. 
 
 Ling. — A cheap fish, rather tasteless; requires a good sauce; fre- 
 quently bought salted. In season November to April. 
 
 Trout. — A fresh-water fish. Those weighing about one pound are 
 best. When in condition have excellent flavour, and are very digestible. 
 In season February to August. 
 
68 THE BOOK OF DIET. 
 
 Smelts. — A very small fish, but mnch esteemed. In season October 
 to April. 
 
 Whitebait. — A very small fish, of silvery appearance ; must be used 
 quite fresh. Best in May, June, and July. 
 
 John Dory. — The flesh is rather tough, and it is the better of being 
 kept a day or two before being cooked. It is best baked. 
 
 The flat fishes form another section of the white fishes, and 
 comprise : — 
 
 Sole. — Very delicate, and easily digested. It is a fish of excellent 
 quality ; medium size is best. In season May to February. 
 
 Plaice and Flounders. — Flat fish of rather poor quality and flavour, 
 easily digested ; moderate price. Choose one with a thick, firm body. 
 They are best fried or baked. In season September to April. 
 
 Skate. — Tough ; a very decided flavour ; improves with keeping for 
 a day or two. The flesh should be firm and creamy in appearance. It 
 requires to be skinned ; unwholesome when out of season. In season 
 November to April. 
 
 Brill. — Like turbot in appearance, and much cheaper. When fresh, 
 the flesh should be of a yellowish tint ; if blue, it is not good. It is 
 generally boiled. 
 
 Halibut resembles turbot in appearance. Its flesh is of excellent flavour. 
 A middle cut of this fish is the best. In season October to March. 
 
 The oily fishes comprise : — 
 
 Turbot. — The richest of the flat fish. The flesh is firm and white. 
 A medium-sized fish is the best. This fish improves by keeping for a 
 day. In season September to April. 
 
 Salmon. — A red fish ; this is very rich in fat, which is found most 
 abundant on the under side. Its flesh is so rich that most people require 
 a corrective such as vinegar or other acid sauce. The more freshly 
 a salmon is cooked the better. In season February to September. 
 
 Eel is exceptionally rich in fat, the proportion being about double 
 that of proteins. Although oily it is readily digestible, and possesses a 
 delicate flavour. 
 
 Herring is the cheapest and most abundant of the oily fishes. This 
 fish should be cooked fresh. When newly caught they have a bright and 
 silvery appearance. Herring are much used in the salted and smoked 
 
CRUSTACEA. 69 
 
 forms. When smoked for an hour or two they are called "bloaters." 
 As the smoking continues they become "kippers," "red herring," or 
 " black herring." In season May to December. 
 
 Mackerel readily taints, and gives rise to symptoms of ptomaine 
 poisoning if eaten in this condition. The mackerel seasons are 
 spring and autumn; the latter fish are the finer. Sardines, sprats, 
 and pilchards belong also to this group of fish. In season October 
 to June. 
 
 Crustacea. — The edible forms of Crustacea are lobster, 
 crab, crayfish, shrimps, and prawns. 
 
 The lobster and crab consist of two distinct parts. The 
 flesh which is contained in the claws, legs, and tail is very 
 indigestible, mainly on account of the density and coarseness 
 of the fibres. The habit of eating vinegar with lobster and 
 crab is perfectly sound, the acid helping to soften the fibre. 
 The body of these animals is also eaten. This is composed 
 mainly of liver ; it contains a considerable quantity of fat. 
 
 Lobster. — The lobster is more digestible than the crab ; the flesh 
 of the claws is better than that of the tail. It decomposes rapidly, 
 and therefore is best bought alive. The bright red part within the 
 body is the ovary. Their spawn is very nutritious, and is often used in 
 sauces for the sake of its flavour and colour. In season January to 
 October. 
 
 Crab is inferior to lobster. The flesh is tougher and more indigestible ; 
 the medium-sized ones are best. Choose a heavy one, for if light it is 
 watery. In season April to September. 
 
 Crayfish. — Used principally as a garnish, or for making soup. Like 
 lobsters in appearance, but smaller and of more delicate flavour. 
 
 Shrimps and prawns can scarcely be classed as a food. They are best 
 cooked in salt water. They are taken as " appetizers." 
 
 Mollusca are represented by the oyster, mussel, whelk, periwinkle, 
 and cockle. Oysters are in season from September to April. There 
 are several kinds ; the " natives " are considered the best. 
 
 The composition of the oyster is mainly water — over 88 per 
 
70 THE BOOK OF DIET. 
 
 cent. J protein, 6 per cent ; and carbohydrates, 3 per cent. 
 The proportion of solid nutriment is not large, three dozen 
 moderate-sized oysters only containing sJ- ounces of solids. 
 When eaten raw, oysters are an exceedingly easily digested 
 food, three medium-sized oysters being completely digested 
 in three-quarters of an hour. Cooking tends to make them 
 tough and leathery. If oysters are grown in the mouths of 
 rivers, they are liable to be contaminated by typhoid or other 
 germs in the sewage. 
 
III. 
 
 VEGETABLE FOODS. 
 
 Cellulose. 
 
 Rye. 
 
 Starch. 
 
 Rice. 
 
 SUGARS. 
 
 
 Sacroses. 
 
 LEGUMES OR PULSES. 
 
 Glucose. 
 
 Peas, Beans, Lentils, etc. 
 
 Invert Sugar. 
 
 Beans. 
 
 VEGETABLE FOODS 
 
 Lentils. 
 
 PROPER. 
 
 Peas. 
 
 
 The Pea-nut. 
 
 SEEDS AND FRUITS. 
 
 
 Cereals Producing Flour 
 
 FRUITS, NUTS, AND FUNGI 
 
 OR Meal. 
 
 Fruits. 
 
 The Cereals. 
 
 Fruits. 
 
 Wheat. 
 
 When to eat Fruit. 
 
 Flour. 
 
 The Uses of Fruit. 
 
 Preparations of Wheat 
 
 Preserving and Cooking of Fruits. 
 
 OTHER than Flour. 
 
 Nuts. 
 
 Other Cereals. 
 
 Nuts. 
 
 Barley. 
 
 Fungi. 
 
 Maize or Com. 
 
 ROOTS AND TUBERS. 
 
 Buckwheat or Blackwheat. 
 
 
 Millet or Sorghum. 
 
 STEMS AND LEAVES- 
 
 Oats. 
 
 GREEN VEGETABLES. 
 
Chapter III. 
 VEGETABLE FOODS. 
 
 The large and varied class of food-stuffs derived from plants 
 have a strikingly common feature as far as their chemical 
 composition goes. They are all very rich in carbohydrates, 
 and as a rule are poor in fats. They contain vegetable 
 proteins in different proportions, and also an abundant pro- 
 portion of water. 
 
 Vegetable proteins exist as vegetable albumin and vegetable 
 casein. They are not so easily digested and assimilated as 
 animal proteins. The proteins in peas and beans are rich in 
 sulphur, and are therefore prone to induce flatulence. 
 
 Though there is no true gelatine substance in carbo- 
 hydrates, there is a peculiar group of bodies known as 
 " peotoses.'' These substances give to fruits their power of 
 forming jellies when boiled. 
 
 On the whole, plant life is not rich in fats. The fat 
 resembles in chemical composition the animal fats, but con- 
 tains, as a rule, more of the oily constituent (olein) and less 
 of the solid components. The solid vegetable fats are cocoa- 
 nut oil and cocoa butter, none of which are in great use as 
 foods. 
 
 Vegetable butters are now made from mixtures of these 
 fats, and closely resemble cooking and table butter. In 
 
 3rt 
 
74 THE BOOK OF DIET. 
 
 addition to the oils obtained by pressure, most plants contain 
 volatile or essential oils, to which they owe their fragrance. 
 These are mainly used in perfumery, but they enter also 
 largely into flavouring agents, and act as condiments to 
 excite the appetite and stimulate the digestive juices. 
 
 The salts of plants exist largely as salts of potash and 
 phosphorus ; in many of the cereals — for example, wheat — 
 iron is also present in combination with phosphoric acid. 
 Chlorides are relatively deficient in vegetable foods, hence 
 the custom of adding sodium chloride (common salt) to 
 vegetable dishes. 
 
 The carbohydrates form the great bulk of vegetable food, 
 and are represented by cellulose, starch, and sugar. There 
 is a framework of cells and binding tissue known as cellulose ; 
 starch is the substance stored in the cells ; and sugar is the 
 partially digested starch which circulates through the plant. 
 These will be shortly considered. 
 
 Cellulose. — When a plant is young some of its cellulose 
 can be digested by man ; but as the plant grows older the 
 cellulose becomes more woody in structure and gets enveloped 
 in resinous material, so that it is as indigestible as paper or 
 sawdust. It is this peculiarly insoluble envelope that makes 
 the cooking of the vegetable group so important for digestion. 
 
 The nutritive parts of the plant are the starch, which is 
 stored up in the cells, and the sugar, which circulates through 
 the framework. The starches and sugars are convertible; 
 the sugar is the digested nutriment of the plant, while the 
 starch is the form in which the nourishment of the plant is 
 stored for further use. All starch eaten by animals has first 
 to be converted into sugar before it can be utilized for the 
 needs of the body. 
 
 Starch is made up of a number of minute cells. The 
 starch granules show concentric markings, showing that the 
 
SUGARS. 75 
 
 cells have been built up layer by layer. Starch grains are 
 insoluble in cold water; when boiled, the starch grains 
 swell up and burst the cellulose envelopes, and form, with 
 water, the sticky substance used in laundry work. Cooking 
 is essential for vegetable foods, in order to rupture the starch 
 granules so that the broken-up grains may be brought more 
 readily into contact with the digestive juices. 
 
 SUGARS. 
 
 Sugars are crystallizable carbohydrates, with oxygen and 
 hydrogen existing in proportion to form water. There are 
 several varieties of sugars — for example, cane sugar, grape 
 sugar, milk sugar, and malt sugar. They present slight 
 differences in their physical properties, and also differ in 
 taste and digestibility. 
 
 Sugars have essentially the same use as starches, for all 
 starch must be converted into glucose or dextrose before it 
 can be made use of in the body. Cane sugar requires to be 
 converted into grape sugar before it is absorbed, and there- 
 fore grape sugar may be considered a predigested carbo- 
 hydrate. 
 
 Sugars are of value as energy and heat producers, and 
 they can also be transformed into fat; they are, however, 
 not essential, and can be replaced by starches and fat. 
 Practically it will be found that all growing children crave 
 for sugar, and this should be supplied in moderation. Sugar 
 also lessens muscular fatigue. Muscular action is dependent 
 on the presence of glucose and dextrose, and so urgent is the 
 demand for sugar that if it or starch be not present in the 
 food, then sugar is formed from the muscles. Sugars and 
 syrups are used to preserve fruits in solution, or in the dried 
 form as preserved cherries and crystallized ginger. 
 
76 THE BOOK OF DIET. 
 
 There are three groups of sugars : — 
 
 1. Sucroses — for example, cane sugar, malt sugar, and milk 
 sugar. 
 
 2. Glucoses — for example, grape sugar (dextrose), fruit sugar 
 (or levulose). 
 
 3. Invert sugar, best known as honey. 
 
 I- Sucroses. — (») Cane sugar is the clarified and crystallized juice of 
 the sugar cane, but may be made also from beetroot. Commercial sugar 
 is extracted from sugar cane and the juice of the compressed betroot by 
 a process of refining which produces commercial white sugar of various 
 grades. 
 
 Coarse brown sugar is somewhat impure, and has a slightly laxative 
 action ; it is not cheaper than the more refined varieties. 
 
 Maple sugar is derived from the sap of the sugar maple of North 
 America. The bark is tapped in early spring, and allows the sap to 
 escape as it flows upwards. The sap is evaporated, the sugar crystallizes 
 out, and the residue is used as maple syrup. 
 
 There is no commercial difference between maple sugar and the 
 other two described above, but it contains certain ethereal substances 
 which give it its peculiar flavour. Maple sugar is chiefly used as a 
 confection. 
 
 Molasses, treacle, and syrup are by-products formed during the process 
 of refining the above sugar ; and all contain — besides sugar — acids, extrac- 
 tives, salts, and more or less impurities. 
 
 Heat applied to sugar makes it change its crystalline form. When 
 strongly heated it melts into a yellowish liquid, and on cooling it 
 does not crystallize, but forms a transparent, brittle mass, &miliar as 
 barley sugar. Sugar candy is made by extremely slow crystallization. 
 Caramel is made by heating refined cane sugar to about 400° F., 
 when it is melted, browned, and converted into a non-crystallizable 
 fluid with a distinctive "caramel" flavour. Caramel may be added 
 to insipid invalid foods, such as milk, custard, farina, arrowroot, and 
 the like. 
 
 (i) Maltose. — Malt sugar is formed in the process of malting. The 
 grain is roasted in the kiln until it shows signs of sprouting, when the 
 temperature is raised to prevent further growth. The grain is now 
 called malt, and is brownish, some of the starch having been changed 
 into dextrine and part of it into sugar. The object of the malting is to 
 
SUGARS. 77 
 
 convert the insoluble starch into the soluble sugar and dextrine (see 
 " Malt Extracts," p. 58). 
 
 {c) Lactose, or milk sugar, is the carbohydrate of milk. It differs 
 from cane sugar in its flavour, being almost tasteless. It is hardly 
 possible to ferment it by yeasts. It is therefore very usefiil in cases of 
 fever and of stomach derangement with fermentation. It is readily split 
 up by micro-organisms to form lactic acid. 
 
 {d\ Mannite is obtained from the sweet juice of the stems of the ash 
 tree ; it is found also in beetroots and some other vegetables. Like 
 sucrose, it crystallizes and is white. It does not ferment with yeast. 
 It is laxative, and may be used in diabetes, not being excreted in the 
 urine as glucose. 
 
 2. Qlucose, or grape sugar, is present in almost all fruits. Grape 
 sugar is known by the name of dextrose. When grapes are dried to 
 form raisins, the little dried masses on the outside are dextrose. Com- 
 mercial glucose is usually obtained by boiling starch with acid, and it is 
 sold in syrupy form. When heated it turns brown, and is used as sugar 
 colouring. Confectionery and sweets are made from cane sugar or glucose 
 (grape sugar), with the addition of butter or other fats, nuts, fruits, starch, 
 and flavouring extracts. Glucose mixed with egg albumin is largely 
 employed by confectioners in the preparation of icing and fondants. 
 
 Lemilose, or fruit sugar, is found in most fruits. It is difficult to 
 crystallize. It is now sold under the name of " Diabetin," for the use 
 of diabetics, on the ground that it is better borne than any other form of 
 sugar. Diabetin is sweeter than cane sugar, and has a somewhat fruity 
 taste. It may be taken in considerable quantities without disordering 
 digestion, as saccharin is apt to do. 
 
 3. Invert Sugar is a mixture of dextrose and levulose. A large 
 proportion of cane sugar is converted into invert sugar in the process of 
 jam-making. Honey is "an invert sugar" prepared by bees from the 
 cane sugar of flowers ; the insect transforms a part of the sugar into 
 dextrose. It is a wholesome, fattening food. Artificial honeycombs are 
 now made from paraffin stamped into cells, which allows the bees more 
 time for the storage of honey. Run honey is mixed with fluid glucose 
 and sold as honey ; it is innocuous, but should be sold at a cheaper 
 rate. 
 
 Saccharin and dulcin (sucrol) are chemical substitutes for sugar. 
 They have many hundred times the sweetening power of sugar, but are 
 of no use as foods. They are used to replace sugar as a flavouring agent 
 in diabetes, gout, and obesity. 
 
78 
 
 THE BOOK OF DIET. 
 
 Sweets in moderation are good for. growing children. 
 There is no proof that sugar is harmful to the healthy; 
 although, doubtless, sweets which adhere to the teeth 
 undergo fermentation with the production of acids which 
 attack the teeth. 
 
 VEGETABLE FOODS PROPER. 
 
 Almost every part of plants furnishes food, but more 
 especially seeds, roots, stems, leaves. These may be classi- 
 fied as follows : — 
 
 Seeds and Fruits. 
 
 Tubtrs and Roots. 
 
 Stems and Leaves 
 
 Cereals — for example, 
 wheat, oats, barley, 
 rye, rice, maize, etc. 
 
 Pulses — for example, 
 peas, beans, lentils. 
 
 Tubers — for example, 
 potatoes. 
 
 Roots — for example, 
 carrots. 
 
 Green vegetables. 
 
 FruiU. 
 Nuts. 
 
 
 
 SEEDS AND FRUITS. 
 
 Cereals producing Flour or Meal. 
 
 The Cereals (from Ceres, goddess of corn) comprise 
 all grains or corn-bearing plants. They contain from 5 to 
 14 per cent, nitrogenous matters, chiefly in the form of 
 gluten ; they contain from 50 to 80 per cent, of starch. The 
 proportion of fat varies in different members of the group, 
 ranging from J to 8 per cent. Salts are present in amount 
 to about 2 per cent. ; this amount depends largely on the 
 kind of soil and manure employed. They consist chiefly of 
 phosphates of soda and potash, with lime and magnesia, and 
 a little silica and iron. The organic salts are almost absent. 
 
SEEDS AND FRUITS. 
 
 79 
 
 Composition of Cereals. 
 
 :Water. 
 
 Carbo- 
 hydrates. 
 
 Barley 
 
 Buckwheat 
 
 Maize 
 
 Millet 
 
 Oats 
 
 Oats, liuUed . . . . 
 Rice in the husk 
 
 (paddy) 
 
 Rice, polished . . 
 
 Rye 
 
 Wheat 
 
 12.3 
 13.0 
 12. 5 
 12.3 
 10.0 
 6.9 
 
 10.S 
 12.4 
 zx.o 
 
 Z2.0 
 
 10. 1 
 10.2 
 
 9-7 
 10.4 
 
 13-0 
 
 6.8 
 6.9 
 10.2 
 
 ZI.O 
 
 1.9 
 
 2.3 
 
 S-4 
 3-9 
 4-5 
 8.1 
 
 1.6 
 
 0.4 
 
 2-3 
 
 1-7 
 
 69.5 
 61.3 
 68.g 
 68.3 
 59-1 
 68.6 
 
 68.1 
 79-4 
 72.3 
 71.2 
 
 8 2 
 z 2 
 
 O 1 
 
 9 2 
 o 3 
 
 3 2 
 
 ° 4 
 
 4 o 
 X 2 
 2 I 
 
 Wheat and rye, owing to peculiarities in their gluten, are 
 the only ones suitable for bread-making, but all of them can 
 be made into cakes, porridge, puddings, or soup. 
 
 The process of grinding first removes the outer coats of 
 cellulose, and an unbroken meal or flour is obtained. The 
 gluten lies next the outer surface. 
 
 The cereals contain a great excess of carbohydrate, and 
 mankind has instinctively added fat and protein ; so that we 
 eat butter with bread, milk with porridge, and make cereal 
 puddings up with eggs and milk. 
 
 Wheat. 
 
 The first place among the cereals must be assigned to 
 wheat 
 
 Flour. — In order to transform wheat grains into a useful 
 domestic substance, the grains have to undergo the process 
 of grinding or milling. It is necessary, in order to follow 
 the processes of grinding, to have some knowledge of the 
 different parts of the wheat grain. These are : — 
 
 1. Husk, or cuticle. 
 
 2. Kernel, or food supply. 
 
 3. Germ, or young plant. 
 
8o THE BOOK OF DIET. 
 
 The husk consists of three layers, consisting mainly of 
 cellulose with some pigment. When' the wheat is decorti- 
 cated the product is known as bran. Wheat bran contains 
 about IS per cent, nitrogen, 3.5 per cent, of fatty matter, and 
 6 to 7 per cent, of mineral matter, mainly phosphates, all of 
 which materials should be nutritious; but very little bran 
 can be absorbed, and it is irritating except to patients with a 
 robust digestion. 
 
 The kernel, or endosperm, consists of the nutritive material 
 for the young embryo, and makes up 85 per cent, of the 
 grain. Microscopically it is found to consist of a honeycomb 
 of cellulose, into which are packed starch cells and gluten 
 granules. Gluten is a protein which has the peculiar property 
 of becoming viscid when mixed with water. This important 
 feature will be mentioned again under " Bread-making." 
 
 The germ, or young plant, represents i J per cent, of the 
 whole grain. This is very rich in nitrogen and fat. The 
 germ as well as the bran is removed in the preparation of 
 flour, for the following reasons. The abundant supply of 
 fat in the germ may become rancid, and so spoil the flour, 
 and the soluble proteins present are apt to act on the starch 
 of the flour, converting part of it into soluble forms (dextrose 
 and sugar), which darken in colour in the oven and detract 
 from the appearance of the cooked flour. Thus, in the 
 process of milling to which the wheat is subjected, its 
 different parts are broken up and various mill products are 
 produced. The outer coats yield bran, fine pollards, sharps, 
 and middlings ; the germ is removed as offal, while the flour 
 is derived solely from the kernel. 
 
 Flour, according to the amount of grinding, is yellowish 
 white from the presence of gluten, or pure white, in which 
 case it is likely to contain Uttle except starch. Good flour 
 should have a pleasant smell, and should have no acid or 
 
WHEAT. 8i 
 
 rancid taste. It should not contain more than 15.2 per cent, of 
 water. The flour itself is classified and divided into two parts — 
 the larger part, known as "bakers'' or "household;" and a 
 smaller portion, very white in colour, and therefore poor in 
 proteins, known as "patents.'' From the latter genuine 
 Vienna bread is made, and also the best class of fancy 
 breads and pastry. 
 
 By removing the germ and the bran the most useful con- 
 stituents of the wheat are lost — namely, germ protein and 
 fat, and the bran minerals and protein matter. Whole 
 wheaten meal baked is more nutritious, much better flavoured, 
 but is apt to be irritating on account of the indigestible outer 
 coat, consisting of cellulose and silica, etc. ; and while it is 
 useful as a laxative, its use has not become general. (The 
 prejudicial effects of bleaching flour are referred to on p. 169.) 
 
 Other flours are obtainable where only the two outer layers 
 (rf the husk are removed. Bread made from these is not 
 nearly so indigestible as bread made from whole wheaten meal. 
 
 Two patent processes have also been devised to prevent 
 the waste. Smith's patent takes the separated germ and 
 partially cooks it by means of superheated steam. This kills 
 the ferment, which otherwise acts on the starch, and at the 
 same time sterilizes the fat, and so prevents it becoming 
 rancid. The germ so heated is ground to a fine meal, and 
 of this one part is added to three of ordinary flour, and the 
 mixture is known as Hovis flour. It is much richer in 
 protein and fat than ordinary flour. There are now several 
 germ breads on the market, in all of which the germ is 
 treated much along these lines. The Frame food process 
 treats the bran. The bran is boiled under high pressure ; 
 the mineral matters and part of the nitrogen are recovered. 
 The watery extract is filtered and evaporated to dryness. 
 This is Frame food extract. This extract forms the basis 
 
82 THE BOOK OF DIET. 
 
 of preparations made by the Frame Food Manufacturing 
 Company. 
 
 (For bread-making and varieties of bread, see chapter on 
 "Cookery," p. 386.) 
 
 Preparations of Wheat other than Flour. 
 
 The wheat grain may be used as a food in its entirety. It is soaked 
 in water till it swells up and bursts. It is then boiled in milk with the 
 addition of sugar, so forming a nourishing dish cMed^fivment}'. 
 
 Wheaten groats are made by crushing, and this can be made into 
 porridge, used like oatmeal. 
 
 Wheatena is a nutritious food containing all the wheat germ excepting 
 the husk, and is finer than crushed wheat and more easily digested. 
 The starch granules are partially cooked. It is eaten as a porridge. 
 
 Granose and Granola are flaky forms of the entire wheat grain. (They 
 are palatable and nutritious, are ready cooked, and are eaten with cream 
 or hot milk. 
 
 Shredded wheat, trisket, and fulled bread are all prepared much the 
 same way. The shredded wheat biscuit is made of wheat thoroughly 
 cleansed and cooked, and treated by machinery, which draws out the 
 wheat kernels into long continuous filaments, without separation of the 
 parts. The shreds are folded into oblong biscuits, which are cooked at 
 successive temperatures until they are quite dry and ready for use. 
 They may be eaten with butter, or soaked in milk, cream, or soup. 
 They are easily digested. They require mastication, and are quite 
 palatable. 
 
 Farina is a general name meaning flour, but sometimes it is also 
 applied to potato flour, which forms a jelly like arrowroot when cooked. 
 
 Farola is another granular preparation, but is made from the 
 endosperm or germ, and is specially rich in proteins and mineral 
 matters. 
 
 Florador, another granular wheat preparation, is recommended for 
 puddings and shapes. It is certainly more nutritious than cornflour. 
 
 Semolina is prepared from the central part of hard wheat, and is rich 
 in gluten. It contains about 1 1 per cent, of protein, or half the amount 
 contained in an equal amount of beef. It is thus a fairly rich nitro- 
 genous food, and is used for making puddings and for thickening soups. 
 
WHEAT AND OTHER CEREALS. 83 
 
 It is also used extensively in the manufacture of the alimentary pastes, 
 such as macaroni. Macaroni, vermicelli, spaghetti, etc., are made 
 from mixing different flours rich in gluten — for example, semolina. The 
 flour is made into a paste, kneaded, put into a cylinder the bottom of 
 which is pierced with holes. A piston descends in the cylinder, and the 
 paste comes out from the perforations in the form of long tubes, which 
 are cooled, cut in lengths, and dried. It contains from 16 to 18 per 
 cent, of gluten, as against 10 and 15 per cent, in the case of white bread. 
 Weight for weight, macaroni may be regarded as not less valuable for 
 flesh-making purposes than beef or mutton. Most people can digest it 
 easily and rapidly. After thorough soaking, and when well cooked by 
 boiling or stewing in milk or stock, it is very nutritious, and it is often 
 served combined with cheese. The other pastes are much the same 
 in composition. They are wholesome but tough, and require prolonged 
 cooking. (For various means of preparation, see ch. xxii.) 
 
 Other Cereals. 
 
 Barley contains more salt, fat, and cellulpse than wheat, 
 but less protein and carbohydrate. The ash of barley is rich 
 in phosphates and iron. The proteins resemble those of 
 oats, and do not form gluten. It cannot, therefore, be made 
 into bread, but is used as barley scones and barley-meal 
 porridge. 
 
 In the preparation of barley the whole grain is ground to 
 form barley meal. When stripped of the husk and roughly 
 ground, it is called pot barley or milled barley; when the 
 grains are further rounded and polished, it is known as pearl 
 barley. In the form of barley broth it forms a common 
 article of diet. 
 
 Barley-water, made from pearl barley or Robinson's patent 
 barley, is a useful sedative in all irritable states of the urinary 
 passages. Barley-water is often added to cow's milk in infant 
 feeding (see ch. xxii.). 
 
 Maize, or Com, may be dried, parched and roasted, whole, 
 or ground into meal of various degrees of fineness. Its 
 
84 THE BOOK OF DIET. 
 
 chemical composition shows it to contain a considerable 
 amount of fat and protein as well as starch, and it furnishes 
 abundant energy and heat. It is very fattening both for man 
 and the lower animals. There are innumerable varieties, but 
 the common kinds are known as white, yellow, and red. As 
 a fresh vegetable, sugar corn, unless eaten very young and 
 tender, is indigestible; and canned corn is notoriously so, 
 chiefly on account of the husk of the kernel. The chief 
 preparations are : — 
 
 Cornmeal. — This is digestible, and, like oatmeal, somewhat laxative. 
 It makes a dry, friable bread, for it contains no gluten. As compared 
 with wheat flour, it contains more fat, but is de6cient in salt. It is not 
 largely used in this country. 
 
 Polenta. — A maize meal largely used by the Italians. 
 
 Corn starch is very white and soft ; contains 53 P^r cent, of starch ; 
 contains proportionately little nourishment. May be used instead of 
 arrowroot, and is sold as "maize cornflour." 
 
 Indian meal is yellow, granular, and coarser than com starch. 
 
 Hominy, cerealine, and samp are preparations of broken or split maize 
 of various degrees of fineness. Samp is very coarse, and can only be 
 used when well boiled. The first two make excellent puddings. 
 
 Cornflour, Maizina, Oswego. — These are made from maize by washing 
 away the protein and fat. They contain very small quantities of 
 nitrogen, and are therefore only agreeable forms of starch, and are 
 generally taken with a protein and fat, such as eggs and milk. 
 
 Popcorn. — A small variety of maize that is roasted and swells up and 
 bursts. It is then known as popped popcorn. It is the basis of many 
 sweetmeats. 
 
 Mush is made of well-grown Indian meal or cornmeal boiled in salted 
 water. It mixes well with cream, and is very digestible and nutritious. 
 
 Buckwheat, or Blackwheat, is used in Russia, Siberia, and 
 Brittany. The meal has less protein and more carbohydrate 
 than flour. It is usually eaten as porridge, and can be made 
 into griddle cakes. It is not used in this country. 
 
 Millet, or Sorghum, is used in Africa, Southern Europe, 
 
OATS. 85 
 
 and in China, but not in this country. It is similar in com- 
 position to buckwheat. White sorghum is a grass or corn, 
 and can be converted into a flour — "dhoora" — much used 
 in India. A fine quality of alcohol may be made from it. 
 In the United States it is grown chiefly for molasses and 
 syrup, and sugar is made from it. 
 
 Bread made from millet or sorghum meal when warm is 
 fairly palatable and nutritious, and is used in China. When 
 it becomes cold it darkens and crumbles. 
 
 Oats contain more protein and fat than flour and meal 
 from other cereals. Starch is present in the proportion of 
 about 38 per cent. There is great difficulty in completely 
 getting rid of the husk, so a good deal of cellulose is left in 
 the meal in the form of sharp particles. Oatmeal is obtain- 
 able in coarse, medium, and fine varieties, the two latter 
 being those in household use. Oatmeal is not a suitable diet 
 for subjects of a weak digestion, but for constipation oatmeal 
 is an excellent article of diet. It is an excellent food for the 
 growing child. In some subjects it heats the blood, causing 
 rashes and gastric derangement. 
 
 If oats are simply cleaned and ground, the result is oatmeal of various 
 degrees of fineness. Oat flour — for example, Scott's oat flour — is the 
 product after the branny particles are removed. This is the best form 
 for infants and invalids. Groats — for example, Robinson's groats — consist 
 of oats from which the husk has been entirely removed. 
 
 Rolling oats is another method of preparation. Rolled oats are more 
 easily softened by cooking; probably the great pressure between the 
 rollers breaks down the cell envelopes. In some of the rolled oats 
 preparations heat is also used. This requires less cooking in the house, 
 and sterilizes the fat, so that there is no fear of the abundant fat present 
 turning sour and altering the flavour. "Rolled oats" Quaker oats, 
 Avenine, Provost oats, and Forage oats are all examples of this 
 preparation. 
 
 Oatmeal is unfitted for bread-making owing to the absence of gluten. 
 It is made into oatcakes by mixing the meal with water, fat in the form 
 
86 THE BOOK OF DIET. 
 
 of dripping or butter, and salt. Made into cakes and baked on the 
 girdle in the form of bread-stuff, it is much used in Scotland as a break- 
 fast bread-stuff, and can either be home-made or bought in tins. Oat- 
 cake is as nutritious as bread, and has a great deal higher food 
 value. 
 
 Oatmeal needs prolonged boiling to soften the cellulose. For persons 
 with limited digestive power oatmeal should be cooked so as to acquire 
 a consistence which enables it to pour readily, and on cooling it should 
 form a soft, gelatinous mass. (For making of gruel and porridge, 
 see ch. xxii.) 
 
 Brose is an old Scottish dish made by stirring oatmeal into boiling 
 water. It is not a food for a delicate digestion. 
 
 A soup-plateful of porridge is equivalent in protein to two 
 slices of a large loaf three-quarters to one inch thick ; if the 
 bread is buttered, it would be equal in food value to a plateful 
 of porridge and one-third pint of good milk. 
 
 Rye may be said to stand very close to wheat in importance 
 as a food. It is in use in Europe, and mainly in Germany. 
 In Germany the rye production is double that of wheat, and 
 in Russia it is even greater. 
 
 Ryt flour yields a coarse, dark, less well-raised bread than wheat, but 
 is equally nutritious, though not so digestible. It contains less gluten 
 than wheaten bread, and it takes less time to raise and bake it, pro- 
 vided the oven is hot. If properly made it is easily assimilated, and to 
 many people its flavour is agreeable. 
 
 Rye is often combined with wheat in France under the name miteil, 
 and the Spaniards combine it with barley. Rye flour is poorer in 
 protein than a wheat flour of a similar grade. It is very apt to be 
 attacked by the fungus known as ergot, which causes the grain to swell 
 up and become dark purple. 
 
 Rice is the cereal which contains least protein and fat ; it 
 contains 76 per cent, starch. Rice, when boiled, swells up 
 and absorbs nearly five times its weight of water, while some 
 of the mineral constituents are lost in the water. It should 
 therefore be steamed, or, if boiled, the water it has been 
 
LEGUMES OR PULSES. 87 
 
 boiled in should be used as stock. Rice water makes a 
 cooling drink. Rice is only moderately easy of digestion, 
 and often gives rise to flatulence. 
 
 Its poverty in protein and fat does not adapt it for 
 an exclusive food. It is rarely taken alone, but is 
 usually taken with other foods, such as milk, curry, and 
 the like. 
 
 It cannot be made into bread, but rice flour is often added 
 to wheaten flour. Rice forms the staple food of about one- 
 third of the human race. The whole grain is called paddy, 
 and is coloured in various shades of yellow. When this 
 coloured skin is removed the grain is known as rice. 
 
 LEGUMES' OR PULSES. 
 Peas, Beans, Lentils, etc. 
 
 The ripe seeds of pulses rank next to cereals in importance 
 as vegetable foods. In respect of nourishment they are 
 practically equal. They are especially rich in nitrogen, the 
 chief proteins being legumin or vegetable casein. They are 
 also rich in starch, but deficient in fats. They are richer 
 in salts than cereals, especially in potash and lime, but 
 poorer in magnesia and phosphates. They contain much 
 cellulose. 
 
 The protein present is rich in sulphur, which tends to 
 produce sulphuretted hydrogen and similar compounds, so 
 that a leguminous diet tends to cause flatulence. Pulses 
 are rather indigestible on account of the leathery external 
 envelope which they possess when old. Hence they require 
 prolonged cooking in order to promote digestibility. They 
 require to be cooked in soft water, since the lime and 
 magnesia found in hard waters form insoluble compounds 
 with legumin. An analysis of the chief pulses is given by 
 
88 
 
 THE BOOK OF DIET. 
 
 Bauer as follows, the average composition of wheat being 
 given for comparison ; — 
 
 
 Water. 
 
 Protein. 
 
 Fat. 
 
 Starch. 
 
 Cellulose. 
 
 Ash. 
 
 Peas 
 
 Beans 
 
 Lentils 
 
 Wheat 
 
 14-3 
 13-6 
 
 I2.S 
 
 I3S 
 
 22.6 
 23.1 
 24.8 
 
 12.4 
 
 1-7 
 2.2 
 :.8 
 
 1-7 
 
 53-2 
 S3-6 
 54- 7 
 
 67.8 
 
 11 
 
 3-S 
 2.6 
 
 2.6 
 
 3-5 
 
 2-4 
 
 1-7 
 
 They are a cheap and efficient means of supplementing the 
 deficiency of nitrogen in a vegetable diet ; and, on account of 
 the large amount of proteins they contain, they are admirably 
 adapted as a food for the poorer classes. Their defects as com- 
 pared with the cereals are their relative in digestibility, their 
 unsuitability for bread-making, and their less agreeable taste. 
 
 Beans. — There are several varieties. The chief are : — 
 
 1. The kidney or haricot bean. 
 
 2. The broad or Windsor bean. 
 
 3. The scarlet runner. 
 
 Haricot beans almost rank first among vegetables as a nourishing 
 article of diet. They hold their own against the beef and mntton of the 
 animal kingdom. By most stomachs haricots are more easily digested 
 than meat, while the comparative cost is greatly in favour of the former. 
 
 The average composition of the haricot 
 
 is as follows : — 
 
 Water 
 
 ... 13.6 per cent. 
 
 Proteins 
 
 ... 23.1 „ 
 
 Fats 
 
 2.2 „ 
 
 Carbohydrates 
 
 ... 53.6 „ 
 
 Cellulose 
 
 ... 3-8 „ 
 
 Ash 
 
 ■•■ 3-S .. 
 
 Haricot beans are only good when fresh, and the younger they are the 
 better. When old they require prolonged boiling. If old beans are not 
 tender after half an hour's boiling, they should be made into a purie or 
 pudding, dishes which are only suitable for a strong digestion. They 
 
LENTILS. 89 
 
 must be eaten immediately after cooking. A stew made up of one part 
 meat with ten parts of haricots is a much more nutritious and wholesome 
 diet than a stew of all meat and no haricots. They are very useful for 
 thickening soup or using as a. salad, flavoured by adding tomato or 
 similar vegetables. Beans form the basis of a great many useful and 
 inexpensive vegetarian dishes. 
 
 The "scarlet runner" is chiefly used as a green vegetable, being 
 served up in the pods under the name of " haricots rus." 
 
 Soya beans are specially rich in proteins, contain a large amount of fat, 
 but are deficient in starch. They are largely used as a bread substitute in 
 diabetes. Several varieties of cheese are made from their vegetable casein. 
 
 Butter beans resemble small haricots, but are finer, and boil down 
 more quickly. They make a rich white soup, and may be used for 
 savouries. They are also very good as a simple stew. 
 
 Lentils are one of the most nutritious pulses. Their 
 general composition is as follows : — 
 
 Water 
 
 12.5 per cent. 
 
 Proteins 24.8 „ 
 
 Fats 1.8 „ 
 
 Carbohydrates 54.7 ,, 
 
 Cellulose 3.5 „ 
 
 Ash 2.4 ,, 
 
 They contain little sulphur, and are therefore less Uable to 
 cause flatulence than peas or beans. They have the further 
 advantage of being specially rich in iron. There are two 
 kinds of lentils, German and Egyptian. The former are 
 green or olive coloured ; the latter are red, and smaller than 
 the German. The German lentils are very savoury, and 
 have a "meaty" flavour. Either kind can be used for 
 making excellent soup and puree. Like all legumes, they 
 require to be steeped in water for twelve hours before boiling. 
 They are sold as split lentils and also as lentil flour. They 
 are an economical as well as a highly nutritious food. 
 
 Revalenta arabica is a patent preparation, composed largely of lentil 
 flour mixed with pea or bean meal, to which oat and barley meal are 
 sometimes added. 
 
90 THE BOOK OF DIET. 
 
 Pea4S. Varieties of Fresh Peas. — Fresh peas are sweetish, 
 and should be cooked by boiling in water with a little salt ; 
 when old they lose water, become very dry, and require pro- 
 longed steeping so as to soften them. When old they lose 
 their colour, and copper is sometimes added as a preservative, 
 and cases of copper poisoning have been ascribed to this 
 source. Garden peas are sometimes served up in an 
 immature state, with the pods included, as " haricots rus." 
 
 Dried peas are met with in two forms — the split yellow pea and the 
 dried whole green pea. Split peas are chiefly used to make pea soup, 
 or are ground into pea flour or pease meal, from which pease brose and 
 pease puddings are made. Pease brose is made from the fine flour of 
 the white pea by forming it into a mass merely by the addition of 
 boiling water and a little salt. It is eaten with milk or butter, and is a 
 good nourishing article of diet, specially suitable for persons with a 
 costive habit. Pease pudding is made by soaking a quart of peas in 
 water for twelve hours, throwing away those found floating on the top, 
 The peas are then drained into a pudding cloth, put into cold water, and 
 boiled from two to three hours till tender. They are then rubbed 
 through a wire sieve. About one and a half to two ounces of butter, 
 with some pepper and salt, are then added to the mass, which is then 
 tied up again in a cloth dusted with flour, and boiled for another hour, 
 when it is ready for serving. This is a cheap food for persons of robust 
 digestion, but the cost of cooking adds materially to the price. 
 
 The Pea-nut is not a nut, but a legume. It resembles 
 nuts in the large percentage of fat in its composition. It is 
 used largely as a diabetic food, and it also enters largely into 
 the composition of the patent food " Nutrose.'' 
 
 FRUITS, NUTS, AND FUNGI. 
 Fruits. 
 Fruits are composed largely of water, with sugar starches, 
 organic acids, pectin, cellulose, and essential oils. Some 
 fruits contain a little protein, chiefly as albumin. 
 
FRUITS, NUTS, AND FUNGI. 
 
 91 
 
 Fruits are valued chiefly for their water and their vegetable 
 acids, free or in combination as salts, upon which their valu- 
 able properties as antiscorbutics depend. The organic acids 
 in the case of fruit are rich in potash salts, and contain also 
 those of lime, magnesia, and iron ; apples, and more especially 
 strawberries, have also much soda. Fruits contain a vegetable 
 jelly which forms the main constituent of fruit jellies. 
 
 Fruits may be classified as follows :— 
 
 Apple, 
 guava. 
 
 pear, quince. 
 
 lime, 
 
 2. Orange, lemon, 
 
 grape-fruit. 
 
 3. Stone fruits — for ex- 
 
 ample, plum, peach; 
 apricot, cherry, olive, 
 date, prune, sloe. 
 
 4. Acid fruits — for example, 
 
 grape, gooseberry, cur- 
 rant, cranberry. 
 
 5. Fleshy fruits — for ex- 
 
 ample, strawberry, 
 raspberry, blackberry, 
 mulberry. 
 
 6. Pineapples, banana. 
 
 Pears and quinces less digestible than 
 apples. Guavas make good table jelly. 
 
 Small unripe oranges are used in making 
 cura9oa. 
 
 A special variety of plum forms, when 
 dried, the medicinal prune. Peaches, 
 apricots, and nectarines contain less 
 sugar than most fruits, and are usefril in 
 diabetes. Dates rank high in nutritive 
 value ; they contain 50 to 60 per cent, of 
 sugar. Olives are little used except as 
 appetizers. Figs are also highly nutri- 
 tious, containing 50 per cent, of carbo- 
 hydrates, and 3 to 4 pef cent, protein. 
 
 A grape cure is sometimes used for consti- 
 pation and obesity. Raisiiis are dried 
 grapes. 
 
 Largely used for jams and beverages. 
 
 Note. — Frequent idiosyncrasy s^ainst 
 strawberries. 
 
 Pineapple not very digestible because of 
 fibrous nature. Dried bananas are 
 ground into a flour, and also used as 
 a coffee. 
 
 7, Nuts. 
 
92 
 
 THE BOOK OF DIET. 
 
 The composition of edible part of fruits is given in the 
 following table. The carbohydrates include sugar and cellu- 
 lose and vegetable gums. As a general rule, it may be taken 
 that about 60 per cent, of the total carbohydrates consists of 
 fruit sugar or levulose. 
 
 
 Water. 
 
 Protein. 
 
 Carbo- 
 hydrates. 
 
 Cellu- 
 lose. 
 
 Acids. 
 
 Apples 
 
 82.5 
 
 0.4 
 
 I2.S 
 
 2.7 
 
 I.O 
 
 Apricots 
 
 85.0 
 
 I.I 
 
 12.4 
 
 
 I.O 
 
 Bananas 
 
 74.0 
 
 I-S 
 
 22.9 
 
 0.2 
 
 
 Blackberries 
 
 88.9 
 
 0.9 
 
 2-3 
 
 S-2 
 
 
 Cherries 
 
 84.0 
 
 0.8 
 
 lO.O 
 
 3.8 
 
 I.O 
 
 Cranberries 
 
 86. s 
 
 °-s 
 
 3-9 
 
 6.2 
 
 2.0 
 
 Currants 
 
 85.0 
 
 0.4 
 
 7-9 
 
 4.6 
 
 1.4 
 
 Figs, dried 
 
 20.0 
 
 5-5 
 
 62.8 
 
 7-3 
 
 1.2 
 
 Gooseberries 
 
 86.0 
 
 0.4. 
 
 8.9 
 
 2.7 
 
 2-5 
 
 Grapes 
 
 79.0 
 
 I.O 
 
 ^S-5 
 
 2-5 
 
 O.S 
 
 Lemons 
 
 89-3 
 
 I.O 
 
 8.3 
 
 
 
 Nectarines 
 
 82.9 
 
 0.6 
 
 15.9 
 
 .•. 
 
 
 Oranges 
 
 86.7 
 
 0.9 
 
 8.7 
 
 i-S 
 
 I.O 
 
 Peaches 
 
 88.8 
 
 o-S 
 
 S-8 
 
 3-4 
 
 0.7 
 
 Pears 
 
 83.9 
 
 0.4 
 
 ii.S 
 
 3-1 
 
 O.I 
 
 Pineapples 
 
 89.3 
 
 0.4 
 
 9-7 
 
 
 
 Plums 
 
 78.4 
 
 I.O 
 
 14.8 
 
 4-3 
 
 I.O 
 
 Prunes, dried 
 
 26.4 
 
 2.4 
 
 66.2 
 
 
 2.7 
 
 Raspberries 
 
 84.4 
 
 I.O 
 
 5-2 
 
 7.4 
 
 1.4 
 
 Strawberries 
 
 39-1 
 
 I.O 
 
 6.3 
 
 2.2 
 
 I.O 
 
 When to eat Fruit. — The laxative effects of fruit are best 
 obtained if the fruit be taken alone the first thing in the 
 morning on an empty stomach, half an hour before breakfast, 
 with a little water. 
 
 The Uses of Fruit are as follows : — i. To supply nourish- 
 ment. The greatest amount is contained in the banana, date, 
 fig, prune, and grape, this being due to the large amount of 
 sugar which they contain. 
 
 2. They are tAirst quenchers, and supply water, the most 
 watery fruits being melons, oranges, lemons, limes, and grapes. 
 
PRESERVING AND COOKING OF FRUITS. 93 
 
 They possess well-marked antiscorbutic properties, especi- 
 ally those which have an abundant supply of potash salts 
 as well as lime and magnesia — for example, apples, lemons, 
 limes, and oranges. 
 
 Their laxative action is due to the cellulose and seed, and 
 to the special influence of their organic ingredients ; the best 
 fruits for constipation are fresh apples, figs, oranges, grape- 
 fruit, prunes, and peaches. 
 
 Their digestibility depends on the fruit, its ripeness, fresh- 
 ness, and the personal idiosyncrasy of the consumer. The 
 most easily digested are grapes, oranges, grape-fruit, lemons, 
 cooked apples, figs, peaches. Somewhat less digestible are 
 water-melons, prunes, pears, apricots, bananas, raspberries, 
 currants, pineapples. The best for invalids are the juice of 
 lemons, oranges, baked apples, pulped stewed prunes, grapes, 
 and pineapple juice. 
 
 Preserving and Cooking of Fruits. — This is most com- 
 monly done by drying, or by making jam, just before they 
 are fully ripe. Dried fruits are more nourishing, but are 
 less digestible. Of these mention may be made of currants 
 and citrons; figs, prunes, raisins, sultanas, and dates con- 
 tain much nourishment ; all are preserved in their own sugar 
 (glucose). 
 
 Evaporated apples, pears, peaches are preserved by the 
 evaporation of the excess of water which they contain. 
 
 Fruits are made into jams and jellies. 
 
 Fruit syrups are made with about half as much sugar as 
 fruit juice. 
 
 Fruit soups are common in Germany, and are prescribed 
 in fevers when there is no diarrhoea (p. 280). 
 
 When fruits are exposed to the sun and to considerable 
 changes in temperature, they are liable to decompose, and 
 undergo fermentative changes which make them injurious to 
 
94 
 
 THE BOOK OF DIET. 
 
 health. Insufificiently ripe or overripe, soft, decomposing 
 fruits are certain to cause diarrhoea, colicky pains, cramp, 
 and sometimes nausea and vomiting. Gastritis may be 
 induced in young people by indulgence in unripe apples, 
 pears, cherries. 
 
 Nuts. 
 
 Nuts contain a large quantity of fat, protein, some starch, 
 and very little water. The shell forms on the average 
 about half the nut. Nuts are not easily digested, owing to 
 the dense cellulose framework which surrounds the kernel of 
 the nut. They can, however, be bought prepared (cleaned), 
 and can be ground down ; in both cases this renders them 
 more easily digestible. Proteid nuts, prepared by Christian, 
 are an excellent sample of a highly nutritious and easily 
 digested food. Most of the nuts are eaten raw, but chestnuts 
 and cocoanuts, almonds and walnuts, are used also in con- 
 fectionery. (For some specially prepared nut preparations 
 and butters, see p. 241.) 
 
 The composition of the common nuts is given in the 
 following table. Their very high proportion of fat and 
 proteins makes them a very valuable food-stuif if carefully 
 employed. 
 
 Composition of Nuts. 
 
 ^ 
 
 Refuse. 
 
 Edible 
 Portion. 
 
 Comparative Value of Edible Portion. 
 
 Water. 
 
 Protein. 
 
 Fat 
 
 Carbo- 
 hydrates. 
 
 Ash. 
 
 Almonds 
 
 Brazil nuts . , . . 
 
 Filberts 
 
 Hickory nuts 
 Pecan nuts . , . . 
 Chestnuts . . . . 
 Walnuts, English 
 
 64.8 
 49.6 
 52-1 
 6z.2 
 53-2 
 z6.o 
 58.0 
 
 3S.2 
 S0.4 
 47-9 
 
 84.0 
 42.0 
 
 4.8 
 5-3 
 3-7 
 3-7 
 3-0 
 4S-0 
 2.8 
 
 21.0 
 J 7.0 
 1S.6 
 15.4 
 zz.o 
 
 6.2 
 16.7 
 
 1^:1 
 65.3 
 67.4 
 71.2 
 
 ell 
 
 17.3 
 7.0 
 13.0 
 11.4 
 13.3 
 42.1 
 14. 8 
 
 2.0 
 3.9 
 2-4 
 2.1 
 
 1-5 
 1-3 
 1-3 
 
NUTS. 95 
 
 Almonds (sweet and bitter) contain a large amount of fat and protein, 
 but no starch and very little sugar. The small proportion of sugar 
 makes them of great use in the treatment of diabetes. They are ground 
 and made into almond cakes and biscuits. Salted almonds are eaten 
 with dinner as an aid to digestion. Macaroons are a pleasant form of 
 cake, composed of almonds and sugar. The bitter almonds contain 
 hydrocyanic acid, and are only used medicinally. 
 
 Walnuts contain a large proportion of protein and fats ; eaten freely 
 between meals, they sometimes have a very laxative effect. They are 
 usaally eaten ripe and dry with dessert ; the unripe food is made into 
 walnut ketchup. The walnuts are taken before the shell has hardened ; 
 they are beaten to a pulp, and the juice is separated by straining ; salt 
 and vinegar are added, also spices, and after considerable boiling down 
 the ketchup is bottled, and may be kept for years. The green walnut 
 is used as a salad in France, mixed with onion, vinegar, salt, and 
 pepper. 
 
 Chestnuts contain a small amount of oil and a large amount of carbo- 
 hydrates. In Italy they form a valuable adjunct to the food supply. 
 They may be boiled, roasted, or ground. When mixed with flavourings 
 and maize meal they form polenta. Flat cakes are made from chestnut 
 flour and water, and baked between flat stones. The meal may be used 
 for soups, puddings, and as the baas of the stuffing of poultry. 
 
 Brazil nuts, pecan nuts, beech nuts, hazel nuts, hickory nuts, pine 
 kernels, filberts, all contain much oil, and are imported in enormous 
 quantities from Spain for the sake of their oil. Barcelona nuts are kiln- 
 dried before export, and keep indefinitely ; if hazel nuts — or their culti- 
 vated varieties, cobs and filberts — are not dried, they lose their flavour 
 unless kept in air-tight vessels. Butter nuts easily become rancid after 
 being shelled. 
 
 Cocoanuts are very indigestible even when thoroughly dessicated and 
 grated. The nuts are eaten both ripe and unripe by the natives of the 
 tropics, and the juice (cocoanut milk) is drawn out and drunk. They 
 contain fiiUy 70 per cent, of cocoanut oil or cocoa butter, which is used 
 as a food or for lighting and lubricating purposes. The butter is suitable 
 for cooking, and can be used instead of margarine. Acorns are used as 
 food in some countries. They are used like chestnuts, and like them 
 contain starch. They are described as a very good fruit, savoury to the 
 taste and healthful to the body. 
 
 Pistachio, a nut native to Syria, has a green-coloured kernel ; it is 
 much used on account of this for confectionery and for ices. 
 
96 THE BOOK OF DIET. 
 
 Fnngi. 
 
 Fungi are largely employed as food in Southern Europe. 
 They are eaten raw. They are also dried or preserved by 
 cooking in vinegar, brine, or olive oil, which takes away the 
 characteristic acrid taste of some of them. They are fairly 
 rich in nitrogenous matter, but experimental observations 
 have shown that this is imperfectly absorbed. They also 
 contain fat, sugar (mannite and dextrose), fungi acid, and an 
 acrid ingredient. They are used in this country chiefly for 
 their flavour, and also for pickling and making ketchup. 
 
 The chief edible fungus is the common mushroom, generally used for 
 making savouries and ketchup. Care must be taken in gathering wild 
 fungi that the poisonous varieties are not collected. 
 
 Lichens. — Iceland moss is a lichen. It contains from 70 to 80 per 
 cent, of an indigestible starch (lichenin) ; its nutritive value is therefore 
 of low order. 
 
 Algi2. — Irish or carrageen moss is a seaweed. It is specially note- 
 worthy as supplying a pleasant drink, made by adding cold water 
 in the proportion of half an ounce of carrageen to three pints of 
 water, then boiling and straining. It may be flavoured by spices if 
 desired. If more carrageen is employed, the result is a mucilage which 
 yields a jelly on boiling, which may be used as a nutritious and pleasant 
 article of food which is fairly easily digested. 
 
 ROOTS AND TUBERS. 
 
 The roots and tubers used for food comprise the potato, 
 turnip, carrot, parsnip, artichoke, onion, with the different 
 plants yielding arrowroot, tapioca, and sago. The main 
 nourishment in these plants is stored up almost entirely in 
 the form of carbohydrates, chiefly starch. They contain 
 very little protein and fat, and are therefore vastly inferior in 
 nutritive value to the cereals and pulses. Some of the 
 
ROOTS AND TUBERS. 97 
 
 members of this group contain vegetable acid, chiefly com- 
 bined with potash, and these salts give them their recognized 
 antiscorbutic properties. A considerable amount of the salts, 
 however, is usually lost in the process of cooking. 
 
 The potato is the most important member of this group. About 95 
 per cent, of the potato consists of water and starch, the rest of the solids 
 being made of fibre, sugar, vegetable jelly, and pectin. It is very poor 
 in nitrogen, and contains practically no fiit. The richness of the potato 
 in starch — about 20 per cent. — is its most marked characteristic, starch 
 being largely extracted from potatoes for commercial purposes. In the pro- 
 cess of cooking the albuminous juices are coagulated, the starch granules 
 swell up and absorb the watery juices, and the potash assumes a mealy 
 appearance. In this form it is easily digested. If the changes described 
 do not take place, as happens with young potatoes, the potato has a 
 more solid and waxy consistence, and in this form is much less digestible. 
 As ordinarily cooked, some of the salts ^are lost, and to avoid this 
 potatoes should be cooked in their jackets, or else steamed. The 
 alkaline salts in potatoes make them specially useful in the treatment of 
 scurvy. 
 
 The sweet potato is not used as an article of diet in this country, but is 
 largely used in France, Spain, and the United States. It contains about 
 16 per cent, of starch and 10 per cent, of sugar. It is too sweet to eat 
 with meat as a vegetable. It is a most wholesome article of diet. 
 
 The yam is a tuber of a tropical climbing plant. It contains much 
 starch. When cooked it becomes mealy and like the potato in flavour. 
 
 Beetroot, — Beet contains from 80 to 90 per cent, of starch and sugar, 
 and is one of the chief sources of cane sugar. Young beets are eaten 
 boiled, and served with salad or eaten with vinegar. 
 
 The Turnip. — The nutritive value of the turnip is very small. It 
 contains about 91 per cent, of water and 5 to 6 per cent, of carbo- 
 hydrates, chiefly in the form of pectin bodies, and about i per cent, of 
 nitrogenous substances. Turnips have a marked tendency to cause 
 flatulence. 
 
 Carrots are more nutritious than turnips, having from 8 to 10 per 
 cent, of carbohydrates, chiefly in the form of sugar. They are not 
 readily digested nor easily absorbed. 
 
 Parsnips closely resemble carrots in composition. They are rich in 
 starch and sugar, the latter being largely lost in the process of cooking. 
 
 4 
 
98 THE BOOK OF DIET. 
 
 Jerusalem artichoke is a tuber. Like turnips, it contains no starch, 
 but is rich in carbohydrates, chiefly a variety of sugar belonging to the 
 gummy series. It has a sweet taste, and remains watery after cooking. 
 It is of no great importance as a food, but is of value for making good 
 soups and sauces. 
 
 Onions are of value both as flavouring agents and as vegetables. They 
 impart a strong typical odour to the breath, due to the presence of a 
 pungent oil. The large Spanish onions are used as food. They have a 
 moderate laxative action, due to their richness in cellulose. 
 
 Arrowroot is derived from the tuber of a West Indian plant (Maranta 
 arundinacea). The roots are dried and pulverized to a fine starchy 
 flour, which consists of practically pure starch, with from 15 to 20 per 
 cent, of water. Its quality is judged by its whiteness, and by the ease 
 with which there is made from it a firm, transparent, pleasant-tasting jelly, 
 which remains firm and of good taste for three or four days. It is easily 
 digested and very completely absorbed, and is therefore of special value 
 in the treatment of diarrhoea and some gastro-intestinal derangements. 
 In cases where there is difficulty in digesting starches or sugars, arrow- 
 root is an unsuitable food. It is also used to thicken clear meat soups 
 and extracts (see p. 382). 
 
 Tapioca. — Tapioca is also a pure starch, obtained from the tuber of 
 Manihot utilissima, cultivated in South America. Its grains are small. 
 It contains over 85 per cent, of starch. It is not quite so easily digested 
 and absorbed as arrowroot. It is useful for adding to soups and for 
 making into puddings with milk. 
 
 Sago is another starch obtained from the pith of the stems of several 
 species of palm. In its composition and uses it is similar to tapioca. 
 
 STEMS AND LEAVES— GREEN VEGETABLES. 
 
 Green vegetables are even less nutritious than roots, and 
 are chiefly valued for their mineral salts — especially salts of 
 potassium — and as a source of ballast, their indigestible 
 residue stimulating intestinal movements. These vegetables 
 contain about 90 per cent, of water and only from i^ to 3 
 per cent, of nitrogenous matter, probably only half of this 
 consisting of protein (see table). In addition, they con- 
 
GREEN VEGETABLES. 
 
 99 
 
 tain cellulose in large amount, chlorophyll, sugars, gum, 
 pectin, and sometimes traces of fat. 
 
 In health, vegetables (and especially green vegetables) 
 should enter into the daily dietary, as their richness in 
 alkaline salts makes them a useful food, and at the same 
 times gives them valuable antiscorbutic properties. As has 
 been indicated, their nutritive value is very low. Their 
 relative indigestibility on account of the large amount of 
 cellulose present, and the liability of the latter to undergo 
 abnormal fermentation, restrict their value as a food for 
 invalids. 
 
 Composition of Vegetables. 
 
 
 Edible Portion. 
 
 Water. 
 
 Protein. 
 
 Fat. 
 
 Carbo- 
 hydrates. 
 
 Calories, 
 per lb. 
 
 Cabbage 
 
 Celery 
 
 Cucumber 
 
 Lettuce 
 
 Onions 
 
 Rhubarb 
 
 Spinach 
 
 Squash 
 
 Tomatoes 
 
 77-7 
 
 75.6 
 8i.i 
 80.5 
 78.9 
 56.6 
 
 92-3 
 44.2 
 
 94-3 
 
 1.4 
 
 '0.9 
 
 0.7 
 
 I.O 
 
 1.4 
 0.4 
 
 2.1 
 0.7 
 0.9 
 
 0.2 
 O.I 
 0.2 
 0.2 
 
 0.3 
 0.4 
 
 0.3 
 0.2 
 0.4 
 
 4.8 
 2.6 
 2.6 
 2-5 
 
 8.9 
 
 2.2 
 3-2 
 
 4-S 
 3-9 
 
 190 
 60 
 
 95 
 100 
 100 
 
 The young vegetable has a bitter flavour, and is more 
 digestible than an old one. As age advances they become 
 tough and stringy from the increase in cellulose. They 
 should be eaten fresh, for, owing to the large quantity of 
 water which they hold, they soon dry when stored, and so 
 lose their freshness. Celery and winter cabbage are excep- 
 tions, as they may be kept for weeks. Before use they 
 should be carefully cleaned, not only by removal of dead and 
 
100 THE BOOK OF DIET. 
 
 decaying parts, but by careful washing and soaking in 
 salt and water, the latter to kill any embryos of tape- 
 worms, etc. 
 
 Vegetables as a whole are not very easily digested on 
 account of the large amount of cellulose. In the process of 
 cooking, vegetables gain much water and lose some of the 
 carbohydrates and proteins, and much of their salts. As the 
 nutritive value and digestibility of vegetables depend largely 
 on their careful cooking — and special attention should be 
 directed to this — a short account of the best methods of 
 preparation is given later (p. 385). 
 
 Artichokes, Green. — A cultivated thistle. The heads are cut before 
 they expand. They are eaten either boiled or raw with salt and pepper. 
 The vegetable contains tannin, and is easily digested ; but has a curious 
 flavour, and is not in common use. 
 
 Asparagus is considered a great delicacy, and was even cultivated by 
 the Romans. There are two varieties, white and green ; the green is 
 probably the finer. This vegetable possesses a very delicate flavour, and 
 is much appreciated by invalids. The seeds are sometimes used on the 
 Continent instead of coffee. The ingestion of asparagus has a diuretic 
 effect, largely increasing the quantity and imparting a strong and dis- 
 agreeable odour to the urine. It appears within one hour after it is 
 eaten, and may persist from twelve to twenty hours. It is due to a 
 sulphur product, which is formed in the intestine during digestion and 
 is excreted by the urine. 
 
 Cabbages. — There are many varieties, but they all contain a large 
 quantity of sulphur, which tends to cause flatulence ; hence they are not 
 suitable for invalids. When fresh and tender, cabbage is a wholesome 
 food for the healthy, and has decided antiscorbutic properties. When 
 young they can be eaten raw with vinegar. They may be used in broth, 
 or boiled and made into a pur^e. 
 
 Cauliflower is the flower of a variety of cabbage grown large and 
 tender by cultivation. It is one of the most easily-digested green 
 vegetables. It is boiled and eaten with white sauce or cheese sauce ; 
 or, if shredded down and dressed with vinegar and oil, it can be added 
 to salad, and it is also used as a pickle. Broccoli is a variety of cauli- 
 flower, but is inferior in flavour. 
 
GREEN VEGETABLES. loi 
 
 " Greens'' or kale, have open heads of leaves. German greens are 
 the most delicate. They should be boiled and mashed like cabbage. 
 
 Seakale are the tender young sprouts of the sea cabbage grown in the 
 dark, so that there is no chlorophyll. The presence of the green colour- 
 ing matter gives a disagreeable acrid taste. When properly cultivated 
 they are as easy to digest as the cauliflower. 
 
 Brussels sprouts are clusters of leaves resembling miniature cabbages 
 growing in the axils of the main leaves. They are very nice when 
 thoroughly cooked. 
 
 Savoy is another variety of cabbage. 
 
 Sauerkraut, a German dish. The leaves of the white cabbage, when 
 fully grown, are taken out, layers of salt laid between them and pressed. 
 This bruises the leaves and squeezes out the juice ; it is then set aside 
 until fermentation commences. It is generally eaten boiled, like fresh 
 
 Celery is much cultivated for the blanched leaf-stalks or for the root. 
 It is eaten raw, alone or in salad. It may be cooked in milk and used 
 as a vegetable, or used in the flavouring of soup. It can also be made 
 into a pur^e and used as celery cream. 
 
 It is not easily digested, but its aromatic flavour makes it very 
 popular. Celery salt and celery seeds are much used as flavourings. 
 It has a great reputation for rheumatism ; the reason for this is not 
 quite clear. 
 
 Cucumbers are mainly eaten raw ; they are generally used in salad. 
 Immature young cucumbers are pickled as gherkins. Cucumber may be 
 cooked and served in the same way as vegetable marrow, and is then 
 easily digested. 
 
 Melon is more of a fruit, but it belongs also to the cucumber family. 
 It is more a drink than a food, since the solids only amount to $ per 
 cent. The juice of the water-melon makes an agreeable cooling drink. 
 Melons are eaten raw either with sugar or with ginger and pepper. The 
 seeds of the Indian melon (kaukoor) contain a great deal of starch and 
 vegetable fat ; they are ground into meal. 
 
 Gourds. — ^Vegetable marrow is the best-known member of this group 
 in the British Isles. The pumpkin is a large-sized variety, and so is the 
 squash. Marrow is a succulent, wholesome vegetable with an ^reeable 
 flavour. It may be baked, boiled, or stuffed, or made into preserves. 
 It is an easily digested vegetable. 
 
 Onion family are all nutritious, containing a quantity of nitrogenous 
 material, also sugar, with a pungent oil rich in sulphur, to which they 
 
102 THE BOOK OF DIET. 
 
 owe their pungency and smell. The parts used are the bulb, young 
 leaves, and seedlings. 
 
 Onions when scalded — that is, covered with boiling water and a pinch 
 of salt — are not nearly so strong in flavour as unscalded ones. Boiling 
 makes them much milder in taste than when raw. Onions are valuable 
 as blood-purifiers. They are edible as fresh vegetables — for example, 
 spring onions in salads— and after long keeping are useful as flavouring 
 agents for salads, stews, soup, etc. There are a good many varieties. 
 
 The onion proper is of two sizes — the strong, small onion, largely used 
 for flavouring, and the Spanish onion, much milder in flavour. Syboes 
 are the young seedlings, and are much esteemed for soups and stews. 
 Shallot or eschalot is a delicate onion with a strong taste, but wanting 
 the pungent smell of onion. Chives, a smaller variety, where the leaves 
 and bulb are also both used. 
 
 All onions impart a strong typical odour to the breath. It appears in 
 two or three hours, and may persist for twenty-four hours or more. 
 This is due to a volatile substance absorbed by the blood from the digestive 
 tract and excreted by the lungs. 
 
 Garlic belongs to the onion femily, but instead of having a bulb it is 
 composed of small bulbs known as "cloves." In Spain it forms part of 
 every dish, and is very nutritious. Used as a condiment it is stimulant 
 and tonic, and aids digestion. Garlic odour is due to oil of garlic, 
 which is a sulphide of allyl, found also in watercress and radishes. 
 
 Rhubarb is composed of the stems of the leaves, and is used more as 
 a dessert, being eaten with sugar and cream. Its flavour is tart. Cook- 
 ing renders it soft and easily digested. It tends to produce calcium 
 oxalate in the urine when eaten to excess, and it is not good for gouty 
 and rheumatic people. 
 
 Salad vegetables (lettuce, endive, cress, green peppers, mint, tarragon, 
 parsley, chevril, borage, chive, horse radish, etc. ). This is a group of 
 vegetables, lettuce being the chief type, the leaves of which are eaten 
 raw. These are not very easily digested ; they are cooling, anti- 
 scorbutic, nutritious, and gently laxative. They furnish a pleasant 
 variety during a meal. They are usually eaten with oil and vinegar, or 
 some other salad dressing. Some of these salad vegetables are used for 
 pickles and relishes, as well as for salad. They stimulate the digestive 
 secretions and give a fillip to the appetite. 
 
 Spinach is a favourite vegetable, but contains practically no nourish- 
 ment. If the leaves are young and tender, and if they are cooked until 
 they are quite soft and then rubbed through a sieve, it is a very easily 
 
GREEN VEGETABLES. 103 
 
 digested vegetable. " Beet tops," turnip tops, and dandelion leaves can 
 all be used in the same way as spinach. 
 
 Tomato, although a fruit, is generally used as a vegetable. It is 
 becoming very much appreciated. It may be eaten ravf with green 
 salad vegetables, or alone with pepper and salt ; it can be baked, fried, 
 stuffed, and used in innumerable ways. The skin should be avoided, 
 the pulp only being eaten. As a flavouring agent, such as tomato 
 sauce, tomato ketchup, tomato beans, an enormous amount of tomatoes 
 are canned every year. They retain more of their original flavour than 
 do most other vegetables treated in this way. Eggplant is allied to the 
 tomato, but contains many seeds and is not so easily digested. 
 
IV. 
 BEVERAGES AND STIMULANTS, 
 
 WATER. 
 
 Spirits. 
 
 Daily Requirements. 
 
 Deficiency of Water a Common 
 
 Whisky. 
 Brandy. 
 
 Dietetic Error. 
 
 Rum. 
 
 Drinking Waters. 
 
 Gin. 
 
 Liqueurs. 
 Malt Liquors. 
 
 WINE. 
 Red Wines. 
 
 Aerated and Mineral 
 Waters. 
 
 Natural Mineral Waters. 
 
 
 White Wines. 
 
 TEA. 
 Composition of an Infusion. 
 
 General Composition of Wines. 
 Alcohol in Wine. 
 
 COFFEE. 
 
 Acids in Wine. 
 Sugar in Wine. 
 
 COCOA. 
 
 Ethers in Wine. 
 
 Chocolate. 
 
 THE USE OF ALCOHOL 
 
 ALCOHOL. 
 
 IN HEALTH AND DISEASE 
 
 General Effects. 
 
 In Acute Diseases. 
 
 Nature, Source, and Varieties. 
 
 In Chronic Diseases. 
 
 4a 
 
Chapter IV. 
 BEVERAGES AND STIMULANTS. 
 
 Water — Aerated Waters — Tea, Coffee, Cocoa — 
 Alcohol. 
 
 WATER. 
 
 Water is indispensable to life. About two-thirds of the 
 total body weight is composed of water, and water also 
 enters largely into the composition of all food-stuffs. It is 
 useful as a solvent, carrying nutrient material to the tissues 
 and effete material to be eliminated by the kidneys and skin. 
 Daily Requirements, — On an average about four pints of 
 water may be taken as the daily requirements of the tissues, 
 of which about one-fourth is ordinarily taken in solid food. 
 The best way of supplying water to the body is by drinking 
 it in its pure state, when its useful solvent and eliminant 
 properties can be fully utilized. The amount of water 
 required daily in fluid form varies with the amount of loss 
 by the excretory organs — skin, kidneys, and lungs ; and this 
 in turn depends to an important extent on the outside 
 temperature, on the amount of muscular activity, and on the 
 nature of the food. In hot weather there is a free 
 diaphoresis, and more fluid is called for ; whereas in cold 
 weather the skin is less active, and less fluid is necessary. 
 
io8 THE BOOK OF DIET. 
 
 Active muscular exercise promotes diaphoresis and diuresis, 
 hence abundance of fluid is desirable. If the diet is a solid 
 and dry one, and rich in nitrogen, more water is necessary 
 in order to eliminate the extra amount of urea and other 
 nitrogenous products ; whereas, if vegetables and fresh fruit 
 enter largely into the dietary, less water is required. 
 Natural foods which are specially rich in water are milk and 
 succulent fruits, such as grapes, oranges, melons, and plums ; 
 also vegetables, such as cucumbers, tomatoes, and salads. 
 All vegetables contain more water than meats, and fresh 
 fruits as a rule contain more water than vegetables. 
 
 Deficiency of Water a Common Dietetic Error. — One of 
 the commonest dietetic errors is taking too little water. It 
 is important to bear in mind that many patients are willing 
 to take water in the form of a table water, who will not 
 readily take it in the form of ordinary drinking water. 
 
 Drinking waters are spoken of as hard and soft, according 
 to the proportion of mineral matters present in the water. 
 Hard water contains excess of lime salts, the drinking of 
 which may induce constipation, indigestion, and disturbance 
 of the general health. By boiling the water its hardness, 
 which is due to the presence of earthy carbonates, is 
 diminished, as the carbonic acid, which assists in holding 
 the carbonates in solution, is driven off. Boiling is also the 
 most effective way of ridding the water of organic impurities. 
 Boiled water when cooled has an insipid taste, but this may 
 be largely got rid of by subsequent aeration in a gazogene, 
 or by simply shaking up the water with air in a stoppered 
 bottle. 
 
 As a general rule, it may be said that at least one and a 
 half to two pints of pure water should be taken daily. This 
 amount, it may be added, is considerably in excess of that 
 taken by the average man. A useful method of prescribing 
 
AERATED AND MINERAL WATERS. 109 
 
 water is to give a full tumblerful of hot or cold water on an 
 empty stomach — (a) the first thing in the morning ; (6) an 
 hour before the midday meal ; and (c) the last thing at night. 
 
 Aerated and Mineral Waters. 
 
 Artificial aerated waters are made by charging water with 
 carbonic acid gas at high pressure. The chief varieties of 
 artificial aerated waters are as follows : — 
 
 1. Aerated distilled water — for example, salutaris water. 
 
 Here all the mineral substances have been removed 
 by distillation prior to being charged with gas. 
 
 2. Ordinary water impregnated with carbonic acid gas. 
 
 3. Alkaline waters, such as soda, potash, or lithia water. 
 
 These contain on an average from five to ten grains 
 of alkaline salt to the bottle. 
 
 4. Seltzer water, an imitation of the natural mineral 
 
 water of Seltzer (in Nassau). This contains common 
 salt, bicarbonate of soda, carbonate of magnesia, and 
 hydrochloric acid. 
 
 5. Sweetened waters, such as lemonade, ginger beer, 
 
 ginger ale, and the Uke. It is important to note 
 that these are very acid drinks, and also rich in 
 sugar. They should be avoided by gouty and 
 rheumatic subjects. 
 
 Natural Mineral Waters. — Mineral waters are frequently 
 taken as substitutes for ordinary water. They differ from 
 ordinary water in the greater amount of gaseous and solid 
 matters they contain. The gaseous constituents are mainly 
 carbonic acid gas, and in much lesser degree sulphide of 
 hydrogen ; the solid constituents are salts of sodium, 
 potassium, magnesium, aluminium, iron, iodine, bromine, 
 chlorine, and sulphur. Some waters have a purgative action, 
 
no THE BOOK OF DIET. 
 
 others a laxative, and others a diuretic effect, according to 
 their composition. For ordinary table use a water must not 
 contain more than i per cent, of mineral matter, otherwise 
 the specific effect of the saline ingredients present may be 
 obtained. 
 
 The natural mineral waters most largely used as table 
 waters in this country are Apollinaris, Johannis, Seltzer, 
 Kronthal, St. Galmier, and Vichy (Celestin). These are all 
 alkaline, well-aerated waters, containing carbonate of lime 
 and soda, and also sodium chloride. 
 
 TEA. 
 
 Tea is a preparation made from the leaves of the young 
 shoots of an evergreen plant — Thea. It is grown chiefly 
 in China, India, and Ceylon. The chief ingredients of tea 
 are caffeine, tannin, and traces of volatile oils. The average 
 composition of tea may be given as follows : — 
 
 Caffeine 
 
 2 to 4 per cent. 
 
 Tannic acid 
 
 ... 10 to 12 „ 
 
 Volatile oils 
 
 \ „ 
 
 As a general rule, China teas have a delicate flavour, with 
 little astringency ; Indian teas have more body and astrin- 
 gency ; Ceylon teas are also rich in caffeine, but not so 
 strong as Indian teas. Most ordinary teas are blends. 
 
 Composition of an Infusion. — As caffeine is very soluble, 
 all the cafifeine present is dissolved at once on the addition 
 of hot water. Tannin is much less soluble, the result being 
 that prolonged boiling increases the amount of tannin 
 present in the infusion. This is specially true of all the 
 cheaper teas. In some high-class China teas, costing 5s. 
 per pound, the proportion of tannin extracted may not be 
 appreciably greater after ten or fifteen minutes' infusion. 
 
TEA— COFFEE. iii 
 
 On an average it may be said that a teacupful of tea, 
 after a few minutes' infusion, contains about one grain of 
 caffeine to rather more than two grains of tannic acid. 
 Tea should be prepared with water that has just come to 
 -^he boil, and is best after three to five minutes' infusion. 
 If extracted too long it contains more than tannin, and a 
 greater proportion of bitter principles. It is important 
 that the water used should not be too hard or too soft. 
 Excessive hardness may be neutralized by adding a pinch of 
 soda to the teapot. A very soft water extracts more fully 
 the bitter principle from the leaves. 
 
 Tea is not a food, but a pleasant beverage which has a 
 stimulating effect on the nervous system. If made with 
 boiling milk, it possesses nutritive properties. It should not 
 be taken more than, at the most, twice daily, and always 
 freshly made. It is specially important to avoid taking tea 
 that has "stood" for some time. The habit of taking 
 "meat teas" is a bad one, as the tannin in the tea interferes 
 with the digestion of the meat. When taken to excess, tea 
 deranges the digestive, the cardio-vascular, and the central 
 nervous systems. Various symptoms of indigestion, excita- 
 bility, sleeplessness, anaemia, constipation, and rapid, feeble 
 pulse are the chief symptoms induced by excessive indulgence. 
 
 COFFEE. 
 
 Coffee is prepared from the seeds of Caffea arabica, the 
 seeds being stripped of their covering and dried, and 
 specially prepared by a roasting process, in which the berries 
 lose about 20 per cent, of their weight by water, and about 
 half the caffeine present in their composition. The roasting 
 process sets free a volatile oil which imparts the characteristic 
 aroma of coffee. After grinding, this volatile oil tends to 
 
112 THE BOOK OF DIET 
 
 disappear, hence the importance of using freshly-ground 
 coffee. 
 
 When coffee is made by infusion in the ordinary ways of 
 this country, there is extracted about 20 per cent. To 
 obtain the full strength of the coffee the example of the East 
 should be followed, and the beverage prepared by infusion 
 and decoction combined. When so prepared, coffee shoul^ 
 yield fully one-third of its weight of extract. Like tea, coffee 
 is not a food, except for the milk and sugar added to it. As 
 ordinarily prepared, the amount of caffeine and tannin in a 
 cup of coffee is very similar to that in a cup of tea. The 
 most common adulterant is chicory (see p. 171), and many 
 people prefer coffee with a chicory flavour. It differs from 
 coffee in having very little caffeine, tannin, or volatile oil ; 
 and is much richer in sugar, having over 10 per cent, of 
 sugar, whereas ground coffee has less than i per cent. 
 There are now some wonderful substitutes used by vege- 
 tariano who object to the stimulating effects of the active 
 principle of tea and coffee. These are prepared by roasting 
 and grinding various cereals. They strongly resemble coffee 
 in appearance and flavour, and are good beverages. 
 
 COCOA. 
 
 Cocoa is prepared from the seeds of Theobroma cacao, 
 deprived of their outer pulp and roasted, in which form, as 
 in the coffee bean, the starch of the seed is changed into 
 dextrin. The peculiar aroma is due to a volatile oil. The 
 striking feature in its composition is the high percentage of 
 fat. It is also rich in starch and albuminous matter. The 
 cocoa when roasted and broken into bits is known as 
 "cocoa nibs." A pleasant drink can be made by boiling 
 the nibs in water for several hours, and straining. This can 
 
ALCOHOL. 113 
 
 often be taken by patients who cannot take ordinary com- 
 mercial cocoa. In many commercial cocoas there is a large 
 addition of sugar and starch. If starch is added, the cocoa 
 must be prepared for use by boiling for a few minutes ; but if 
 sugar is added to the cocoa, the cocoa only requires the 
 addition of boiling water or milk. By reason of its richness 
 it is not a suitable drink for people with weakened digestion. 
 Peptonized cocoas are excellent nourishing drinks. Savory 
 and Moore and Allenbury supply good brands. 
 
 Chocolate is cocoa to which have been added starch, sugar, 
 and flavouring substances, generally vanilla. It contains 
 about 1.5 of theobromine, 15 per cent, of fat, about 60 per 
 cent, of sugar, and 5 per cent, of nitrogenous substances. 
 
 ALCOHOL. 
 
 The desire for a stimulant of some kind other than that of 
 food is practically universal. There are no civilized and few 
 uncivilized or semi-civilized people, with the exception of 
 Mohammedans, Buddhists, and Northern Eskimos, who do 
 not practise the distillation of alcohol in some form or other 
 from the materials most available. Thus in Lombardy 
 alcohol is made from potatoes, and in Japan from rice. 
 The preliminary excitation of the central nervous system 
 induced by alcohol is followed by a diminished excitability, 
 which renders the person under its influence less conscious 
 of unpleasant conditions affecting either his body or mind, 
 and imparts a sensation of general well being and comfort 
 that is the foundation for the long-established use of alcohol 
 as a beverage. 
 
 It will be convenient to consider the subject in the 
 following order : (a) the general effects of alcohol ; (d) the 
 nature and source of alcohol, and the composition of 
 
114 THE BOOK OF DIET. 
 
 different alcoholic beverages ; and (c) hints regarding the use 
 of alcohol in health and disease. 
 
 General Effects. — Alcohol is a general stimulant, small 
 doses exciting, larger doses paralyzing the nervous system, 
 beginning with the higher centres; it also stimulates the 
 heart and blood-vessels, accelerating the circulation, but not 
 notably increasing the force of the heart. In large doses the 
 blood-vessels are paralyzed, thus becoming dilated, resulting 
 in a fall of the body temperature. 
 
 When taken in moderate amount, alcohol is completely 
 oxidized — that is, burnt up in the tissues; when taken in 
 larger amounts, it escapes unoxidized with the breath and 
 urine. Liebig, the renowned chemist, states that nine quarts 
 of the best ale contain as much nourishment as would lie on 
 the end of a table-knife. We must, therefore, conclude that, 
 when judged by the requisite standards, alcohol cannot be 
 regarded as a food. It may be true that in very acute illness 
 a patient may live for some days on nothing but large 
 quantities of whisky, brandy, or champagne, and may 
 apparently not emaciate in that time as much as he would 
 have done if he had been living merely on his own tissues ; 
 but even if this be so, it does not justify us in regarding 
 alcohol as in any real sense a food. 
 
 A further effect of alcohol has to be noted — namely, 
 alcohol as a cause of deficient oxidation of tissue. In 
 virtue of its affinity for oxygen, it interferes with the process 
 of oxidation in the tissues, and so leads to fatty degeneration 
 and infiltration of the tissues. Hence the obesity observed 
 in many subjects who take alcohol to excess. 
 
 Nature, Source, and Varieties. — Alcohol is obtained from 
 fermentation of grape-sugar by means of yeast. The source 
 of the grape-sugar is grain, especially barley, grapes, and in 
 some instances potatoes — the different kinds of alcoholic 
 
ALCOHOL. 115 
 
 liquors obtained depending to some extent on the particular 
 kind of sugar, and also the special yeast employed. The 
 various by-products in the process of fermentation also 
 materially influence the nature of the product. The strength 
 of alcoholic liquors is usually expressed as the percentage of 
 alcohol by volume, the percentage of alcohol by volume in 
 some of the commoner alcoholic beverages being roughly as 
 follows : — 
 
 Whisky"! 
 
 Brandy r 
 
 Rum } 
 
 Gin 
 
 Port 
 
 Sherry 
 
 Champagne 
 
 Hock 
 
 Claret 
 
 Bottled beer 
 
 Lager 
 
 We have to consider shortly the three different classes of 
 alcoholic beverages — spirits, malt liquors, and wines. 
 
 Spirits. — Spirits are obtained by distillation of the products of 
 fermentation of different saccharine (sugary) substances, the alcohol and 
 various volatile substances being separated by distillation. Distillation 
 of malted barley furnishes whisky, malted grape yields brandy, and 
 malted molasses give rum as a distillation product, the flavour in each 
 instance being due to the by-products of fermentation. The by-products 
 can be entirely removed by means of patent stills, leaving an almost 
 pure spirit known as silent spirit, so called because its source cannot be 
 traced. Amongst the by-products of fermentation there are alcohols in 
 a higher series, a mixture of which is known as fusel oil (amyl alcohol). 
 Fusel oil is the last product of distillation, and is formed especially when 
 spirit is made from grain or potatoes instead of malt. It should be 
 noted that all spirits are free of sugar, and all have a very low degree of 
 acidity. 
 
 .. 43 per 
 
 C( 
 
 •■ 35 
 
 
 .. 25 
 
 
 21 
 
 
 10-15 
 
 
 .. 10 
 
 
 •• 9 
 
 
 7 
 
 
 •• 4 
 
 
Ii6 THE BOOK OF DIET. 
 
 Whisky. — Whisky is a spirit made from malt, or malt and grain 
 It is of two kinds — malt whisky, made in pot stills, and grain whisky, 
 made in patent stills, ordinary whisky being usually a blend of the two. 
 In the case of malt whisky the by-products of distillation give the 
 whisky a raw and disagreeable taste ; this, however, gradually mellows, 
 the percentage of alcohol diminishing by 5 to 8 per cent, in the course 
 of a few years. Irish malt whisky differs from Scotch whisky in being 
 prepared from a mixture of malted barley with unmalted grain, the malt 
 not being dried over peat, as in the manufacture of Scotch whisky. 
 
 Grain whisky is made from a mixture of grains — barley, rye, and 
 maize — ^with a little malt to convert the starch into sugar. It is distilled 
 in patent stills in order to separate to a large extent the by-products of 
 fermentation, including fiisel oil. Its method of manufacture makes it 
 soon ready for use, and, unlike malt whisky, it does not improve on 
 keeping. Most commercial whiskies are blends of malt and grain 
 whisky. In recent years the introduction of patent stills and the 
 extended scale of manufacture have led to an increase in the amount of 
 potato and grain spirit, and it is in these spirits, made from unaltered 
 starch, that fusel oil is specially found. The legal limit for dilution of 
 whisky is 42.7 alcohol by volume. 
 
 Brandy. — Genuine brandy is a product of the grape, and is prepared 
 from the distillation of wine. Good brandy improves on keeping, due 
 to the formation of the volatile ethers. Most commercial brandies, 
 however, are not genuine brandies, but are made from silent spirit, the 
 product of potato or grain coloured with burnt sugar, and flavoured by 
 special essences in imitation of genuine brandy. The alcoholic strength 
 of brandy and whisky are the same — namely, 43 per cent. Good malt 
 whisky is more likely to be pure than brandy, and it has the advantage 
 of being much cheaper. 
 
 Bum is the product of distillation of fermented molasses obtained in 
 the manufacture of raw sugar, the by-products of fermentation giving 
 rum its characteristic flavour. The best varieties are made from fermen- 
 tation of the juice of sugar cane. Much of the commercial rum is 
 made, as in the case of brandy, from silent spirit flavoured with special 
 essences, the colour being imparted to it by the addition of burnt sugar. 
 The alcoholic strength of rum is rather greater than that of whisky — 
 from 50 to 60 per cent, by volume. 
 
 Gin is a product of fermentation of a mash of rye and malt, and 
 distillation of the product ; juniper berries, a little salt, and occasionally 
 hops being added in the final distillation. Genuine gin is made in 
 
ALCOHOL. 117 
 
 Holland. Much of the commercial gin is made, as in the case of brandy 
 and rum, from silent spirit, flavoured with juniper berries, salt, 
 turpentine, etc. The legal strength of gin is 37 per cent, by volume, 
 the usual strength being about 50 per cent. A sweetened and diluted 
 gin goes by the name of "Old Tom." Unlike other spirits, it is not 
 coloured by the presence of oil of juniper or similar oils, which cause a 
 railkiness when diluted with water, since they are insoluble in water. 
 The oil of juniper gives gin distinct diuretic properties, the excretion of 
 urine being notably increased. 
 
 Liqueurs are liquid spirits which essentially consist of very strong 
 spirits sweetened with cane sugar, flavoured with aromatic or other 
 herbs or essences, and often brightly coloured by vegetable colouring 
 agents. The proportion of alcohol in them is high, ranging from 35 to 
 over 55 per cent. ; they are usually rich in sugar, such liqueurs as 
 Chartreuse, Kiimmel, Anisette, and Benedictine containing about 30 
 per cent, of cane sugar. Absinthe is a yellowish-green liquid con- 
 taining a poisonous oil which has a deleterious effect on the nervous 
 system. It contains about 50 per cent, of alcohol, and from i to 2 per 
 cent, of sugar. 
 
 Malt LiQUOrs. — Beer is the product of fermentation of malt (barley) 
 with hops. In the preparation of most commercial beers, however, 
 cheaper substitutes for malt are employed. These include potatoes, 
 maize, and rice. The yeast fungus lives upon sugar, converting 
 ordinary sugar into fermentable sugar, and then decomposing part of 
 the latter into alcohol, giving off carbonic acid gas in the process. 
 Only a part of the sugar originally present in the solution is converted 
 into alcohol, since the yeast plant is killed where the proportion of 
 alcohol rises above a certain point. The quality of beer depends largely 
 on the temperature at which the "mashing" is carried out — the higher the 
 temperature the greater the proportion of malt sugar in the beer ; also on 
 the temperature at which the fermentative process is conducted. As this 
 is usually high, most of the sugar is broken up, and beer is, therefore, 
 fairly rich in alcohol. In Germany the fermentation is carried out at 
 a lower temperature, with the result that German beers contain less 
 alcohol and more carbonic acid. A light beer is one which contains 
 more malt and less hops, and in its preparation the malt is dried at a 
 higher temperature. Some beers — for example, India pale ale — are 
 very thoroughly fermented, and therefore contain very little sugar. 
 The essential substances in beer are four in number — alcohols, sugars, 
 free acids, and bitters. The proportion of alcohol varies from about 2 
 
ii8 THE BOOK OF DIET. 
 
 to 7 or 8 per cent., the latter strength being that of some stronger 
 British beers— for example, Bass's and M'Ewan's. If beer or other 
 alcoholic liquors produced by fermentation are exposed to the air, further 
 oxidation takes place, part of the alcohol being changed into acetic acid 
 under the influence of the acetic acid bacillus. 
 
 Stout and porter are made in the same way as beer, but the malt is 
 first subjected to a roasting process, which induces the formation of 
 caramel, to which the colour is due. Caramel is added artificially in 
 the preparation of many commercial liquors. Porter is a mixture of 
 dubious composition, containing often liquorice, treacle, linseed, etc. 
 
 On an average, it may be taken that the chief ingredients of a pint 
 (20 ounces) of good bottled beer are as follows : — 
 
 Alcohol ... I fluid ounce. I Free acids ... 25 grains. 
 Extract ... I to 2 ounces. [ Salts 13 
 
 Common salt is sometimes added to beer to induce thirst, and sugar 
 to increase the head of beer and give an appearance of fuller body. 
 
 WINE. 
 
 Wine is (or should be) the product of the juice of the 
 grape by fermentation. When so prepared it is an alcoholic 
 solution varying in strength from 6 to 25 volumes per cent., 
 and containing flavouring and other substances. The chief 
 chemical constituents of the juice are sugar, for fermentation 
 of alcohol ; organic acids or their salts, chiefly of tartaric, 
 citric, or malic acid ; and albuminous substances. The 
 stones or seeds furnish essential oils, which are largely 
 responsible for the bouquet of wines, and the skins and 
 stones furnish pigment and tannin. The quality of wine 
 depends on the amount of sugar and albumin in the juice. 
 In the process of fermentation the yeast germs split up the 
 sugar, with the formation of alcohol. If there are a small 
 amount of the sugar and a large amount of albumin in the 
 juice, fermentation goes on till all the sugar is split up. 
 This furnishes a dry wine with a slightly acid taste — for 
 example, hock. If, on the other hand, there is a large 
 
WiNfi. 119 
 
 aitiount of sugar and a much smaller amount of albumin, the 
 fermentation is less complete ; some sugar is left in the wine, 
 as in " sweet wines.'' When, as a result of fermentation, the 
 proportion of alcohol has risen to 15 per cent, by volume, 
 the process of fermentation is arrested by the alcohol ; hence 
 a natural wine never contains more than 1 5 per cent, alcohol. 
 Wines are often fortified by the addition of spirit. This has 
 the twofold effect of adding to their strength and preserving 
 them from further fermentation, and so preventing the produc- 
 tion of the acetic and other acids which make the wine sour. 
 
 The natural salts in the juice of the grape consist largely 
 of cream of tartar, which is often deposited as a crust in 
 bottles and casks. The presence of lime in wines is largely 
 due to the process of "plastering." A natural wine is 
 muddy in colour, and in order to improve the appearance, 
 making it transparent, plaster of Paris (sulphate of lime) is 
 added. This has the effect of removing the impurities ; at 
 the same time some sulphate of lime is left, and this is 
 an insoluble salt, and its presence is partly responsible for 
 the gout-producing properties of some wines. Good wines 
 improve on keeping : the tannin is deposited, leaving the 
 wine light in colour ; the proportion of sugar diminishes, 
 making the wine less sweet ; the volatile ethers increase at 
 the expense of the tartaric acid, so that the wine becomes less 
 acid. Wine that has been long in bottle becomes "corked," 
 due to the action of a mould which penetrates from without. 
 
 Many of the cheap wines imported into this country are 
 artificial, being made from cider and ordinary potato and 
 grain spirit, flavoured with oenanthic ether, and coloured by 
 aniline dyes or by vegetable extracts such as madder, beet- 
 root, or logwood. 
 
 For the detection of these impurities, elaborate schemes 
 are given in analytical works. 
 
lao THE BOOK OF DIET. 
 
 Red Wines. — Dark grapes are used in the making of red 
 wines, the skins and stones being left to ferment with the pulp, 
 to which they yield tannin, pigment, and extractives. The 
 average composition of red wines may be taken as follows : — 
 
 Alcohol 
 
 .. 8 to II per cent. 
 
 Acids 
 
 .. 0.5 to 0.65 ,, 
 
 Sugar 
 
 0.5 
 
 Tannin and pigment 
 
 .. 0.1 to 0.2 
 
 White Wines are usually made from white grapes. They 
 are produced in great variety, and they have, as a rule, a 
 rather higher percentage of alcohol than red wines. 
 
 General Composition of Wines. — The important ingre- 
 dients in wines are the following : — 
 
 Alcohol, Sugars, 
 
 Acids, Ethers. 
 
 Alcohol in Wine. — The amount of alcohol (ethylic) 
 present in wines ranges from 8 to 11 per cent., or more in 
 fortified wines — for example, port. All natural wines are 
 comparatively poor in alcohol, and thus readily undergo the 
 acetic fermentation, and so becoming sour. A fortified 
 wine, therefore, keeps better, subsequent fermentation being 
 restrained. Amyl alcohol and other higher alcohols are 
 present in traces even in sound wines. As is invariably the 
 case when alcohol is formed by fermentation, carbonic acid 
 gas is given off, and if a wine is bottled when this action is 
 all over, the product is a " still wine;'' if, on the other hand, 
 the wine is bottled, like beer, before the fermentation is 
 quite over, then the liquor becomes charged with carbonic 
 acid gas, which effervesces or liberates, producing a 
 "sparkling" wine. Sparkling wine may also be made on the 
 principle of aerated waters, by passing carbon dioxide into 
 the wine under pressure. 
 
WINE. 121 
 
 Acids in Wine. — In a good wine the total acidity should 
 be not more than .3 to .7 per cent The taste of a wine 
 cannot be regarded as a criterion of its acidity, as the acids 
 may be masked by a high proportion of sugar. The acidity 
 is due to natural acids and acids produced by fermentation. 
 The natural acids in wine are tartaric, tannic, and malic 
 acid. Tartaric acid exists in combination with potassium in 
 the form of potassium bitartrate. As the proportion of 
 alcohol in wine increases with age, the bitartrate becomes 
 less soluble, and settles out in the form of "tartar." The 
 tannic acid in wine is responsible for the astringent taste of 
 certain wines. 
 
 Acetic, formic, succinic, and other fatty acids are produced 
 in wines by fermentation. Red wines usually contain rather 
 more of these volatile acids than white wines. If present 
 in excess, the wine is slightly "turned" — that is, on its way 
 to become vinegar. 
 
 According to Dupre, the amount of acid, reckoned as 
 tartaric, in a bottle of wine is- as follows : — 
 
 Claret ... 65 to 77 grains. I Sherry ... 54 to 6 1 grains. 
 Hock ... 571070 „ I Port ... 491062 „ 
 Marsala 39 to 46 grains. 
 
 Sugar in Wine. — A natural wine should contain about 
 J per cent, of sugar. Fortified wines may contain 2 per cent, 
 or more, and sweet wines as much as 20 per cent. The 
 following analysis is given by Dupre : — 
 
 Hock ... 
 
 1.4 to 8.6 
 
 grains per bottle. 
 
 Claret... 
 
 .. II „ -8 
 
 »i 
 
 ,, 
 
 Sherry 
 
 .. 217 „ 421 
 
 i» 
 
 f» 
 
 Port ... 
 
 .. 221 „ 519 
 
 i> 
 
 ft 
 
 Old Marsala .. 
 
 . 388 „ 451 
 
 »i 
 
 »i 
 
 Sauterne 
 
 .. 125 grains per 
 
 bottle. 
 
 
 Champagne . . 
 
 . . 5CX} grains down to almost none. 
 
122 THE BOOK OF DIET. 
 
 Ethers in Wine. — The ethers present in wine impart to 
 it its bouquet. The volatile ethers are derived from the 
 volatile acids — for example, acetic acid ; the fixed ethers are 
 the product of the fixed acids — for example, tartaric acids. 
 
 As already stated, wines are divided into two great classes, 
 natural wines and fortified wines. The chief natural wines 
 are claret, hock, and the Hungarian, Italian, Australian, and 
 Californian wines ; the principal fortified wines being port, 
 sherry, Marsala, Madeira, and, as a rule, champagne. A few 
 short notes on these various wines are appended, attention 
 being chiefly directed to the points of practical importance 
 from the medical point of view — namely, the proportion of 
 alcohol, sugar, and acid present in each. 
 
 Claret. — A natural wine containing from 8 to 13 per cent, of alcohol, 
 about \ per cent, of sugar, and about \ per cent, of acid. 
 
 Burgundy. — Similar to claret, rather higher percentage of alcohol as 
 a rule, and richer in extractives, and has, therefore, more body. Chablis 
 is a white Burgundy made from white grapes. 
 
 Hock. — Similar alcoholic strength to claret ; only traces of sugar, and 
 acidity about the same as claret ; very small amount of acetic acid ; good 
 keeping qualities. 
 
 Hungarian Wines. — Two varieties — red and white; alcoholic strength 
 as in claret ; almost free of sugar. 
 
 Italian Wines. — Red and white ; rather low percentage of alcohol 
 and relatively high acidity. 
 
 Californian and Australian Wines. — Full-bodied natural wines ; red 
 and white variety. 
 
 Port. — A fortified wine, containing from 15 to 20 per cent, of alcohol ; 
 full of body, on account of large amount of extractives ; relatively low 
 acidity, but good deal of tannic acid, which diminishes with age. Rich 
 in sugar (from I to 6 per cent.), giving a strong, dry wine or strong, 
 sweet wine respectively. 
 
 Sherry. — The white wine of Spain. A fortified wine ; percentage of 
 alcohol similar to port. Amount of sugar varies very greatly ; may contain 
 mere traces or as much as 4 per cent., giving a strong, dry wine or strong, 
 sweet wine respectively. Low acidity ; improves greatly with age. 
 
THE USE OF ALCOHOL. 123 
 
 Madeira. — Similar to sherry; rich in volatile ethers. Dry and sweet 
 varieties, as with port and sherry. 
 
 Marsala. — A Sicilian wine resembling sherry, but contains on an 
 average more sugar ; very slightly acid. 
 
 Champagne. — A fortified sparkling wine ; may be dry or sweet. Sugar 
 varies from nothing to 12 or 14 per cent. True dryness is the result of 
 age, and is due to a very slow conversion of sugar into alcohol ; in many 
 commercial preparations the "dryness" is attained artificially, and 
 really represents very varying degrees of acidity. Acidity, about \ per 
 cent. ; alcohol, about 10 to 12 per cent. 
 
 Cider and Perry. — Made from apple and pear respectively ; very 
 mildly alcoholic, 2 to 8 per cent. ; sugar, 2 to 6 per cent. ; slightly acid, 
 I to 5 per cent., chiefly malic acid. The more acid wines may contain 
 as much as 20 grains of tartaric acid per tumblerful. 
 
 Medicated Wines. — There are several varieties of " medicated wines " 
 in the market, such as "meat and malt wine," made from extract of 
 meat, malt extract, and sherry or port ; and " coca wine," made from 
 coca leaves and sometimes cocaine. The use of these wines is to be 
 strongly deprecated from every point of view. 
 
 So called British Wines — for example, ginger, currant wine, etc. — are 
 not wines at all, but made-up drinks, coloured and flavoured with 
 special essences. 
 
 TEE USE OF ALCOHOL IN HEALTH AND DISEASE. 
 
 Healthy people do not need alcohol, and are probably 
 better without it. When used in strict moderation, however, 
 and on appropriate occasions it adds to the pleasures of life, 
 and has no injurious effects on the tissues. But this raises 
 the question, What constitutes a strictly moderate quantity of 
 alcohol ? What constitutes the maximum amount of alcohol 
 that can be taken daily without injury ? Is it, for example, one 
 or two glasses of whisky or their equivalent ? No very precise 
 answer can be given to this question, because our sensations 
 are not a safe guide, and the tissues of a man who feels 
 perfectly well while taking what he thinks a strictly moderate 
 daily allowance, may be all the time undergoing insidious 
 
124 THE BOOK OF DIET. 
 
 injury. The statements of insurance authorities show 
 clearly that the mortality of total abstainers is considerably 
 less than that of temperate drinkers ; but this fact gives, of 
 course, no indication of what constitutes the harmless maxi- 
 mum for the average individual. In arriving at a decision 
 regarding the average amount of alcohol that may be taken 
 by a healthy individual, consideration must be given to the 
 following points : — 
 
 1. Alcohol acts more injuriously on the tissues of those 
 leading a sedentary life. 
 
 2. The purity or otherwise of the whisky, wine, or beer is 
 all-important, the injurious effects being proportionate to the 
 degree of rawness and adulteration, which is considerable in 
 many preparations. 
 
 3. The harmful effects of various alcoholic beverages 
 sometimes depends on the sugar and acids present, and not 
 on the alcohol. 
 
 4. The question of idiosyncrasy has to be considered : 
 some people cannot take certain wines or other liquors 
 without feeling the worse for it. 
 
 In deiining the term strict moderation, it may be laid 
 down that one glass of whisky, or a couple of glasses of port, 
 or a pint of pale ale or their equivalent are the maximum 
 daily allowance for a man in health. The habitual daily 
 consumption of alcohol in any form is, however, a mistake. 
 More harm to the individual results from the habitual indul- 
 gence in so-called moderation than by occasional indulgence 
 in rather larger quantities. 
 
 Reference has already been made to the importance of 
 drinking only good liquors. Raw and immature whisky, 
 adulterated wines, and malt liquors of very doubtful quality are 
 extensively sold, especially among the poorer classes, and are 
 largely responsible for many of the injurious effects of alcohol. 
 
USE OF ALCOHOL IN DISEASE. 125 
 
 A word may be added as to the proper time to take 
 alcohol. There is no doubt that, if taken at all, alcoholic 
 liquors should be taken with meals. The habit of drinking 
 between meals is to be deprecated. Drinking in the early 
 part of the day is a specially pernicious habit, and the man 
 who has a desire for an early morning drink is in reality a 
 dipsomaniac. 
 
 A remarkable change has occurred during the past twenty 
 years in the attitude of the medical profession on the ques- 
 tion of the value of alcohol in the treatment of disease. 
 Whereas formerly wines and spirits were largely used in 
 the treatment of many acute and chronic diseases, the 
 present tendency is more and more to discard alcohol in 
 the treatment of disease. This change in the custom of 
 the profession is very well shown by a reference to the 
 following figures. In the year 1890 the annual cost of 
 wines and spirits per occupied bed in the Royal Infirmary 
 of Edinburgh was 12s. io|d.— 10s. for spirits, and 2s. io|d. 
 for wines. In 1908 the annual cost was is. per head per 
 annum for spirits, and nothing for wines. 
 
 While the use of alcohol in the treatment of disease is 
 now very restricted, there is no question as to its undoubted 
 value in the treatment of certain diseases, more especially 
 in their critical stages. 
 
 There is little doubt that this restriction in the use of 
 alcohol has not been attended with any disadvantageous 
 results to such patients as would in former years have been 
 freely "stimulated." On the contrary, there is reason to 
 think that this alteration in the custom of the medical 
 profession regarding the use of alcohol in disease has been 
 a factor of some value in diminishing the number of those 
 who ultimately fall a victim to its effects. We must, at the 
 same time, recognize that alcohol is a very valuable thera- 
 
126 THE BOOK OF DIET. 
 
 peutic agent in the treatment of some diseased conditions. 
 These call for detailed consideration. 
 
 In Acute Diseases. — In certain acute fevers, such as 
 pneumonia, diphtheria, and the like, when the circulation is 
 distinctly failing, as shown by a rapid, weak, and irregular 
 pulse, the administration of alcohol in doses of i dram to 
 I ounce every two or four hours, according to the age of 
 the patient; is of great value. It should be noted, however, 
 that the proportion of cases of pneumonia which call for 
 its administration is a really small one. In the general run 
 of cases occurring in healthy subjects of non-alcoholic habits 
 ihere is no necessity to have recourse to stimulants. In 
 exceptional cases, however, and in those who have been 
 previously addicted to its use, the free use of stimulants is 
 necessary. Diphtheria is such a treacherous condition, and 
 the risks of establishing a habit from its use are here so 
 remote, that it is advisable to have recourse to the use of 
 stimulants if there is the least dissatisfaction with the general 
 state of the patient or the condition of his circulation. It 
 may be given in doses of i to 4 teaspoonfuls or thereby 
 every two or four hours, according to indications. In weak 
 elderly subjects suffering from bronchitis with congestion of 
 the lungs, and in elderly subjects with chronic heart disease, 
 a little whisky, brandy, or dry champagne is often of very 
 great value as a stimulant. It may have at the same time 
 a sedative effect on the nervous system, as it often tends to 
 promote sleep. 
 
 In Chronic Diseases. — Alcohol is sometimes of consider- 
 able value in cases of failure of digestive power, as indicated 
 by inability to take and enjoy food, as also in states of 
 general weakness. Here it may be given in the form 
 of a little whisky (J oz.), twice or three times a day with 
 meals ; or as a glass of dry champagne or other sound wine, 
 
USE OF ALCOHOL IN DISEASE. 127 
 
 given with luncheon and dinner. Great care is, however, 
 necessary in prescribing alcohol in these cases, more especi- 
 ally in the case of female patients suffering from general 
 nervous exhaustion, as these are so prone to become per- 
 manently addicted to its use. The use of all medicated 
 wines, elixirs, and the like cannot be too strongly deprecated. 
 A glass of beer or stout given with one meal daily for a 
 time is occasionally of distinct value, acting as a bitter tonic, 
 and at the same time supplying a relatively large amount of 
 nutriment in a fluid form. 
 
V. 
 
 CONCERNING MEALS. 
 
 Introduction. 
 
 Breakiast. 
 
 Lnneheon. 
 
 Afternoon Teas. 
 Dinner. 
 Meat Teas. 
 
Chapter V. 
 CONCERNING MEALS. 
 
 The number and nature of the meals partaken of by the 
 average man are very much a matter of habit. Customs 
 differ considerably in different races and also among different 
 classes of society. The system common in France and other 
 Continental countries may be described as a two-meal regime, 
 the Continental breakfast being an extremely light repast and 
 (scarcely ranking as a meal according to British standards. In 
 this country three meals a day may be regarded as the recog- 
 nized custom. The different systems in vogue may be shortly 
 represented as follows : — 
 
 French. 
 
 Breakfast. — A cup of coffee with one or two small rolls 
 and butter. 
 
 Dijeuner. — A substantial meal about midday. 
 Dinner. — A good dinner in the evening. 
 
 British. 
 
 In this country the custom varies with the social circum- 
 stances of the individual. The two chief systems are the 
 following : — 
 
 1. Breakfast; luncheon; tea (afternoon tea) ; dinner. 
 
 2. Breakfast; dinner; tea (a light tea, or a "meat tea"); 
 supper. 
 
132 THE BOOK OF DIET. 
 
 We shall have more to say presently with regard to the 
 question of tea, but in the meantime it may safely be afifirmed 
 that, under ordinary circumstances, the above represents the 
 maximum number of meals of any kind that should be taken 
 in the twenty-four hours by healthy individuals. As a matter 
 of fact, those who limit their meals strictly to three well- 
 selected meals are acting in the wisest way. 
 
 The habit of taking " early tea," on waking, is not to be 
 commended, although this is permissible and often advisable 
 in the case of elderly people. Another custom, which is only 
 mentioned to be condemned, is that of taking a snack in the 
 forenoon, between breakfast and lunch. This usually takes 
 the form of tea or milk and bread or cakes. It is note- 
 worthy that the people who are most prone to indulge in it 
 are those who have least need of extra sustenance, as the 
 habit is most frequently seen in those who have had a 
 substantial breakfast, consisting largely of animal food — ;for 
 example, ham and eggs. 
 
 A striking and useful lesson may be learned from a com- 
 parison of the immediate results observed in those who take 
 a light breakfast as contrasted with those who take a large 
 breakfast, including one or two courses of animal food. If, 
 for example, a man engaged in sedentary occupation takes 
 a breakfast containing a liberal supply of ham and eggs, or 
 a rich "two course" hotel breakfast at 8.30 a.m., in nine 
 cases out of ten he is hungry before twelve o'clock ; whereas, 
 if he takes a more frugal meal of porridge and cream or milk, 
 with a cup of tea and slice of toast — a diet which, to a super- 
 ficial observer, is much less " nourishing " — he is less hungry 
 at one o'clock than he is an hour earlier on the stronger 
 regime, and at the same time he feels generally lighter and 
 fitter for his morning work on the less stimulating meal. The 
 fact is that strong meat is stimulating, but the stimulus is 
 
POINTS IN DIET. 133 
 
 not necessarily a good one, as it begets the need for a fresh 
 stimulant. Exactly the same thing holds good with regard 
 to luncheon. The man engaged in sedentary occupation 
 who takes a large two or three course luncheon, with much 
 rich meat food, is more ready and anxious for the fresh stim- 
 ulus of afternoon tea or other stimulant, three hours later, 
 than the man who has taken a light lacto-vegetarian meal. 
 Confirmatory evidence of this is afforded by the experience 
 of the average Britisher who, for the first time abroad, makes 
 a trial of the Continental breakfast. He is surprised to find 
 that he feels fit and well all morning after a meal which is a 
 mere shadow of the breakfast which he has been accustomed 
 to take at home. All things considered, it may be affirmed 
 that a moderate breakfast, a light luncheon, and a good dinner 
 constitute the ideal system for the average man. Before 
 considering these further, it is well to mention some general 
 points which should be kept in mind, for example : — 
 
 1. The diet must be selected to agree with the "consti- 
 
 tution" rather than with the stomach. This is of 
 special importance in those predisposed to obesity, 
 gout, etc. 
 
 2. Thorough mastication is all important ; it is not only 
 
 of great value as an aid to healthy digestion, but it 
 diminishes the risk of indulgence to excess. 
 
 3. Fluids, except in the case of soups, should be taken at 
 
 the end of a meal ; the swilling down of food with 
 fluid should be avoided. 
 
 4. Keep in view that light meals may not only be very 
 
 palatable, but are usually more nourishing than rich, 
 
 heavy meals. 
 A few words will now be directed to a consideration of the 
 meals in detail, in the first place considering the meals under 
 Bystem i, in which dinner is taken in the evening. 
 
134 THE BOOK OF DIET. 
 
 Breakfast. — No food or drink should be taken before 
 breakfast, unless it be a tumblerful of hot or cold water the 
 first thing in the morning, which is an excellent practice. For 
 those engaged in sedentary work, a meal of porridge and 
 cream or milk, followed by a cup of tea and toast, may be 
 recommended as a light, nutritious, and ample meaL If 
 preferred, another cereal may be substituted, such as barley 
 meal, whole wheat meal, hominy, granose flakes, puffed 
 rice, grape nuts. There are, however, many people with 
 whom porridge or other cereal does not agree, and these 
 may advantageously take a one-course dish of egg, fish, or 
 bacon and egg, with tea, coffee, and toast or roll. On the 
 other hand, if the man of sedentary occupation is going to 
 the country for a day's golfing or shooting, he will be well 
 advised not to be content with his usual plate of porridge, 
 but should supplement it with an extra dish. 
 
 Luncheon. — The luncheon meal should certainly be a light 
 one for all who are engaged in brain-work or are otherwise 
 leading a sedentary life. Anything of the nature of a three- 
 course meal, which is virtually a dinner, should be avoided. 
 A light two-course meal is all that is required or is desirable, 
 and this is specially true of subjects past middle life. It should 
 be selected mainly from the lighter white-meat foods, such as 
 fish, chicken, or game, with vegetables, a second course tak- 
 ing the form either of biscuit and cheese and cup of coffee, if 
 desired, or a light pudding. An alternative luncheon, which 
 may be commended, as highly suitable for many people lead- 
 ing an inactive life physically, is one composed solely of fruit, 
 vegetables, bread and cheese, with a glass of milk or cup of 
 coffee. Some appropriate recipes of this type of luncheon 
 are given in ch. xxii. 
 
 Afternoon Teas: — Afternoon tea is, to a large number of 
 people, an institution. Friends and acquaintances meet to 
 
DINNER. 135 
 
 discuss each other over a hot muffin, some sweet cakes, and 
 two or three cups of tea, often of doubtful freshness and 
 temperature. As previously stated, three meals a day are 
 enough for any one, and afternoon tea is not therefore neces- 
 sary ; but if the three meals are judiciously selected, a cup 
 of freshly made good tea in the afternoon, with a wafer of 
 bread or light cake, will do no harm, and it certainly makes an 
 agreeable setting for an afternoon gossip. It becomes dis- 
 tinctly harmful from the dietetic point of view when it is 
 made a meal of. Two or three cups of tea with scones and 
 cakes in abundance constitute a meal, which is unnecessary 
 and inadvisable for those who take a sensible luncheon in the 
 middle of the day and dine in the evening. 
 
 Dinner. — If a man has planned his earlier meals along the 
 lines laid down above, he will be ready for the chief meal of 
 the day, and there is no reason, from the dietetic point of 
 view, why it should not be a good one. A good family 
 dinner is made up as follows : — 
 
 r. Soup. 
 
 2. Fish. 
 
 3. Joint or game. 
 
 4. Sweets. 
 
 5. Savoury. 
 
 One or more of these courses may be omitted according to 
 taste, in which case a proportionately greater amount of the 
 other courses may be taken. With regard to soups, attention 
 has to be directed to the difference in the nutritive value of 
 soups — for example, eight or ten ounces of a clear consomme 
 constitute merely a stimulating liquid with practically no 
 nutritive value, whereas the same amount of lentil soup or 
 Scotch broth is a highly nourishing food. 
 Soup is taken as the first course at dinner, as it is, or 
 
136 THE BOOK OF DIET. 
 
 should be, a hot fluid. It stimulates the blood-vessels and 
 glands of the stomach, and calls forth the gastric juices re- 
 quired for the digestion of the solid food to follow. Fish 
 comes next, as it is, generally speaking, a light diet, and 
 suitably introduces the stomach to the more arduous work 
 of digesting the most substantial dish — the joint After the 
 chief nutritive supply has been provided, more delicate dishes, 
 eaten in smaller quantities, are supplied. These are provided 
 in the form of sweets and savoury. While the above may be 
 set down as a sound regime for a good family dinner, it is 
 advantageous to take occasionally a meal in which the meats 
 are of the white variety only — for example, fish, poultry, game. 
 This gives the digestive juices, and the tissues as a whole, 
 a rest which is wholly beneficial to the individual. 
 
 Attention may now be directed to the system of meals 
 largely in vogue in the industrial classes, in which the 
 chief meal of the day is taken in the middle of the day. 
 It is extraordinary to note the different systems of feeding 
 which prevail. In my experience of hospital patients I fi-e- 
 quently find men whose dietary includes rich animal food 
 in the form of red meat, bacon, and sausages, at least four 
 times daily. (Fish too seldom enters into this diet list.) 
 The other side of the picture is also seen frequently in young 
 women whose diet consists of four, five, or more meals a day, 
 consisting largely of tea and bread foods, to the exclusion of 
 good animal foods. Both extremes are bad, and inevitably 
 lead those who adopt them into ill-health. The following 
 regime may be recommended : — 
 
 Breakfast. — Porridge and milk, followed by a piece of fish 
 or bacon, with bread or toast, and cup of tea or coffee. 
 
 Dinner should consist of two or three courses, either 
 (i) soup, meat, and pudding ; or (2) meat and pudding ; or 
 (3) a highly nutritious soup and pudding. Some highly 
 
SUPPER. 137 
 
 nutritious, cheap, and very palatable dinners, suitable for 
 working people with limited means, are given in ch. xii. 
 
 Supper. — This may take one of the following forms : (i) 
 Porridge or other cereal, if not taken at breakfast, fol- 
 lowed, if desired, by a cup of coffee and bread ; (2) a fish 
 or egg dish, with bread and milk or coffee. Sausages may 
 be included in the list of suitable dishes, as they frequently 
 contain little meat, being largely composed of bread foods 
 and other vegetable material. 
 
 The system of " meat teas " is only mentioned to be con- 
 demned. Tea and meat, more especially of the red variety, 
 do not mix well, or perhaps it is more correct to say that 
 they combine too well, the tannin in the tea combining with 
 the rich albumin in the meat in a manner which seriously 
 interferes with its digestibility. A fish or egg dish is less 
 open to objection, especially if its digestion is not hampered 
 by the inclusion of vegetables. Coffee or cocoa is a more 
 suitable drink, on account of the smaller proportion of tannin 
 present. 
 
 5a 
 
VI. 
 
 PATENT AND PROPRIETARY FOODS. 
 
 FOODS PREPARED FROM 
 MEAT. 
 
 Meat Extracts. 
 
 Meat Juices. 
 
 Meat Powders. 
 
 FOODS MADE WITH EGGS. 
 
 FOODS MADE FROM 
 VEGETABLE PROTEINS. 
 
 FOODS PREPARED FROM 
 COW'S MILK. 
 
 CARBOHYDRATE FOODS. 
 
Chapter VI. 
 PATENT AND PROPRIETARY FOODS. 
 
 Meat Foods — Egg Foods — Milk Foods — Starchy Foods 
 
 Patent foods are made, by processes of concentration, evap- 
 oration, and condensation, from meat, eggs, milk and milk 
 products, cereals, vegetables, fruits, and nuts. In some, 
 partial or complete predigestion of the natural food is carried 
 out A short account is here given of the leading facts in the 
 composition and uses of the best-known proprietary foods. 
 A full description of these is given in the author's larger 
 work on " Food and Feeding.'' 
 
 FOODS PBEPABED FROM MEAT. 
 
 These exist under the name of " meat teas,'' meat extracts, 
 meat juices, peptones, peptonoids, dried meat powders, and 
 lozenges. A large number of meat preparations do not con- 
 tain the nutritive constituents of meat, or contain them only 
 in very small proportions ; on the other hand, they contain 
 large amounts of extractives which may derange digestion and 
 impair the action of the kidneys. When it is stated that i lb. 
 of meat extract is equal to 34 lbs. of meat, it should be clearly 
 understood that i lb. of the extract contains only the whole 
 flavouring matter from the 34 lbs. of meat, and nothing more. 
 These extractives have no nutritive value as tissue-builders 
 or energy-producers, but have some value as stimulants of the 
 
142 THE BOOK OF DIET. 
 
 digestive secretions and for removing temporary muscular 
 fatigue. Such preparations, therefore, as contain little or 
 none of the nutritive constituents of meat are to be regarded 
 as flavouring agents rather than as foods. If given in too 
 large amount they may induce thirst, diarrhcea, and other 
 evidences of deranged health. It will be convenient to dis- 
 cuss these preparations in the following order : (i) Meat teas 
 and meat extracts ; (2) meat juices ; (3) meat powders and 
 lozenges ; (4) partially digested preparations. 
 
 Meat Teas and Meat Extracts. 
 
 A meat tea or meat extract is prepared by cutting up the 
 meat into small pieces, heating slowly in water, then boiling 
 quickly ; the product is then strained, the protein (which is 
 coagulated by heat and which forms a nutritive sediment) is 
 thrown away, and the result is a fluid with an agreeable 
 flavour, consisting of water, extractives, salts, and a very 
 small amount of gelatine. One pound of lean beef extracted 
 with one pint of water yields from 25 to 30 oz. of good 
 beef-tea, which contains about i^ per cent, of protein and 
 extractives. Some commercial meat-teas are strengthened 
 by the addition of some of the shredded-down meat fibres. 
 Meat teas are often made from some of the proprietary meat 
 extracts in place of fresh meat, and a meat tea so prepared 
 compares very ftivourably with the home-made preparations, 
 alike as to flavour, stimulating properties, and expense. 
 
 All beef-teas haVe little nutritive value, but are useful 
 stimulants. They are, therefore, an expensive form of diet. 
 In fevers and certain debilitating conditions associated with 
 impaired digestion, poor appetite, and furred tongue, the 
 patient can take a hot, clear, and slightly nutritive drink 
 more readily than any other form of food. The rest given 
 
MEAT TEAS AND MEAT EXTRACTS. 143 
 
 to the digestive organs associated with the use of such a diet 
 for twenty-four or forty-eight hours will be helpful in restoring 
 the patient's capacity to digest and assimilate a really nutri- 
 tious diet such as milk. 
 
 The better known of these preparations are as follows ; — 
 
 Mason's Home-made Beef-tea. 
 Composition, 
 
 Meat fibre 3.74 per cent. 
 
 Soluble albuminoids and extractives 10.58 ,, 
 Mineral salts 2.37 „ 
 
 The directions are : Dilute a tinful with a pint of water. 
 This reduces the nutritive value to one-third, and brings it in 
 strength to much the same proportion as in good home-made 
 beef-tea. The cost works out at about 3|d. a pint. A com- 
 parison of the cost of this with that of other preparations may 
 be given in tabular form : — 
 
 Lemco ijd. per pint. 
 
 Oxo 2d. „ 
 
 Invalid bovril zjd. „ 
 
 Mason's beef-tea 3id. „ 
 
 Brand's beef-tea ... ... ... 4jd. „ 
 
 The cost of home-made beef-tea varies with the quality of 
 beef used. One pound of meat yields i^ pints, and the cost 
 can be calculated from the quality of beef. On the whole, 
 home-made beef-teas as ordinarily prepared are more expen- 
 sive than those made from the above meat extracts. 
 
 Of the pure meat extracts, Liebig's is the most represent- 
 ative : 34 lbs. of pure beef yields i lb. of extract, which makes 
 70 pints of beef-tea, each pint containing the extractives from 
 J lb. of meat. The composition of the extract is roughly as 
 follows : — 
 
 Moisture 16 to 21 per cent. 
 
 Mineral salts 18 to 22 „ 
 
 Extractives 56 to 60 „ 
 
144 THE BOOK OF DIET. 
 
 It contains no protein and no fat. Numerous modifications 
 of Liebig's process have been introduced since it was recog- 
 nized that the fluid had practically no nutritive value. These 
 modifications consist in the addition of meat fibre, so as to 
 give the extract some definite nutritive value. These extracts 
 have considerable value as stimulating and, in proportion 
 to the protein present, as nutritive beverages. They can 
 advantageously be used to add to other food-stufis. The 
 composition of the best-known meat extracts is given in the 
 Appendix, p. 437. Good recipes for combining the meat ex- 
 tracts with soups, custard, eggs, etc., are given in ch. xxii. 
 
 Meat Juices. 
 
 Meat juices are quite different from the extracts. They 
 consist of the fluid substance contained in the muscle fibre. 
 They are prepared by extracting the juice by strong pressure 
 and subsequently concentrating the product by evaporation 
 in vacuo. Heat has to be avoided, as it coagulates the sol- 
 uble proteins. The process is expensive, and the product is 
 liable to decomposition. Glycerine, salt, or other preservative 
 is added. 
 
 Home-made Fresh Meat Juice is cheaper and, on account 
 of its freshness, more valuable than the proprietary prepara- 
 tions. The blood-red colour characteristic of many of the 
 meat juices is repugnant to many patients. This difficulty 
 can be overcome by serving in a red glass or cup. The 
 preparation of home-made beef juice is given on p. 384. 
 
 Puro is extremely rich in protein, which is present in the form of egg 
 albumin. It is a dark-brown fluid, becoming red on the addition of 
 water. Its colour is repugnant to many patients, but the flavour is 
 agreeable. However, If such a food is necessary, it is cheaper and just 
 as eflicacious to take the white of an egg (which contains approximately 
 12 per cent, of egg albumin) ; with this prepare albumin water (p. 53), 
 
DRIED MEAT POWDERS. 143 
 
 and add to it a few drops either of meat extract or home-made beef- 
 tea. In this way a nourishing fluid rich in protein is prepared, at a much 
 less cost than by the use of the proprietary preparations. (See Meat 
 Extract Soup, pp. 410, 411.) 
 
 Bovinine is one of the cheapest meat-juice preparations. It contains 
 a large proportion of protein. There is no doubt its nutritive value is 
 high, but its flavour is not very agreeable. The amount of cos^lable 
 protein is much less in Brand's beef juice, Bovril Company's juices. 
 Liquor carnis, and Wyeth's, though all may be regarded as uncooked 
 juices. 
 
 Special mention may be made of Valentine's meat juice, which, 
 according to Chittenden, contains only .55 per cent, proteins, and has 
 therefore no more claim to being m nourishing meat juice than many of 
 the beef extracts and soups. , 
 
 Vincep is made of blood, boric acid, and a little alcohol, and contains 
 16 per cent, of protein ; the flavour is not agreeable. Alcoholic com- 
 pounds of meat extracts should all be condemned, even if strengthened 
 with malt or other carbohydrate food. These are apt to induce the 
 alcoholic habit. 
 
 The composition of the beef juices is given in the Appendix (p. 437). 
 
 Dried Meat Powders. 
 
 These can be made at home by mincing cold boiled beef, 
 drying it thoroughly in a slow oven, and grinding it up in a 
 coffee or nut mill. In the preparation of a meat powder, 
 nothing is removed except the water of the fresh meat and 
 the tough, stringy, and indigestible portion rejected in sifting. 
 One ounce of the powder is equivalent in nutritive value to 
 four ounces of fresh lean meat. A meat powder may be 
 utilized to increase the nutritive value of soup. The best 
 examples are the following : — 
 
 Pemmican, — To every 50 parts of powdered meat 40 parts of fat are 
 added, the resulting product being a food rich in both proteins and fat. 
 
 Mosquera beef meal is a preparation of high nutritive value. It con- 
 tains 90 per cent, of nutritive material, 13 per cent, of this being fat. 
 The meat is partially digested by the ferment of pineapple juice. 
 
146 THE BOOK OF DIET. 
 
 Meatox is a powdered beef which contains above 75 per cent, of nutri. 
 tive matter. 
 
 Brand's nutrient powder consists of powdered muscle fibre from 
 which the moisture has been removed at a temperature below the coagu- 
 lation point of the muscle proteins ; it is readily digested and assimilated. 
 Reference is later made to somatose, a similar preparation, in which the 
 proteins are partly transferred into albumoses. 
 
 Marvis is a dried iish powder, consisting largely of proteins ; it can 
 be used in the same way as other meat powders. 
 
 Meat lozenges, beef-tea tabloids, and all combinations of 
 meat extracts with other food-stuffs are not to be commended. 
 They are quite useless as a food, and are simply concentrated 
 salts and extractives. 
 
 Ovo. — A powder made up in packets is sold as a substitute 
 for eggs, each packet containing the equivalent of one egg. 
 It is the egg dried, and on the application of water is redis- 
 solved. It is only to be used for cooking purposes if fresh 
 eggs are not obtainable. 
 
 Egg and custard powders are also sold as substitutes for 
 eggs. They consist chiefly of starch, baking soda, tartaric 
 acid, and some vegetable dye, and have practically no nutritive 
 value. 
 
 PROPRIETARY FOODS MADE WITH EGGS. 
 
 These exist usually as combinations with milk proteins, 
 animal proteins, and fat ; the most useful are the following. 
 
 Virol, a valuable preparation made from marrow fat, yolk 
 of egg, egg-shells, malt extract, an"d lemon juice, is a palatable 
 preparation of considerable nutritive value. The maker's 
 analysis gives the composition as 20 per cent, of fat and 
 60 per cent, of malt extract. 
 
 Virvis is a similar preparation of much the same com- 
 position. 
 
PROPRIETARY FOODS. 147 
 
 Sanose is a powder consisting of about 80 per cent, casein 
 and 20 per cent, of albumose, derived from white of egg. 
 
 Muffler's Food, sold by the Aylesbury Dairy Company, 
 consists of desiccated milk, powdered white of egg, wheaten 
 flour, and lactose. 
 
 Puro, a meat-juice preparation, contains much egg albumin. 
 
 The preparation by Brand termed Fever Food is most 
 nutritious ; it consists of essence of beef, eggs, and cream. 
 In appearance it resembles custard, and has a very agreeable 
 flavour, which is quite distinct from the meaty flavour of 
 the beef juices and extracts. 
 
 PROPRIETARY FOODS MADE FROM VEGETABLE 
 PROTEINS. 
 
 The chief vegetable proteins are : — ■ 
 
 Alenion, prepared from the proteins of wheat — a white, 
 tasteless, fairly soluble preparation ; also 
 
 Aleuronat, a yellowish-brown powder, almost insoluble in 
 water. These are extremely rich in protein, fairly cheap, 
 and are valuable in the feeding of diabetics. 
 
 GlidJue, a concentrated protein food, is prepared wholly 
 from wheat; it is free from carbohydrate, and is easily 
 digested and assimilated. 
 
 Legnmln, a vegetable casein, is made from pulses, and is a 
 useful vegetable protein food. 
 
 Roborat is made from cereals ; it is the most soluble of 
 all the vegetable protein preparations. 
 
 Tropon and Vegox are two preparations of recent intro- 
 duction in which the protein of vegetables is combined with 
 the protein of animals, chiefly fish. They are used chiefly 
 stirred up in thick soups and purees. 
 
 Emprote (Miles) is a concentrated vegetable protein manu- 
 
I4S 
 
 THE BOOK OF DIET. 
 
 factured from the proteins and salts of milk, wheat, and fruit. 
 Further reference is made to proprietary vegetable prepara- 
 tions in the vegetarian section, under Nut Meats, and Nut 
 Butters (p. 239). 
 
 Cow's Milk with Cereal Additions. 
 Mention must be made of some proprietary foods made 
 from cow's milk to which have been added carbohydrates 
 from cereals. There are three varieties : — 
 
 1. Foods with the starch practically unchanged. 
 
 2. Foods with the starch partly or entirely converted 
 
 into soluble carbohydrates. 
 
 3. Foods partially predigested. 
 
 FOODS WITH THE STARCH PRACTICALLY 
 UNCHANGED. 
 
 The chief ingredients of these foods are condensed milk, 
 baked wheat flour, and sugar. These foods are rich in starch 
 and sugar, and deficient in fat and proteins, and from their com- 
 position are unsuitable foods for infants. The chief varieties 
 are Anglo-Swiss, American-Swiss, and Franco-Swiss foods. 
 
 
 1 
 
 ! 
 
 Fat. 
 
 Carbohydrates. 
 
 Ash. 
 
 Remarks. 
 
 Soluble. 
 
 Starch. 
 
 Anglo-Swiss .. 
 American-Swiss 
 Franco-Swiss . . 
 
 Muffler's Food 9 
 
 6.S 
 5.6 
 4-4 
 
 S-6 
 
 io.z6 
 10.54 
 13.0 
 
 14-3 
 
 4.91 
 5.81 
 3.70 
 5.8 
 
 46.4 
 46.0 
 »7-4 
 
 29.4 
 30.0 
 30.8 
 
 44-4 
 
 3.02 
 
 X.2 
 
 1.4 
 2.3 
 
 Much cane sugar. 
 
 /Contains powdered 
 \ white of egg. 
 
 FOODS PREPARED FROM COW'S MILK. 
 
 These include condensed milks of different kinds, and 
 various dried milk preparations which are described under 
 "Milk" (p. 49). 
 
CARBOHYDRATE FOODS. 149 
 
 OABBOHTDBATE FOODS. 
 
 Many of these foods are made from wheat flour or mixed 
 flours, and consist of practically unchanged starch. 
 
 As examples, mention may be made of Albany food, Marr's 
 food. Ridge's, Robinson's patent barley, Scott's oat flour, Hovis 
 oats, Quaker oats, and other varieties. Sometimes the flour 
 is baked, the heat converting a small amount of the carbo- 
 hydrates into a soluble form. In other foods of the same 
 kind a small amount of fat and a pulse food are added — for 
 example, falona — consisting of baked cereals and a pea flour. 
 Sugar may also be added, as in Frame food. The com- 
 position of these foods is given in the Appendix, p. 437. 
 
VII. 
 PREDIGESTED FOODS. 
 
 The Action of Ferments. 
 Home Peptonizing. 
 Peptonized Soups, Blancmanges, 
 
 and Jellies. 
 Predigested Milk Products. 
 
 Predigested Meats and Peptones, 
 Malt Extracts. 
 Malted Proprietary Foods. 
 Invalid Foods. 
 
Chapter VII. 
 PREDIGESTED FOODS. 
 
 Ferments — Milk Foods — Malt Foods — Malt 
 Extracts — Invalid Foods. 
 
 Predigested preparations are foods which have been partially 
 digested by means of ferments. The development of many 
 large commercial concerns for the manufacture and sale of 
 predigested proprietary foods has been a striking feature in 
 the past two decades. The various preparations may be 
 classified as follows : — 
 
 1. Ferments for predigesting foods at home. 
 
 2. Predigested proprietary milk foods, either alone or 
 
 in combination with starch. 
 
 3. Predigested proprietary meat preparations. 
 
 4. Malt and malt extracts. 
 
 5. Malted foods in which starch is partially changed or 
 
 completely changed into soluble carbohydrates — 
 "invalid foods." 
 
 The Action of Ferments. 
 
 There are three ferments employed to make predigested 
 foods — (i) pepsin, prepared from the mucous membrane of 
 the stomach ; (2) a ferment, pancreatin, prepared from the 
 
154 THE BOOK OF DIET. 
 
 pancreas (stomach sweetbread); (3) a vegetable ferment, 
 diastase or malt. Pepsin and pancreatin act upon the 
 proteins of the food, these ferments possessing enormous 
 energy, and being capable, even when only in very weak 
 solution, of dissolving many thousand times their weight of 
 food-stuff. Pepsin can only act in an acid medium ; the 
 pancreatic ferment, on the other hand, acts in neutral, alkaline, 
 or feebly acid solution, and its action continues after the 
 food leaves the stomach. For this reason practically all 
 predigestion of foods is done with pancreatin, and when we 
 speak of peptonized food we mean food that has been pre- 
 digested by the pancreatic ferment. The ferments may be 
 obtained as powders or as fluid preparations. Powders are 
 preferable, being more constant in their action and less liable 
 to impart their peculiar taste to the food. 
 
 The digestive ferments find their use in the following 
 directions : (i) As peptonizing agents for the artificial diges- 
 tion of food as described above ; (2) as therapeutic agents, 
 being used as remedies for indigestion — here the prepara- 
 tions are administered with or immediately after food. It 
 is important to distinguish between the two different ways of 
 using the ferments. 
 
 Peptonizing foods should only be employed when it is 
 necessary to assist the digestive organs for a time by giving 
 the alimentary canal some degree of physiological rest. 
 This is indicated in many acute diseases associated with 
 impairment of the gastric functions, such as gastric ulcer, 
 cancer of the stomach, and some severe constitutional 
 diseases in which irritability of the stomach is a prominent 
 feature. Some details of the different preparations will now 
 be given. 
 
 Pepsin in the form of pepsin powder or tablets, pepsencia 
 (Fairchild's) or liquor pepticus (Benger's), is administered 
 
HOME PEPTONIZING. 155 
 
 after a meal, and is not mixed with the food before being 
 swallowed, because, as already explained, to get it to act on 
 the food the pepsin must be mixed with dilute hydrochloric 
 acid, and this spoils the flavour of the food. 
 
 Savory and Moore have produced a saline essence of 
 pancreatin and pepsin ; this has an agreeable ketchup odour 
 and flavour, and may be used with roast meat or fowl as 
 a sauce, or a small quantity may be added to beef-tea, soup, 
 or broth. 
 
 Home Peptonizing. — In actually peptonizing milk and 
 foods by means of pancreatic ferments, there are several 
 reliable preparations that may be employed. Liquor pan- 
 creaticus (Benger's, Allenbury's), extractum pancreaticus, and 
 peptonizing powders, and Byne pancreatin are all reliable ; 
 the latter can be used either for peptonizing food or can 
 be taken with meals. Fairchild's "zymine" powder and 
 peptonizing tubes are also reliable. Savory and Moore 
 manufacture peptonizing pellets, each weighing 5 grams. 
 This form of powder does not require a large excess of alkali, 
 and the flavour of the food-stuff is hardly altered. 
 
 All these peptonizing preparations give full directions for 
 their use on their wrappings; in addition, the recipes for 
 peptonized milk, gruel, soup, etc., given in ch. xxii., may be 
 recommended. 
 
 Peptonized Soups, Blancmanges, and Jellies. — With a 
 little ingenuity a variety of peptonized dishes can be obtained. 
 There is no difBculty in doing this if it is always remembered 
 that any peptonized fluid after standing at most two hours 
 must be boiled, in order that the action of the ferment may 
 be arrested. For the making of soups, use peptonized gruel 
 instead of water; for the making of blancmanges, pepton- 
 ized milk is added to the cream. 
 
 For jellies, mix the liquor pancreaticus with gelatine in 
 
156 THE BOOK OF DIET. 
 
 the proportion of two teaspoonfuls to the pint, allow it to 
 stand for one and a half hours in a warm place, and then 
 check the further action by boiling. 
 
 Predigested Milk Products. — Mention must be first made 
 of Fairchild's peptogenic milk powder. By means of 
 this powder the cow's milk is so modified as to conform 
 remarkably to normal mother's milk, thus affording a food 
 for infants exactly suited to the powers of infant digestion ; 
 the predigesting process can be gradually reduced until the 
 infant can digest normal milk. Savory and Moore supply a 
 number of concentrated peptonized milk preparations — 
 namely, condensed peptonized milk, peptonized cocoa and 
 milk, and a really excellent and highly nourishing prepara- 
 tion, caf6 zylak, a peptonized coffee and milk (this, when 
 diluted with hot water, makes a superior cup of cafi au tait) ; 
 milk chocolate peptonized is a specially good sweetmeat for 
 children ; all are palatable and nutritious foods, which can 
 be very readily prepared. Some of the milk companies prepare 
 a predigested milk, and predigested varieties are sold under 
 the name of Leeflund's peptonized milk and Backhaus's milk. 
 These are not to be recommended, as there is no means 
 of knowing how far the predigestion has been carried. 
 
 Milk in combination with cereals, with the starch partly 
 or entirely converted into soluble carbohydrates. (The chief 
 foods in this group are given in the table in the Appendix, 
 f.v., which gives also the composition.) 
 
 From the point of view of infant foods these foods have 
 all the disadvantages of condensed milk, in respect of lack of 
 freshness and deficiency of fat. The chief difference between 
 these and condensed milk preparations is the form of the 
 soluble carbohydrates in place of the cane sugar. 
 
 Predigested Lleats and Peptones. — The advantages of 
 having a meat nutriment which contains the albumins in a 
 
PREDIGESTED MEATS AND PEPTONES. 157 
 
 soluble and readily assimilable form is obvious in the treat- 
 ment of those patients in whom the digestive powers are 
 more or less in abeyance, either in acute or chronic medical 
 conditions or in some surgical emergencies. Predigested 
 soups and meats can be prepared at home (see ch. xxii.) ; 
 there are also many preparations in the market in which 
 the proteins have been largely converted into albumins and 
 peptones. These include various preparations of peptones, 
 peptonoids, fluid meats, meat jellies, and meat powders. The 
 strong meaty odour and the bitter taste of the peptones are an 
 objection to their use to many patients. A further difficulty 
 sometimes encountered is the occurrence of vomiting and 
 diarrhoea induced by the albuminoids and peptones. The com- 
 position of the various preparations varies widely, the amount 
 of protein albumins and peptones varying from 5 per cent, in 
 Valentine's meat juice to over 70 per cent, in somatose. In 
 some of the preparations — for example, Carnrick's — a large 
 amount of carbohydrate is present, this being derived from 
 wheat. The approximate composition of the chief peptone 
 preparations is given in the table on p. 438. 
 
 Somatose is a meat preparation in which the albumin of 
 the meat is mainly converted into albuminoids. It is a valu- 
 able preparation for increasing the nutritive value of other 
 foods. 
 
 Savory and Moore's meat peptone is another useful 
 concentrated form of nourishment. It possesses a full, meaty 
 flavour. It may be used as soup or spread between bread 
 and butter as sandwiches. 
 
 Benger's Peptonized Jellies. — These consist of meat and 
 chicken respectively, boiled and digested by means of the 
 ferment in the Liquor Pancreaticus, by which means almost 
 all the flesh is converted into soluble bodies. The fluid is 
 then made into a jelly by the use of gelatine. These jellies 
 
158 THE BOOK OF DIET. 
 
 can be used cold, or dissolved with hot water to form a 
 soup. 
 
 Panopeptone is made [from both meat and cereals, and 
 claims to contain the nutritive principles of beef and bread. 
 It may be used in several ways : — 
 
 1. Panopeptone with Whey. 
 
 Place in a small teacup one or two teaspoonfiils of crushed 
 ice, add one tablespoonful of panopeptone, stir, then fill the 
 cup with whey. Drink slowly. (Refreshing and nourishing — 
 an admirable liquid food for fever and convalescent patients.) 
 The whey may be omitted. 
 
 2. Panopeptone. 
 
 To a small teacup two-thirds full of boiling water add 
 one tablespoonful of panopeptone and one teaspoonfiil fresh 
 lemon juice, a little sugar, or flavour with salt and pepper or 
 with celery salt. Drink immediately, sipping slowly. A light 
 nourishing drink at night. 
 
 Malt Extracts : Diastase and Maltose. — Diastase or malt 
 is a vegetable ferment which has the property of converting 
 starch into the soluble sugar maltose. It is the action of this 
 diastase which causes the ripening of fruits and vegetables by 
 converting their starches into dextrins and sugars. 
 
 Farinaceous meal of any kind mixed with one-eighth of its 
 weight of ground malt forms a highly digestible combination. 
 These malted foods are in great demand for the feeding of 
 invalids and children in any condition where the digestive 
 power has been weakened — for example, convalescence from 
 fever, tuberculosis, sepsis, neurasthenia, and disorders of 
 digestion. Malt extracts can also be made and added to any 
 ordinary farinaceous dish. 
 
 Malt extracts are malt infusions evaporated down in vacuo 
 to a low temperature in order not to destroy the diastase 
 ferment; this makes them expensive. The average per- 
 centage composition of malt extracts is as follows : — 
 
MALT EXTRACTS. 159 
 
 Froteiiu.. 
 
 5 to 6 per cent. 
 
 Soluble starch ... 10 to 15 „ 
 
 Sugar SO to 55 „ 
 
 Ash I to 2 „ 
 
 Water 22 to 34 „ 
 
 Malt extracts and malted foods in general are simply pre- 
 digested starches, with other nutritive substances as above. 
 As foods they are, however, deficient in fats and proteins. A 
 useful combination would be a farinaceous meal of any kind 
 mixed with one-eighth of its weight of ground malt. The chief 
 proprietary extracts of malt are ; — 
 
 1. Kepler's malt extract is a, thick, treacly preparation, and can be 
 given in teaspoonful doses after meals in milk or soda water, or it may 
 be spread on any form of starchy food. This type of extract is a very 
 good one to mix with cod-liver oil. It is rich in diastase. 
 
 2. Hoff's malt extract (or homax) is given as a wineglassftil with meals. 
 It is a liquid preparation not unlike beer, and to many people is more easily 
 taken than the sticky preparation. It can be taken diluted with water, 
 soda water, or milk. It contains considerable diastase, and not more than 
 10 per cent, alcohol. In the author's experience it is of special value in 
 the treatment of some forms of indigestion in gouty subjects. 
 
 3. Trammer's diastatic extract of malt, made from barley malt, very 
 syrupy in consistence, and sweet. A teaspoonful dose at first is enough 
 to start with. 
 
 4. Maltine is made from three cereals — barley, wheat, and oats. It 
 is rich in diastase. It is frequently given mixed with equal parts of 
 wheat or barley flour, the mixture being used as a diluent of milk. It 
 may be taken after meals, either plain or in various combinations, such 
 as cod-liver oil, hypophosphates, etc. 
 
 Bynin, a fluid malt extract prepared by Allen and Hanbury. 
 
 In the desiccated malt extracts all the water has been removed — for 
 example, Curtis's desiccated malt extract and gramalt. Cremalto is a 
 mixture of Devonshire cream and malt, and is a good way of supplying 
 easily digested fat. 
 
 Malt may also be made as an infusion at home, and can be prepared 
 freshly; it is much cheaper than the preparations above mentioned. 
 Recipes for making malt infusion and malted gruel will be found in the 
 chapter on " Recipes," p. 397. 
 
l6o THE BOOK OF DIET. 
 
 The malted proprietary foods in the market may only be 
 partly converted into dextrins, maltose, and dextrose. 
 
 In some members of this group the starch is little 
 altered; in others — Allenbury's No. 3, Hovis babies' 
 No. 2, and Moseley's food — considerable conversion has 
 taken place; and it is stated that some of them — for 
 example, Coomb's malted food — are completely changed 
 during the preparation, and therefore rank as completely 
 malted foods. Mellin's food, Horlick's food, Hovis babies' 
 food No. I, are examples of completely malted foods. 
 
 Of foods which are completely malted or nearly so the 
 best are Mellin's, Horlick's, Paget's malted farina, Chiltine 
 maltose food, diastased farina, Hovis babies' food No. i. 
 The composition of these various malted foods is given in 
 the Appendix. 
 
 Invalid Foods. — These are a group of foods of various 
 composition that are of great use in the dietary of invalids. 
 
 Benger' s food contains ferments which convert the proteins and starch 
 during the preparation. It consists of cooked wheaten meal, to which 
 is added the natural digestive ferment of the pancreas. 
 
 When mixed with warm milk, as recommended, the carbohydrates are 
 nearly all converted into soluble dextrine and sugar, and the proteins 
 are also partially peptonized. This is certainly one of the most useful 
 proprietary foods on the market. It is specially useful in the feeding of 
 weakly infants, and in cases of acute gastric intestinal derangements such 
 as typhoid fever and malnutrition generally. 
 
 Benger' s pancreatiaed Until flour is specially prepared for children and 
 invalids. Lentils form a highly nutritious food, being rich in nitrogenous 
 matter, and the method of preparation of the flour makes it easy of 
 digestion. 
 
 Savory and Maoris Best Food for Invalids. — The manufacture of this 
 food was originally suggested by Liebig, but the process has since been 
 much improved. The flour is specially prepared and then partially 
 malted. On mixing in the manner described on the label of directions, 
 the diastase converts the carbohydrates into soluble forms. It is very 
 
INVALID FOODS. 161 
 
 digestible, and may be given in all cases in which a milk diet is in- 
 dicated. Its pleasant malty Bavour makes it a favourite food. 
 
 Savoro is another nutrient food prepared by Savory and Moore. The 
 carbohydrates are partially malted and contain active diastase, assisting 
 enfeebled digestive fianction. The milk and cereal proteins are not 
 peptonized, so that the digestive apparatus has little work to perform. 
 
 ' Alknburys ' diet No. 3, like the above, is a farinaceous food which 
 requires the addition of cow's milk. It is a partially digested food, com- 
 posed chiefly of carefully cooked wheaten flour ; to this is added malt in 
 a soluble form. This food, though intended primarily for the use of 
 infants after the fifth or sixth month, is of great value for invalid and 
 convalescent diet. 
 
 Camrick's soluble food is another preparation in this class. It con- 
 sists of desiccated milk, malted wheat flour, and milk sugar. In the 
 preparation the starch granules are partially digested, but much starch 
 remains unchanged. This preparation is not so valuable as those 
 mentioned above, as the latter have the advants^e of being made with 
 fresh milk. 
 
 By the use of the above-mentioned foods in combination 
 with milk a variety of dishes can be made. The special 
 directions for each food are detailed on the tins, and the 
 directions should be closely followed. A number of useful 
 receipts will be found in ch. xxii. 
 
VIII. 
 
 FOOD PRESERVATIVES, FOOD ADULTERA- 
 TION, AND DISEASES CAUSED BY FOOD. 
 
 FOOD PRESERVATIVES. 
 
 Sugar. 
 
 Dried Foods. 
 
 Honey. 
 
 Smoked Food. 
 
 Treacle and Syrup. 
 
 Salting. 
 
 Jams. 
 
 Freezing and Refrigerating. 
 
 Mustard. 
 
 Treatment by Refrigeration. 
 
 Pepper. 
 
 Canning. 
 
 Spices. 
 
 Preservatives. 
 
 Tea. 
 
 General Effects of Preservatives on 
 
 Coffee. 
 
 the Food. 
 
 Cocoa. 
 
 
 Vinegar. 
 
 FOOD ADULTERATION. 
 
 Lemon and Lime Juice. 
 
 Milk. 
 
 
 Condensed Milk. 
 
 
 Cream. 
 
 DISEASES CAUSED BY 
 
 Butter. 
 
 FOOD. 
 
 Cheese. 
 
 Ptomaine Poisoning. 
 
 Lard. 
 
 Poisoned Non-putvefying Meat. 
 
 Flour. 
 
 Foods Containing Parasites or their 
 
 Bread. 
 
 Embryos. 
 
Chapter VIII. 
 
 FOOD PRESERVATIVES, FOOD ADUL- 
 TERATION, AND DISEASES 
 CAUSED BY FOOD. 
 
 FOOD PRESERVATIVES. 
 
 A SHORT account is first given of the different methods of 
 preservation of foods, and of their effects on the nutritive 
 value of the food. 
 
 Dried Foods. — Milk, vegetables, and fruits are preserved 
 in this way: the watery constituents of the food may be 
 partially removed, as in the case of condensed milk, or com- 
 pletely removed, as in the desiccated form, the dried milk 
 powder being used to increase the nutritive properties of 
 other foods (see p. 49). Tea and coffee are examples of 
 food-stuffs prepared in this way ; so also are peas, beans, 
 grapes (raisins), apples, prunes, and figs. Sugar or salt is 
 frequently employed to aid the drying and to assist in 
 preventing the decomposition of the food. 
 
 Smoked Food. — The process of smoking is applied to 
 beef, fish, tongue, ham, and bacon. It consists in hanging 
 the meat in a chamber, in which the air is saturated with 
 wood smoke, the antiseptic substances derived from the com- 
 bustion of the wood impregnating the outer layers of the meat 
 
i66 THE BOOK OF DIET. 
 
 and so preserving the whole. This process is usually em- 
 ployed after salting. Meat so prepared is not so easily 
 digested as fresh meat. 
 
 Salting. — The addition of salt to meat or fish absorbs the 
 moisture, and dries and preserves the meat. In the process 
 some of the extractives and salts of the meat may be removed. 
 Food so prepared is rather less nutritious and digestible than 
 fresh meats. Salted meat requires prolonged cooking. 
 
 Freezing and Refrigerating. The Process of Freezing. — 
 The process of freezing consists in subjecting meat to a 
 temperature of about 26° F. below zero, the meat when hard 
 being transferred to a refrigerating chamber. Meat so pre- 
 pared can be kept almost indefinitely. Frozen meat should 
 be cooked when thawed, as decomposition sets in more 
 readily than in the case of non-frozen meat. Frozen meat 
 loses some of its nutritive value in cooking, this loss being 
 greater than in the case of non-frozen meat ; it also loses a 
 little delicacy of flavour. These disadvantages, however, are 
 more than outweighed by the diminished cost. 
 
 Treatment by Refrigeration. — Here the meat is not 
 actually frozen, but is kept in chambers maintained at a 
 temperature a few degrees above freezing point. The 
 temperature is maintained by a draught of cold air. This 
 process involves less alteration in the meat than freezing. 
 In addition to meat, fish, eggs, fruits, and vegetables can be 
 so treated. 
 
 Canning. — The decomposition of all foods is prevented or 
 retarded by excluding air from the food. This is done by 
 the process of canning, or by varnishing the food, or by 
 covering it with a substance of an impermeable nature, such 
 as melted fat. Canned foods are very extensively used at the 
 present time. The food is first made sterile by heat, or by 
 the use of chemicals — the latter method being often abused 
 
FOOD PRESERVATIVES. 167 
 
 in the hands of unscrupulous people. Canned foods are on 
 the whole less digestible and also less tasty than fresh foods. 
 It has also to be borne in mind that some people may have 
 an idiosyncrasy to the preservative used. The possibiUty 
 of the occurrence of copper, tin, lead, or zinc poisoning from 
 the prolonged use of canned meats must be borne in mind, 
 the ingredients in some foods having a solvent action on the 
 cans, as a result of which toxic symptoms are set up. 
 
 Preservatives. — A large number of antiseptic and preserv- 
 ative substances are used with the object of preserving food. 
 Many of these are innocuous — for example, sugar, oil, and 
 vinegar ; others are harmless in minute doses but injurious 
 in the amounts that are occasionally present, such as salicylic 
 acid, formalin, borax, and sulphuric acid. 
 
 General Effects of Preservatives on the Food. — Generally 
 speaking, the effects of preservatives are to render the food a 
 little less nutritious, probably by interfering with the normal 
 action of the digestive ferments. In some cases the food is 
 rendered less tasty, and its nutritive value thereby impaired. 
 
 FOOD ADULTERATION. 
 
 Food may be adulterated either by the fraudulent sub- 
 stitutes of cheaper foods, or by the addition of substances 
 which have a deleterious action. The objects aimed at by 
 the manufacturer who engages in this malpractice are : (i) 
 to increase the bulk of the food ; (2) to give an erroneous 
 impression as to the strength of the food ; and (3) to alter 
 the appearance in a manner favourable to the manufacturer. 
 
 The process of food adulteration has called for legislative 
 action, but the condition is not always easily detected by any 
 analytical method. It has been shown experimentally that 
 the addition of boric acid to the food in the proportion of 
 
i68 THE BOOK OF DIET. 
 
 ^ per cent, is not injurious to health ; this would be equiv- 
 alent to the consumption of about 7 J grains of boric acid 
 daily. In conditions where the excretory functions of the 
 kidneys or bowels are defective, smaller amounts of salicylic 
 acid, borax, formalin, and the like in the food would produce 
 injurious results more readily than under normal conditions. 
 The injurious results that may be induced are gastro-intestinal 
 derangement, albuminuria, and an impairment in the general 
 health. 
 
 A short account is here given of the more common 
 adulterations of some of the principal food-stuffs : — 
 
 Milk. — The most commonly encountered adulteration is 
 dilution with water. When the dilution is made with pure 
 water it is a fraud, and when, as sometimes happens, the 
 water is from an impure source, it is a crime. Milk is some- 
 times artificially coloured by the addition of minute quan- 
 tities of colouring matter, a little special pigment being added 
 to impart the yellow colour characteristic of good cream. A 
 pinkish or reddish coloration of the milk may arise from the 
 ingestion by the animals of food rich in pigment. Various 
 preservatives are added to the milk, notably borax, boracic 
 acid, formalin, salicylic acid, and these may be very pre- 
 judicial to the digestion of milk in the case of infants and 
 delicate children. Mixtures of borax and boric acid are sold 
 to farmers and dairymen under the trade names conservine, 
 preservitas, and others. Formalin is used under the trade 
 names of "lactic fluid," "steryl," etc. Milk after a pre- 
 liminary dilution is sometimes fortified by the addition of 
 flour, farina, whiting, tragacanth or magnesium carbonate ; 
 the addition of one or other of these substances gets rid of 
 the thin appearance of diluted milk. Sugar is also added 
 to diluted milk to raise its specific gravity to a satisfactory 
 standard. 
 
FOOD ADULTERATION. 169 
 
 Condensed Milk is frequently adulterated by the removal 
 of the fat from the original milk before concentration. 
 Glucose is sometimes substituted for cane sugar as a pre- 
 servative in condensed milk, and preservatives may be 
 looked for in the same manner as in milk. 
 
 Cream is commonly adulterated by gelatine, more rarely by 
 dextrin and starch added with a view of thickening the 
 cream; colouring matters are frequently added as in the 
 case of milk. The preservatives commonly added to milk 
 should all be looked for. 
 
 Butter is frequently preserved by the addition of borax, 
 boric acid, sulphites, and nitrates. An addition of 5 per 
 cent, expressed as boric acid is allowed by law. Some 
 butters contain a large amount of water. Cocoa-nut oil is 
 also frequently used as an adulterant in butter fat. 
 
 Cheese is often adulterated by the incorporation of animal 
 fat. Various colouring matters are also employed, but so 
 long as these are not injurious, such addition is not regarded 
 as adulteration. 
 
 Laxd (animal fat) is commonly adulterated on a large scale 
 by the admixture of beef stearin, either alone or with vegetable 
 oils, specially cotton-seed oil, cocoa-nut oil, or maize oil. 
 
 Flour. — A large part of the flour made in this country 
 is bleached artificially by passing nitrous oxide gas through 
 it. The bleaching is done by special machinery, the gas 
 being made by an electric discharge, and the term electrified 
 air — a misleading term — is applied to the gas. There is good 
 reason to believe that the nutritive value of flour treated in 
 this way is below that of the natural product of the wheat. 
 In America the bleaching of flour has been made illegal, 
 and it is to be hoped that ere long the process will be made 
 illegal in this country, except when the flour is certified as 
 bleached. Legislation on the subject of the bleaching of 
 
 6a 
 
I70 THE BOOK OF DIET. 
 
 flour and the addition of so-called "flour improvers" is 
 urgently called for at the present time. 
 
 Bread. — Alum is added to bad or slightly damaged flour 
 by both the miller and the baker (Blyth). There is some 
 difference of opinion on the question whether in the moderate 
 doses in which alum is taken in pastry, or bread, or cakes, the 
 flour of which has been mixed with alum or an alum baking 
 powder, it has the slightest appreciable influence on health. 
 As, however, the addition of alum to bread and bread-foods is 
 interdicted by law, its use must be regarded as an adultei-ation. 
 
 Sugar is sometimes adulterated by the addition of starch 
 sugar, chalk, sand, and various species of flour. 
 
 Honey, the saccharine matter collected and stored by bees, 
 is not infrequently adulterated by the addition of starch sugar 
 in the form of syrup. There is a commercial American 
 artificial honey which is entirely composed of glucose syrup, 
 while the comb is also artificial and made of paraffin. 
 
 Treacle and Syrup, products of the sugar industry, have 
 frequently glucose sugar as an adulterant. 
 
 Jams are very readily adulterated, since any tasteless 
 vegetable tissue, such as vegetable marrow, turnips, etc., 
 when mixed in jam, cannot be readily detected by the palate. 
 
 Mustard. — The adulteration most commonly met with is 
 a dilution of ground mustard with wheat flour, and coloured 
 by either turmeric or a special yellow coal tar product. 
 
 Pepper has been adulterated for at least two centuries and 
 a half. Linseed meal, rice, wheat flour, sago, woody fibre, 
 powdered laurel leaves, olive stones, bone dust, marine salt 
 have all been used. 
 
 The various spices — ginger, allspice, nutmeg, cloves, and 
 cinnamon — which are sold in powder form are specially liable 
 to adulteration, various starches, stems, barks, sawdust, and 
 ground olive stems all being used for this purpose. 
 
FOOD ADULTERATION. 171 
 
 Tea. — Leaves and other vegetable tissues other than those 
 derived from the tea plant are used as adulterants for tea. 
 The principal leaves used are the lime, hawthorn, and 
 sloe. These can be detected by the chemical test — namely, 
 every part of the tea-producing plant yields the active 
 principle (theine) as a crystalline product, whereas leaves 
 used as adulterants do not. The special form of adulteration 
 known as " Facing of Tea" is thus described by M. S. Julian : 
 The leaves are mixed either with powdered indigo, with 
 powdered plaster, or with slaked lime, sometimes even all 
 three substances being put together in small proportion to 
 the tea leaves. These matters attach themselves to the leaves 
 and communicate to them the bluish-green characteristic of 
 green tea. Prussian blue is sometimes used instead of indigo. 
 
 Coffee is extensively adulterated, the chief agents used 
 being roasted cereals of all kinds, potato flour, sawdust, 
 ground date stones, peas, beans, and chicory. Chicory is 
 added to some coffees and sold as an essence of coffee 
 and chicory. Chicory influences the composition of coffee 
 as follows (Blyth) : — 
 
 1. It decreases the tannin, chicory being destitute of 
 
 tannin. 
 
 2. It decreases the fatty matter, the fat of chicory ranging 
 
 from I to 2 per cent., that of coffee from about 14 
 up to over 20 per cent. 
 
 3. It decreases the theine, chicory possessing none. 
 
 4. It increases the sugar, roasted coffee having usually 
 
 about 2 per cent, of sugar, while chicory when 
 roasted has at least from 8 to 9 per cent. 
 Cocoa. — The chief constituents of cocoa are these — namely, 
 cocoa butter, theobromine, and cocoa red. It is often adul- 
 terated, particularly with tallow, sesame, and cocoa-nut oils, 
 beeswax, and paraffin wax. 
 
172 THE BOOK OF DIET. 
 
 Vinegar may be adulterated with various mineral acids, 
 especially sulphuric acid, and various organic substances, 
 such as colouring agents and capsicum. 
 
 Lemon and Lime Juice are similar in their composition, 
 containing citric acid as the predominant free acid, and a 
 small amount of sugar and other organic matter. These 
 drinks are rather extensively adulterated, and it is by no 
 means uncommon to meet with a wholly factitious article 
 under this name. The chief adulterants are tartaric acid, 
 mineral acids, glucose, cane sugar, and various preservatives. 
 
 DISEASES CAUSED BY FOOD. 
 
 Ptomaine Poisoning.— This may arise from tainted meat, 
 milk, or fish, more especially shellfish. Ptomaines are al- 
 kaloidal substances produced by decomposition, or putrefac- 
 tion of proteins under the influence of bacterial action. 
 Serious and even dangerous symptoms — pain, sickness, 
 vomiting, collapse — may arise from eating food tainted as 
 above. In the case of poisoning from eating tainted fish or 
 mussels, the symptoms may arise within an hour or two, 
 and affect mainly the central nervous system. Ptomaine 
 poisoning more commonly arises from eating canned meats 
 which have stood some time after opening. In these cases 
 it may not be easy to determine whether the poison is derived 
 from the tainted meat, or is due to metallic poisoning from 
 the ingredients used in the process of tinning. It is well 
 also to keep in view the possibility that it is the result of the 
 preservative used. In addition to meat, milk, cream, ice- 
 cream, and cheese may also be tainted and induce acute 
 ptomaine poisoning. In connection with ptomaine poisoning, 
 it is important to keep in mind the frequency with which 
 idiosyncrasy is met with to special articles of diet, such as 
 shellfish, strawberries, and the like. 
 
DISEASES CAUSED BY FOOD. 173 
 
 Food-poisonmg due to Poisoned Non-putrefying Meat. — 
 
 Reference must be made to the occasional occurrence of 
 cases of this kind — for example, turkey eating deadly night- 
 shade leaves, followed by symptoms of atropine poisoning in 
 the human subject ; grouse and hares have been known to 
 be poisoned through eating the tender shoots of the laurel 
 and rhododendron shrubs ; oysters similarly may be the cause 
 of typhoid, from being taken from contaminated oyster beds. 
 Foods Containing Parasites or their Embryos. — Food 
 sometimes serves as the medium for the introduction of 
 parasites or their embryos, such as tapeworm, roundworm, 
 echinococcus, and trichina. The chief source of infection is 
 the use of raw or imperfectly-cooked flesh, a rarer source 
 being the ingestion of vegetables that have been tainted from 
 the excrement of infected animals. Trichinosis is acquired 
 from eating ham or pork infected with the parasites. It may 
 be a serious and is sometimes a fatal disease. 
 
IX. 
 
 INFANT FEEDING. 
 
 BREAST FEEDING. 
 Daring the Second and Third Day. 
 Hours of Feeding. 
 Length of Time allowed at the 
 Breast. 
 
 The Reasons for Weaning 
 A Baby. 
 Failure to gain in Weight. 
 Fretfulness. 
 Colic. 
 Vomiting. 
 Constipation. 
 Diarrhoea. 
 
 WEANING. 
 
 ARTIFICIAL FEEDING OF 
 
 INFANTS. 
 Cow's Milk. 
 Milk Preparations. 
 Proprietary Foods. 
 Foods suitable for Infant Feeding 
 other than Milk, and Milk and 
 Cereal Proprietary Foods. 
 
 Cow's Milk. 
 
 Modification of Cow's Milk. 
 
 To counteract the Impurities. 
 
 Scalding. 
 
 Pasteurization. 
 
 Sterilization. 
 
 Sterilized Milk. 
 
 Subsequent Care of the 
 Milk. 
 
 Feeding Bottles and Teats. 
 Alteration of the Percent- 
 
 age Composition op the 
 Nutritive Element. 
 Plain Water. 
 Barley Water. 
 Lime Water. 
 Fat Addition. 
 Sugar Addition. 
 
 Ingredients of Milk 
 
 Mixture. 
 
 Alterations to Increase the 
 
 Digestibility. 
 Use of Whey. 
 Citrated Milk. 
 Peptonized Milk. 
 
 PROPRIETARY FOODS. 
 Proprietary Foods made 
 from Milk. 
 "Humanized Milk." 
 Condensed Milk. 
 Dried Milk Preparations. 
 
 Malted Cereals. 
 With Carbohydrates completely 
 
 Malted. 
 Foods where the Carbohydrates 
 are partially Malted. 
 
 Farinaceous Foods. 
 
 FOODS SUITABLE FOR IN- 
 FANTS—OTHER THAN 
 MILK AND CEREALS. 
 
 Albumin Water. 
 
 Raw Beef Juice. 
 
 Meat Broths. 
 
 DIET FROM WEANING UP 
 TO EIGHTEEN MONTHS. 
 
 DIET FROM EIGHTEEN 
 MONTHS TO TWO YEARS. 
 
Chapter IX. 
 INFANT FEEDING. 
 
 The appalling mortality of infancy is due in no small degree 
 either directly or indirectly to faulty feeding. The woeful 
 ignorance in the feeding of infants is not limited to the 
 very poor ; it is by no means uncommon amongst the 
 well-to-do industrial classes, who trust to advice from any 
 one — for example, the mother who gave advice and said, 
 "How can any one know better than I do? I have had 
 fourteen children, and buried twelve ! " There is reason for 
 believing that this defective feeding is due more to ignorance 
 than to lack of means. We shall treat of — 
 
 1. Breast Feeding. 
 
 2. Weaning. 
 
 3. Artificial Feeding. 
 
 BREAST FEEDING. 
 
 An infant at birth cries lustily ; this is of value in promot- 
 ing a healthy expansion of the lungs. If the child continues 
 to cry it is supposed to be hungry, and the first mistake in 
 its feeding is then made — namely, the nurse at once giving 
 ordinary sugar and water, or milk and water. The sugar and 
 milk may set up irritation in a child with a delicate digestion, 
 
178 THE BOOK OF DIET. 
 
 therefore it is better to avoid giving anything more than a 
 couple of teaspoonfuls of cooled boiled water. Most healthy 
 infants, however, are contented and happy after being washed 
 and dressed, and require no food for the first twenty-four 
 hours. 
 
 During the Second and Third Day. — After the first twelve 
 hours the infant begins to be hungry. The secretion of 
 mother's milk does not start before the third day after the 
 birth, but it is advisable to put the child to the breast on the 
 second day. By this means the baby empties the breast of 
 the first milk, known as colostrum, which acts as a purgative, 
 and clears out all the black material that is lying in the infant's 
 bowel. The nursing should be done every six hours until 
 the milk flow becomes established. Most babies require 
 some extra nourishment, and it is best to give sugar of milk 
 (obtained at the chemist), dissolved in hot water, the propor- 
 tion being half a teaspoonful in half a pint of warm water. 
 This should be sufficient, but in the case of a specially large 
 and lusty child, a little milk and boiled water may be given 
 — one teaspoonful of milk in six or eight teaspoonfuls of 
 boiled water. 
 
 On the third day the milk flow commences, and at this time, 
 and during the first three weeks, the mother needs every 
 encouragement to persevere in the nursing. The discomfort 
 from the engorged breasts, the tenderness of the nipples, the 
 difficulty of making many infants suck properly, are all very 
 real trials to the mother ; and she often, from the lack of 
 encouragement from the doctor and nurse, decides that she 
 is unable to nurse, and the infant immediately is started on 
 artificial feeding. This is frequently a mistake, and if the 
 points now described are attended to, she can frequently 
 continue to nurse, or partially nurse, with great advantage 
 to the child. 
 
BREAST FEEDING. 179 
 
 For breast feeding there are two important rules. 
 
 1. The child must be fed at regular and stated hours. 
 
 2. The child should not be allowed to remain at the breast 
 
 more than from fifteen to twenty minutes. 
 Hours of Feeding. — For first two months the child should 
 be fed every two hours during the day, and not oftener than 
 twice during the night — that is, between 10 p.m. and 8 a.m. 
 
 Hours for Feeding. Interval. Night Feed. Total Feed. 
 
 From first week to end of 
 
 sixth week 2 hours ... 2 ... 10 
 
 End of sixth week to end 
 
 of third month 2J ,, ... i ... 8 
 
 End of third month to end 
 
 of sixth month 3 „ ... I ... 7 
 
 End of sixth month to 
 
 weaning 3 ,, ... o ... 6 
 
 After 10 p.m. the baby should sleep as long as possible, and if it 
 requires only one drink, say at 4 a.m., so much the better. 
 
 From the start the baby should be accustomed to miss 
 one feed at night, so that at least four hours uninterrupted 
 rest may be secured for the mother. This interval without 
 food is gradually increased, so that at three months the child 
 should go from 11 p.m. to 5 a.m. After six months a healthy 
 infant may be allowed to sleep seven to eight hours at night 
 without being disturbed for food. 
 
 The question whether an infant should be roused during 
 the day is an important one. It is certainly better to keep 
 strictly to the feeding hours, and the infant will become 
 regular in its habits, waking at the right time and sleeping 
 through the night. The monthly nurse can do much to 
 establish good habits, and if once started rightly the healthy 
 infant gives little trouble. Neglect of regular hours is often 
 the main cause of flatulence, colic, hiccough, fretfulness, and 
 sleeplessness. 
 
i8o THE BOOK OF DIET. 
 
 Over-frequent and irregular suckling stimulates the mother's 
 breast too much, and affects the quality of the milk in such a 
 way as to render it less digestible. 
 
 Length of Time Allowed at the Breast. — As it is impos- 
 sible to gauge the amount taken by the infant at the breast, 
 it is safer to feed by time. The child soon learns that it is 
 expected to take the breast and suck steadily for ten to 
 twenty minutes. This allows an ample supply of milk, even 
 to a child with feeble sucking powers. If one breast is 
 empty before the feed is ended, the other breast may also be 
 given. 
 
 When nursing, the mother should sit in a low chair, with the 
 infant on a pillow ; when it is small, this allows the nipple 
 to get into the child's mouth without straining the mother. 
 
 If these two rules are adhered to, what are the signs of a 
 thriving infant ? 
 
 1. The child gains steadily in weight after the first week. 
 
 A healthy child should gain four ounces per week 
 (see Chart). 
 
 2. The child sleeps well. A healthy child should fall 
 
 asleep after food, or lie awake contented and happy. 
 When an infant, though gaining in weight, frets and 
 cries and disturbs the house, it is suffering from in- 
 digestion in some form. There is also the good 
 baby, who does not gain in weight, but actually loses 
 weight week by week. This is much less trouble- 
 some in the home than the fretful baby, but is the 
 cause of much more anxiety. The child does not 
 have indigestion, but it fails to assimilate its food. 
 This type of malnutrition should invariably be under 
 a doctor's care. 
 
 3. The child is anxious for its food, and, after feeding for 
 
 ten or twenty minutes, is quite satisfied. 
 
IWEIGHI A G 
 
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 25 
 
 
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 23 
 
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 22 
 
 
 21% 
 
 ^^ 
 
 21 
 
 
 20% 
 
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 t 
 
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 18 
 
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 7 
 
 
 I 
 
i82 THE BOOK OF DIET. 
 
 4. The bowels move regularly. There should be at least 
 two motions in the twenty-four hours, of the consist- 
 ence and colour of thickly-made mustard, and there 
 should be no curd in the motions. 
 
 The Reasons for Weaning a Baby. 
 
 As has been said above, the infant ought to be breast- 
 fed for eight months if possible. If the mother can't do the 
 whole of the nursing, she should give as many feeds as pos- 
 sible, and make up with an artificial food. The feeding is 
 then spoken of as mixed feeding. 
 
 There are some maternal conditions when nursing is contra- 
 indicated. If the mother is acutely or seriously ill, she is 
 probably not able to nurse, and if she is tuberculous or 
 epileptic, or if exceedingly delicate, she should not attempt to 
 nurse. When, on two or three previous occasions, attempts 
 at nursing have proved failures, artificial feeding must be 
 adopted. 
 
 Weakly-looking subjects may make as good or better nurses 
 than big strong women ; emotional and highly-strung natures 
 do not, as a rule, make good nurses. Undue physical and 
 mental excitement acts unfavourably on the secretion of milk. 
 
 The following signs show that the breast feeding is not 
 being carried out satisfactorily, some alteration either on the 
 side of the mother, or on the length of time between meals, 
 or on the regularity of the feeding time, being called for : — 
 
 1. Failure to gain in weight. 
 
 2. Fretfulness. 
 
 3. Colic. 
 
 4. Voiiiidng. 
 
 5. Constipation. 
 
 6. Diarrhoea. 
 
BREAST FEEDING. 183 
 
 Failure to gain in weight may be due to one of two 
 causes : — 
 
 1. There is not sufficient milk being secreted, or 
 
 2. There is some quality in the milk interfering with the 
 
 child's power of absorbing the milk properly and 
 causing indigestion. 
 
 If the breasts are not secreting enough to feed the child 
 at alternate meals, both may be used for a feed; the 
 infant may cry when the breast is taken away, even if it has 
 sucked for longer than the usual period. The breasts them- 
 selves may not fill up before the meal, and it may be difficult 
 to squeeze even a small quantity of milk from the nipple. 
 This condition may be transitory — from the mother being too 
 tired or from some emotional cause. 
 
 A longer rest in the daytime is sometimes indicated. It 
 is sometimes advantageous to keep the infant in another 
 room at night, and just bring it to the mother at the nursing 
 hours. An increase in the mother's food may be indicated. 
 An increase of red meat (chop or grilled steak) or a little 
 extra milk may improve her nursing powers. However, if, in 
 spite of these precautions, the infant still fails to gain, artificial 
 feeding must be substituted at two or three meals in the 
 twenty-four hours, and this mixed feeding is very much better 
 for the baby than complete artificial nourishment. 
 
 Fretfulness. — On the other hand, the breasts may appear 
 full and overflowing, and yet the infant fails to gain in weight, 
 and is fretful, cries often, and sleeps badly. These babies 
 may pass undigested food in the motions in the form of 
 curd, or the motion may be green in colour. The question 
 arises, Is the mother taking indigestible food and causing 
 indigestion herself, or is she very constipated ? 
 
 The mother should put herself on the simplest of food — 
 fish, egg, meat, milk — for some days, take a good dose of 
 
i84 THE BOOK OF DIET. 
 
 castor oil, and, if constipated, attend carefully to the regular 
 action of the bowels. Lengthen the time between the feeds 
 by half an hour. This makes the milk become more watery. 
 
 The breast milk can be still further diluted by giving the 
 child three or four teaspoonfuls of cooled boiled water five or 
 ten minutes before each feed. If the infant is passing curd, 
 a dose of castor oil (one teaspoonful) is often beneficial. 
 
 If the motions are green, a doctor should be consulted. It 
 is unnecessary to say again that the rules of regular hours of 
 feeding and time at the breast should be strictly adhered to. 
 If, in spite of giving these suggestions a fair trial, and the 
 infant for two or three weeks does not gain in weight, and 
 shows signs of discomfort, it will be necessary to wean him, 
 as there is probably some ingredient in the mother's milk 
 which does not suit 
 
 Colic is a great trial to many babies. Occasional attacks 
 are the fate of almost all, but some have it constantly in 
 spite of all that can be done in the way of regulating their 
 feeds. Yet these children may gain in weight It is very 
 distressing ; but a child that suffers from colic when breast- 
 fed will probably suffer more from colic if artificially fed. 
 The suggestion as to the mother's diet, lengthening time 
 between meals, the giving of water or lime-water (a table- 
 spoonful before meals), an occasional dose of lime-water, five 
 or six drops of essence of dill in warm water with a little 
 sugar of milk, all help, and as the child grows older it gets 
 less inclined to have these attacks. 
 
 Vomiting. — Many children shortly after feeding bring up 
 mouthfuls of milk which is not sour or curdled (this is 
 posseting), and is simply the overflow firom an over-distended 
 stomach. If the child vomits mouthfuls of sour-smelling 
 fluid any time over half an hour from its last meal, it is 
 suffering from indigestion, and the suggestions laid down on 
 
BREAST FEEDING. 185 
 
 page '17 9 should be given effect to. The mother should eat 
 less and drink more fluid, and take more exercise. If this 
 vomiting still continues after these remedial measures have 
 been adopted, the medical adviser should be consulted. 
 
 Sometimes a child vomits by shooting with consider- 
 able force the stomach contents from its mouth. Such a 
 case of " projectile vomiting " should be under the doctor's 
 care. 
 
 Constipation is a common condition among breast-fed 
 infants, and when present is often very obstinate in yielding 
 to treatment. In these cases the motions lose the " mustard 
 colour " and have a grayish tinge. 
 
 The mother must attend to her own diet and see that 
 her bowels are kept active. She should take more cream 
 and butter, fruit and meat, and less milk. The idea of 
 laxative drugs taken by the mother purging the child by 
 being excreted by the milk is not generally correct, except 
 in the case of castor oil, which apparently in many cases 
 does affect the child. Other drugs which purge the mother 
 seem only to alter the quality of milk and upset the child. 
 If altering the mother's diet is not suflScient, the infant may 
 have three times a day half a teaspoonful of cream (or more), 
 diluted with two teaspoonfuls of boiled water, or the same 
 amount of best olive oil in a little hot water. After the 
 child is three months old, orange or grape juice (a teaspoonful 
 thrice daily) may be given. The child's abdomen may also 
 be gently rubbed, or the constipation may be combated by 
 the use of a glycerine injection or a soap and water enema. 
 But before starting any of these remedies the child should 
 be seen by a doctor. The habitual use of drugs is not to be 
 recommended. Castor oil is the best to be used occasion- 
 ally. Dinneford's fluid magnesia, Phillips's milk of magnesia, 
 or a few drops of syrup of figs, may also be used. 
 
i86 THE BOOK OF DIET. 
 
 Diarrhoea is very rare with breast-fed infants, but may 
 occur after a chill or from some indiscretion on the mother's 
 part. If it does supervene, clear out the bowels with a dose 
 of castor oil, rest the digestive tract by not nursing for twelve 
 hours, and afterwards giving alternate breast feeds and feeds 
 of albumin water (p. 53). This may be continued for 
 another twenty-four hours. The breasts will have to be 
 relieved by the breast-pump, otherwise they become very 
 painful. 
 
 WEANING. 
 
 This process should be gradual, and take from three to 
 five weeks to accomplish. If a baby has been entirely breast- 
 fed, the ninth month is a good time to make the change 
 from breast to artificial feeding ; but if the child is cutting 
 teeth, or if the weather is very hot, the change should be 
 delayed for a few weeks. If the child is eight months old or 
 more, it is a mistake to start the child on the bottle ; it 
 should be fed by spoon or drinking cup. In weaning a child 
 we should aim at giving at first a weak artificial food ; this 
 would be applicable to a bottle-fed baby of the same age. 
 
 A suggested table of the process of weaning is given on 
 p. 187. 
 
 When from social or other causes, as mentioned above, it 
 is found necessary to supplement the mother's milk with 
 artificial food during the earlier months, the process is some- 
 what different from what has just been described. The 
 mother may be able to nurse the child only during part of 
 the day or during the night. 
 
 Under these circumstances the hours for feeding must be 
 strictly adhered to, and the infant here begins with a milk 
 and water mixture (or other artificial food) corresponding in 
 strength to that for an infant four or six weeks younger, and 
 
WEANING. 187 
 
 
 is" 
 
 1 
 
 cream, J oz. 
 Gruel as fourth 
 week. 
 
 3 
 
 Milk with pro- 
 prietary food. 
 
 Milk as in third 
 week, and a 
 crust. 
 
 Milk as at 6.30 
 a.m. 
 
 i 
 
 S 
 
 
 
 (S4 
 
 (S 
 
 Milk, 6 oz. ; 
 water, 2 oz., 
 thickened 
 with oat flour 
 or farola 
 (sweetened). 
 
 Milk. 6 oz. ; 
 water, 2 oz. ; 
 cream and a 
 
 crust. 
 As in third 
 week. 
 
 As in third 
 week. 
 
 Breast. 
 
 
 1^ 
 
 As second week 
 — increase 
 milk, lessen 
 water. 
 
 n 
 
 Same as 9.30 
 meal, and 
 thickened 
 with propri- 
 etary food. 
 
 Milk, 5 oz. ; 
 water, 3 oz. ; 
 cream, 2 tea- 
 spoonf u Is 
 (sweetened). 
 
 Breast. 
 
 
 M 
 
 Milk, 4 oz. ; 
 water, 4 oz., 
 thickened 
 with a pro- 
 prietary food 
 (Allenlbury — 
 Savory and 
 
 
 Milk, 5 oz. ; 
 water, 3 oz. ; 
 cream, 2 tea- 
 spoonf uls 
 (sweetened). 
 
 Breast. 
 
 Breast. 
 
 
 1 
 
 1 
 
 
 Milk, 4 oz. ; 
 water, 4 oz. 
 (sweetened 
 and warm) ; a 
 crust to suck. 
 
 Breast. 
 
 Breast. 
 
 
 s 
 
 B 
 <i 
 
 
 
 
 i, 
 
 S 
 d. 
 
 
 
 i i^ 
 
 i si 
 
 2 ^^ 
 
i88 THE BOOK OF DIET. 
 
 the mixture is gradually strengthened till it is of suitable 
 strength for the infant of that particular age. (For details, 
 see under " Artificial Feeding.") 
 
 ARTIFICIAL FEEDING OF INFANTS. 
 
 When it is found that it is impossible to feed the baby on 
 the breast for some of the reasons above noted, it is neces- 
 sary to have recourse to artificial feeding. The different 
 methods of artificial feeding must be considered in some 
 detail. The choice of food has to be selected from the 
 following : — 
 
 1. Cow's Milk. — Milk from goat, ass, and mare may be 
 employed, but is seldom practicable. 
 
 2. Milk Preparations — 
 
 Humanized milk. 
 Whey. 
 
 Citrated milk. 
 Peptonized milk. 
 Condensed milks. 
 Koumiss. 
 
 3. Proprietary Foods — 
 
 Dried milks. 
 Malted cereal foods. 
 Partially malted foods. 
 Farinaceous foods. 
 
 4. Foods suitable for Infant Feeding other than Milk, 
 and Milk and Cereal Proprietary Foods — for example : — 
 
 Albumin water. 
 Malt soup. 
 Raw beef juice. 
 Meat broths. 
 
ARTIFIQAL FEEDING OF INFANTS. 189 
 
 Cow's Milk. 
 
 For all practical purposes this is the only milk that needs 
 to be considered, the facility with which it can be obtained 
 everywhere placing it within the reach of all. It is necessary 
 to again emphasize the importance of getting milk from a 
 source which is scrupulously clean. In view of the great 
 danger incurred by the child by drinking milk infected with 
 tubercle or other germs, the importance of this cannot be too 
 greatly emphasized. 
 
 If the chapter on "Milk" (p. 34) be carefully studied, it will 
 be seen that cow's milk requires modification to make it 
 conform to the composition of human milk, and to carry out 
 this modification intelligently a knowledge of the essential 
 differences between the two milks is necessary. The table 
 on p. 34 shows that the chief differences between the two 
 milks are : — 
 
 1. Cow's milk contains a much larger amount of protein. 
 
 2. This protein, when curdled by the stomach ferment, 
 rennin, forms a coarse, tough curd, which is more in- 
 digestible than the delicate curd of human milk. 
 
 3. (a) Human milk is sterile, cow's milk is not — hence 
 the necessity for scalding or pasteurizing. 
 
 (6) Cow's milk must, therefore, be treated in such a 
 way as to make it conform in purity and in chemical 
 composition, as much as possible, to the mother's milk. 
 This is effected in the manner now to be described. 
 
 Modification of Cow's Milk. 
 
 I. To counteract the impurities and management of the 
 milk in the home. 
 
190 THE BOOK OF DIET. 
 
 2. Alteration of the percentage composition of the nutritive 
 
 elements. 
 
 3. Alterations to increase the digestibility. 
 
 To Counteract the Impurities. — Cow's milk as it reaches 
 the consumer contains a large number of bacteria. If the 
 milk is from healthy cows, and has been collected and con- 
 veyed in a cleanly way, these bacteria are of a harmless 
 variety, and are not excessive in number. If, on the other 
 hand, the sanitary conditions in the dairy have been defect- 
 ive, or if the cows have been affected with tuberculosis, 
 serious diseases may be conveyed by the milk — for example, 
 typhoid fever, scarlet fever, diphtheria, tuberculosis. 
 
 On account of the grave risk of infection through milk, 
 much more attention is now being paid to sources of supply. 
 The inspection of dairies, cow-sheds, etc., has resulted in 
 much more cleanliness in handling the milk, and when it is 
 withdrawn it is now quickly cooled and kept on ice. This 
 is found to reduce the number of bacteria. Cold hinders 
 the development of bacteria, and thus limits the degree of 
 impurity of the milk. In hot weather milk is chiefly respon- 
 sible for that most terrible menace to infant life, " summer 
 diarrhoea." 
 
 In order to ensure the destruction of germs, the milk must 
 be subjected to heat. The application of heat of various 
 degrees for different lengths of time destroys the germs, but 
 at the same time impairs to a certain extent the nutritive 
 value of the milk. The milk before heating must be fresh ; 
 no amount of heat will make turned milk fit for infant food. 
 There are three methods adopted for destroying the 
 bacteria — namely, scalding, pasteurizing, and sterilizing. In 
 these the milk is not absolutely freed from bacteria, but all 
 the most dreaded pathogenic (disease-producing) bacteria are 
 destroyed. In the third method — sterilization — the milk is 
 
ARTIFICIAL FEEDING OF INFANTS. 191 
 
 exposed to a great heat for a sufificient time to destroy all the 
 germs present. 
 
 Scalding. — By this is meant rapidly bringing the milk to 
 boiling point, and then at once stopping the process by 
 quickly cooling the milk. It is advisable to stir the milk 
 frequently during the heating, so that the whole of it may be 
 heated to boiling point.^ Sufficient milk to last twelve hours 
 can be prepared at a time. The proper quantity of milk and 
 cream and water should be mixed before boiling. After 
 boiling, the mixture should be put at once into clean bottles, 
 which are closed with tight-fitting stoppers, and should be 
 at once placed in cold water to cool rapidly. Laboratory 
 experiments show that, for all practical purposes, milk which 
 has been treated thus is a perfectly safe food ; even virulent 
 tuberculous milk is rendered innocuous after an exposure of 
 five minutes to a temperature of 185° F. 
 
 Pasteurization means keeping the milk at a temperature 
 of from 155° to 165° F. for twenty or thirty minutes. This is 
 found to render the milk innocuous, so far as disease- 
 producing germs are concerned. Its effect on the milk is 
 similar to that of scalding : it does not make the milk sterile. 
 This method is more troublesome and no more efficacious 
 than scalding and quickly cooling. The same apparatus as 
 described under sterilization is used, but a lower temperature 
 is maintained. 
 
 Sterilization means the destruction of all bacteria and 
 spores, so that milk so treated will keep indefinitely. This 
 requires the milk to be kept at a temperature of 212° F. for 
 at least forty minutes, and subsequent rapid cooling. 
 
 Various apparatus are made for the purpose under the 
 name of " milk sterilizers," which are also used for pasteur- 
 izing. It consists of a double pan ; water is placed in the 
 outer vessel, and a thermometer is attached, and the milk is 
 
192 THE BOOK OF DIET. 
 
 in the inner vessels. The water for pasteurizing is raised 
 to from 155° to 165° F., and the source of that heat is re- 
 moved, and the milk is allowed to stand twenty minutes. 
 
 If the milk is allowed either to boil, and much more so 
 if it be sterilized, some change is effected in the milk, so 
 that the long use of such milk produces infantile scurvy, the 
 milk having lost its antiscorbutic power. Occasionally, also, 
 infants who have continuously been fed on milk boiled for 
 ten or fifteen minutes may show no sign of scurvy, but are 
 not getting on; they are peevish and miserable, the skin 
 shows an earthy pallor, the muscles are flabby, and the 
 child generally presents the appearance of malnutrition and 
 cachexia. 
 
 To sum up. All these methods of preparation are to be 
 regarded as necessary evils and not as virtues in themselves ; 
 but until all risk of contamination from the milk has been 
 eliminated, one or other system must be adopted, and prefer- 
 ably that of scalding the milk. 
 
 Sterilized Milk is now widely sold for commercial pur- 
 poses, and can be obtained in most towns, and " humanized 
 milk" as sold in the shops is also sterilized; the latter is 
 open to the same objection as the sterilized milk. These 
 sterilized preparations are very useful where, for any reason, 
 as in travelling, it is impossible to obtain fresh milk. In 
 some cases, also, sterilized milk seems to be more easily 
 digested than milk prepared in other ways, but this is quite 
 exceptional. 
 
 Subsetiuent Care of the Milk. 
 
 All jugs and bottles to be used for storing the milk must 
 be scrupulously clean ; this should be effected by boiling. 
 
 As soon as the milk has been heated and prepared, 
 it should be measured into the clean bottles, and carefully 
 
ARTIFICIAL FEEDING OF INFANTS. 193 
 
 stoppered with tight-fitting stoppers. These will supply the 
 feeds for the day. 
 
 After preparation, the bottles should be stood in water to 
 cool rapidly. The advantage of these arrangements is that 
 the bottles are prepared at one time, and only require the 
 stopper to be removed and the rubber teat to be put on. 
 The milk bottles should be warmed when required by stand- 
 ing for a few moments in a jug of boiling water. 
 
 Feeding Bottles and Teats. 
 
 The infant's feeding bottle must never be one to which 
 a tube is attached, as efficient cleaning is then impossible. 
 A suitable bottle is one that can be easily cleaned — a 
 number of different shapes are on sale — but a cylindrical 
 one with no corners to clean out is probably the most satis- 
 factory, and it is best to have enough bottles (four or five), so 
 that the meals need not be prepared oftener than twice in 
 the twenty-four hours. To these bottles a teat only is 
 attached, which is fastened on just before use. The teats 
 can easily be procured of varying sizes, and the best are 
 those made of plain black rubber. 
 
 The hole in the teat should not be too large, but sufiScient 
 to allow the milk to drop out when the bottle is inverted. 
 If the milk comes too quickly, the infant gulps it down, and 
 is very apt to be sick afterwards. A teat after being in use 
 some time tends to have too large a hole. 
 
 The most scrupulous care of bottle and teat is absolutely 
 necessary. After use, the bottle should be well washed out 
 with boiling water, and allowed to stand filled with water 
 until used. The teat especially must be carefully cleaned 
 and turned outside in after each feed, and allowed to lie in 
 boracic lotion when not in use. An occasional thorough 
 boiling of the bottles and teats is a good preventive measure. 
 
 7 
 
194 THE BOOK OF DIET. 
 
 Alteration of the Percentage Oomposition of the 
 Nutritive Element. 
 
 As has been noted, the essential difference between 
 human milk and cow's milk lies in the larger quantity of 
 protein in the latter and its more indigestible quality. In 
 order to reduce the excess of protein, the milk must be 
 diluted in one of the following ways : — 
 
 1. Plain Water is most commonly used ; it reduces the 
 percentage of protein, and also lessens the size of the curd. 
 This is often quite sufficient ; sometimes, however, the diges- 
 tion of the curd has to be assisted by using a thickened 
 diluent. 
 
 2. Barley Water. — This sometimes suits when the 
 dilution with plain water does not. It probably acts by 
 mechanically hindering the formation of the large curd. 
 As a food, barley water is of little value, and contains a little 
 starch, which may sometimes cause flatulence, colic, and 
 diarrhoea in very young children. In a constipated child, 
 barley water is often a very satisfactory laxative. Rice 
 water (p. 400) and oatmeal water (p. 400) can be used in the 
 same way. Rice water is advantageously used when there is 
 any tendency to diarrhoea. Oatmeal water has also a laxative 
 effect. Gelatine, in the form of a thin jelly, may also be used. 
 
 3. Lime Water used in the proportion of i tablespoonful 
 to 3 oz. of milk and water mixture, as well as acting as a 
 diluent, acts by lessening the size and toughness of the curd, 
 and its alkalinity is useful in the milk. Bicarbonate of soda 
 and fluid magnesia can also be used. 
 
 It has been found that sodium citrate, in the proportion 
 of 2 grains to i oz. of milk, prevents the curd formation 
 altogether. The use of it as an ingredient to be continued 
 for any length of time is not to be recommended. 
 
ARTIFICIAL FEEDING OF INFANTS. 195 
 
 Fat Addition. — After the dilution to reduce the protein, 
 the milk will have too small a proportion of fat, and, 
 therefore, it is necessary to add fat in the form of cream — 
 obtained by standing the milk for some hours and pouring 
 off the cream. 
 
 Sugar Addition. — The carbohydrate of the cow's milk is 
 also too much reduced by the dilution, and it is found best 
 to add milk sugar. This is added to the diluted milk. Cane 
 sugar may be used, and a lump about half an inch square 
 would be about equivalent to a level teaspoonful of the 
 milk sugar. These modifications produce a " milk mixture" 
 closely resembling human milk, which can be made suitable 
 for infants of different ages. 
 
 The strength, quantity, and number of feeds of the mixture 
 vary with the age of the child, and the following table will 
 be a good guide : — 
 
 Ingredients of Milk Mixture. 
 
 Measure out the ingredients and dissolve the milk sugar in water of 
 the mixture before adding other ingredients. Scald, pour into bottle, 
 close tightly, and cool rapidly. It is most convenient to prepare the 
 required quantity twice daily. 
 
 Age of 
 Infant. 
 
 No. of Feeds 
 in 24 Hours. 
 
 a?,7e'is: 
 
 Amount at one Time. 
 
 Note. 
 
 3rd- 10th 
 day. 
 
 10 feeds, every 
 2 hours from 
 8 p.m. to 10 
 p.m.; 2 feeds 
 during night. 
 
 1 oz. or 
 
 2 table- 
 spoon- 
 fuls. 
 
 Milk, 2 teaspoonfuls. 
 Milk Sugar, J teasp. 
 Water, ij tablesp. 
 
 
 loth day, 
 increasing 
 to end of 
 1st month. 
 
 Same as 
 above. 
 
 14 to If 
 oz. 
 
 Milk, J to } tablesp. 
 Milk Sugar, i teasp. 
 
 Cream, J teaspoon. 
 
 Water, ij.tablesp. 
 
 More water 
 
 than milk : 
 
 I milk to 3 
 
 water. 
 
 Food dur- 
 ing 2nd 
 month. 
 
 Food every 
 
 2^ hours, and 
 
 once at night. 
 
 Total, 5. 
 
 2 oz. 
 
 Milk, ij tablespoon. 
 Milk Sugar, J teasp. 
 
 Cream, I teaspoon. 
 
 Water, 2^ tablesp. 
 
 More water 
 
 than milk : 
 
 I milk to 2 
 
 water. 
 
196 
 
 THE BOOK OF DIET. 
 
 Age of 
 Infant. 
 
 No. of Feeds 
 in 24 Hours. 
 
 Quantity 
 at I feed. 
 
 Amount at one Time. 
 
 Note. 
 
 Food dur- 
 ing 3rd 
 month. 
 
 2} hourly ; 
 
 1 feed at 
 
 night. 
 
 24 to 3 
 oz. 
 
 Milk, 2j to 3 tablesp. 
 Milk Sugar, I teasp. 
 
 Cream, 2 teaspoon. 
 
 Water, 3 tablesp. 
 
 Almost equal 
 parts milk 
 and water. 
 
 Beginning 
 
 4th 
 
 month. 
 
 7 feeds every 
 
 3 hours ; 
 
 I at night. 
 
 4t0 4j 
 oz. 
 
 Milk, 4 to 4j tablesp. 
 Milk Sugar, i teasp. 
 
 Cream, 2 teaspoon. 
 
 Water, 3J tablesp. 
 
 More milk 
 than water. 
 
 month. 
 
 7 feeds as 
 above. 
 
 50Z. 
 
 Milk, 6 tablespoon. 
 
 Milk Sugar, 1 teasp. 
 
 Cream, 3 teaspoon. 
 
 Water, 3 tablesp. 
 
 2 pts. milk. 
 I pt. water. 
 
 6th 
 month. 
 
 6 feeds daring 
 
 day (3 hourly); 
 
 discontinue 
 
 night feed if 
 
 possible. 
 
 6 oz. 
 
 Milk, 8 to 9 tablesp. 
 Milk Sugar, I teasp. 
 Cream, 2 to 3 teasp. 
 Water, 2 to 3 tablesp. 
 
 3 pts. milk. 
 I pt. water. 
 
 7th 
 month. 
 
 3 hourly, 6 
 
 feeds; none 
 
 at night. 
 
 7to7i 
 oz 
 
 Milk, 10 to 12 tablesp. 
 
 Milk Sugar, J teasp. 
 
 Cream, i teaspoon. 
 
 Water, i to 3 tablesp. 
 
 
 8th 
 month. 
 
 3 hourly, 6 
 
 feeds ; none 
 
 at night. 
 
 80Z. 
 
 Milk, 12 to 14 tablesp. 
 Milk Sugar, i teasp. 
 Cream, J to i teasp. 
 Water, i to 2 tablesp. 
 
 
 It must, however, be kept in view that no table suits every 
 child; a delicate baby may require a more diluted milk, 
 while a large healthy child can take a stronger milk 
 mixture. The diluent may take the form of barley water, 
 rice water, or lime water, according to the indications set 
 forth above. 
 
 The rules for regularity and hours of feeding given under 
 " Breast Feeding " are applicable to artificial feeding. 
 
 A further milk mixture can be prepared, known as the 
 "cream mixture," but it requires constant skilled super- 
 vision, and is not suitable for children not under medical 
 
ARTIFICIAL FEEDING OF INFANTS. 197 
 
 observation. The milk mixture already described is now- 
 prepared and given out by institutions for feeding babies of 
 the poorest classes in many large towns, who are quite 
 unable to give the time and care to preparing an infant's 
 food properly. This is supplied at almost cost price. 
 
 If it is found that cow's milk, correctly diluted, with the 
 addition of cream and sugar of milk as indicated, does not 
 suit the infant, steps must be taken to improve the xiigesti- 
 bility of the milk, as follows : — 
 
 Alterations to Increase the Digestibility. 
 
 At any time during the first eight months of infancy an 
 attack of illness may supervene, in which, for the time being, 
 the infant's powers of digestion are diminished, and one of 
 the following methods of increasing the digestibility of the 
 milk may have to be adopted : — 
 
 (a) Use of Whey. — Whey is very useful where children 
 are unable to digest casein, as in cases of exhaustion after 
 acute diarrhoea, or in the last stages of wasting (marasmus). 
 It is commonly ' prepared by adding one teaspoonful of 
 essence of rennet (Mackay's) or Benger's curdling fluid to 
 half a pint of milk at about blood-heat (98° F.), allowing to 
 stand in front of the fire until the curd has set, then breaking 
 up the curd with a fork, allowing to stand for fifteen minutes, 
 then straining through muslin, and finally heating the whey 
 to boiling point. Whey thus prepared contains a little 
 soluble protein (lactoalbumin), and most of the milk sugar, 
 very little fat, and almost all the inorganic salts of the milk. 
 It can also be made by using sherry : heat half a pint of 
 milk to boiling point, add a good wineglassful of sherry, 
 then bring to boiling point, and allow it to stand until the 
 curd has settled, then strain through muslin. For infants 
 
igS THE BOOK OF DIET. 
 
 whose digestion has become enfeebled by a long course of 
 unsuitable diet, and who seem unable to digest anything, the 
 sherry whey acts as a stimulant to the gastric functions and 
 is an easily assimilated food, so that after a few days it is 
 possible to add cautiously other food, and so gradually get 
 the infant back to more nourishing diet. 
 
 If whey has to be taken for more than a few days, it is 
 advisable to add cream ; and many infants make excellent 
 progress for a week or two on a whey and cream mixture, 
 such as the following : — 
 
 Whey 4 tablespoonftils. 
 
 Cream J to i teaspoonfiil. 
 
 Milk Sugar ^ teaspooniul. 
 
 {b) Citrated Milk. — The addition of sodium citrate in 
 the proportion of one grain of the citrate to one ounce of 
 milk modifies the toughness of the curd in a very favourable 
 manner, and is sometimes of great value in the feeding of 
 infants. This method of modifying the milk should only be 
 used for a short time. Constipation is a frequent symptom 
 of infants fed with citrated milk. 
 
 (c) Peptonized Milk. — By artificially digesting the food 
 (peptonizing) previous to its administration, the digestive 
 powers of both stomach and bowel are rested, and this 
 method of feeding is often of great value. The peptonized 
 milk should never be continued unduly. It is necessary 
 to give the digestive powers some work to do, so the 
 peptonizing must be gradually lessened, then stopped; it 
 should not be continued for more than from four to six 
 weeks. For infants, Fairchild's peptogenic milk powder may 
 be recommended, and is used according to directions. 
 Extract of pancreas (Armour's), with soda bicarbonate 
 added, and Benger's liquor pancreaticus are also reliable 
 preparations. 
 
PROPRIETARY FOODS. 199 
 
 PROPRIETARY FOODS. 
 
 The name of these is legion, and it is impossible to 
 describe them in detail. The art of the advertiser is used 
 to induce mothers to try their foods, and the fact that the 
 names of these foods are constantly before the public 
 induces their use to an extent which is uncalled for and 
 injudicious. There are very few cases in which any of these 
 proprietary foods should be allowed to become the principal 
 article of diet, and, in spite of all the advertisements and 
 testimonials adduced, there is not a single infant food in the 
 market which can adequately replace cow's milk as a food 
 for infants. 
 
 There are three main groups of proprietary foods : — 
 
 1. Made from milk — for example, humanized milk, 
 
 condensed milk, and dried milks. 
 
 2. Malted cereals ; these may be completely malted and 
 
 the starch wholly changed, or partly digested only. 
 
 3. Farinaceous foods. 
 
 The value of the individual preparations depends upon two 
 factors, namely : (i) tfie amount of fat present, and (2) the 
 extent to which starch has been converted into a soluble sugar. 
 
 The low proportion of fat present in all the preparations 
 makes them quite unfit for infant food unless cream is added. 
 None of the "infant foods" which contain unconverted 
 starch should be given to an infant under six months, and 
 most infants are much better without any of these prepara- 
 tions until they are nine months old. 
 
 All these proprietary foods, if given alone for any length 
 of time, induce infantile scurvy. The food, in some way, is 
 devitalized in the process of manufacture, in the same way 
 as milk is affected by sterilizing, and general malnutrition 
 results. Many infants fed on these foods, without showing 
 
200 THE BOOK OF DIET. 
 
 the typical symptoms of scurvy-rickets, spongy gums, tender- 
 ness of the limbs, hemorrhages into the ends of the long 
 bones, show signs of impaired health — for example, earthy 
 colouring, cachexia, and malnutrition, which are closely 
 dependent on feeding with these prepared foods. 
 
 If, therefore, any of these preparations are to be used for 
 more than a few weeks, fresh fiod in some easily digested 
 form must be substituted — for example, white of egg in 
 albumin water (p. 53), raw meat juice (p. 384) ; lemon 
 whey, a teaspoonful of orange juice. The necessity of this 
 is recognized by some of the makers of these foods, who give 
 directions as to the simultaneous giving of fresh food. 
 
 Proprietary Foods made from Milk. 
 
 "Humanized Milk." — This is the name given to milk 
 specially modified and then sterilized so as to conform as 
 nearly as possible to human milk. It is sold in various 
 strengths, and can be procured from the larger dairy com- 
 panies. The principles of preparation are identical with 
 those described for the home modification of milk, but it is 
 devitalized by sterilization. As a temporary measure such 
 milk is often of great value where for any reason it is 
 impossible to carry out the careful modification of cow's 
 milk at home, but the home-made preparation is to be 
 preferred. 
 
 Condensed Milk. — This is cow's milk which has been 
 evaporated in vacuo and sterilized by heat. The variations — 
 whole unsweetened, whole sweetened, and skimmed and 
 sweetened — are fully described, with their advantages and 
 disadvantages, on p. 46. 
 
 Condensed milk should not be used as the only food for 
 an infant except for very short periods, as in travelling or 
 
PROPRIETARY FOODS. 201 
 
 during very hot weather. A very large proportion of infants 
 fed on condensed milk develop rickets — partly, no doubt, 
 owing to the excess of sugar and the deficiency of fat. The 
 lack of freshness in the food is an additional factor in the 
 production of infantile scurvy. 
 
 Dried Milk Preparations. — These are often particularly 
 well digested by infants who are quite unable to digest 
 ordinary cow's milk, and they are useful foods to give in 
 combination with breast feeding. The fresh mother's milk 
 given two, three, or four times daily does away with the 
 objection to their not containing the vital elements of fresh 
 milk. Some of the best known are " Allenburys " foods. No. i 
 and No. 2, and Horlick's malted milk, which all contain 
 a satisfactory amount of fat. These dried milk foods are 
 made with the addition of boiled water, and, on account of 
 an acid added during their preparation, the curd is much 
 finer than in ordinary cow's milk, and is an easily digested 
 one. These foods prove to be rather acid for some infants, 
 but this can be readily corrected by the addition of a pinch 
 of bicarbonate of soda to the bottles. 
 
 Nestl^'s milk food and Manhu infant food are mixtures 
 of desiccated milk with a partially malted wheat flour. Neither 
 of these is suitable for an infant under six months of age. 
 
 Malted Cereals. 
 
 I. With Carbohydrates completely Malted. — These can 
 be given at a much earlier age than those which contain 
 unconverted starch. Mellin's food is the best known of this 
 class of food. All the carbohydrates are in a soluble form. 
 It is made up with milk, and, if made according to directions, 
 there is little or no objection to its use. The addition of one 
 or two teaspoonfuls of Mellin's food to one or two of the 
 
 la 
 
202 THE BOOK OF DIET. 
 
 bottles daily proves useful, by helping the digestion of the 
 milk. This food has a laxative effect, and should not be 
 used if there is any tendency to diarrhoea; but if there is 
 obstinate constipation and poor digestion, Mellin's food may 
 be given once or twice daily in the milk as early as the third 
 month. 
 
 2. Foods where the Carbohydrates are partially 
 Malted. — After preparation, as directed, these foods contain 
 some unconverted starch. The best of them are taken 
 mixed with milk; they are deficient in fat When used 
 made with milk they are sometimes of service during the 
 eighth, ninth, and tenth months, but should not be given earlier 
 than the sixth month. They should not be given with every 
 feed ; once or twice in the day is usually sufficient. The 
 best known of this class are : — 
 
 Savory and Maoris Food is composed of wheat flour and 
 malt. When prepared with milk almost all the starch is 
 converted into the soluble form. 
 
 Be tiger's Food. — ^A mixture of wheat flour and pancreatic 
 extract. When prepared according to directions, almost all 
 the carbohydrate is converted, and the protein of the milk is 
 partially digested. This is a very good preparation to start 
 with for a delicate baby who is being weaned about the 
 seventh or eighth month. 
 
 " Allenburys " Malted Food (No. 3). — A mixture of wheat 
 flour and malt. When prepared as directed it still contains 
 some unaltered starch. 
 
 Diastased farina contains very little unaltered starch. 
 
 Nutroa Food. — A mixture of cereals, containing pea-nut 
 flour, which gives it a bitter taste. It is self-digesting, but 
 when prepared for use still contains much undigested 
 starch. 
 
 Coomb's Malted Food also contains much unaltered starch. 
 
PROPRIETARY FOODS. 203 
 
 Farinaceous Foods. 
 
 Farinaceous Foods, in which there is little or no conversion 
 of the starch, are not suitable for infants under ten months. 
 These include Ridge's food, only good if made with milk ; 
 Neave's food, only good if made with milk; Frame food, 
 a food specially rich in nitrogenous matter; entire-wheat 
 flour; Robinson's patent groats; Robinson's patent bar- 
 ley ; Chapman's whole flour ; Scott's oat flour ; Robbs's 
 baby biscuits, rusks, etc. 
 
 It is certain that some infants digest such foods as 
 early as the seventh month, but these are the exceptions, 
 and their use at this time more often results in flatulence 
 and colic or more serious forms of indigestion. The use 
 of these foods before the sixth month is frequently seen 
 in the children of the poor, and a serious state of health, 
 leading to marasmus and not infrequently death, may be 
 attributed to this. 
 
 FOODS SUITABLE FOB INFANTS — OTHER THAN 
 MILE AND CEREALS. 
 
 Albumin Water is made from white of egg (see p. 53) 
 It is of value chiefly as a protein food, and is useful in those 
 rare cases where the infant is unable to digest the proteins of 
 cow's milk It is also of value in cases of severe vomiting 
 and diarrhoea, where it is advisable to withhold all other 
 nutriment for twelve or twenty-four hours. 
 
 Raw Beef Juice is a very useful article of diet, and its 
 preparation is described on page 384. When given well 
 diluted it is readily digested by infants, and provides protein 
 in cases where the protein of cow's milk cannot be digested. 
 It can also with advantage be given to supply the fresh 
 
204 THE BOOK OF DIET. 
 
 element in an infant's food in the case of infants fed very 
 largely on sterilized food, or on the various proprietary 
 preparations. 
 
 An infant of six months may take a teaspoonful of raw 
 meat juice in a spoon, or mixed with diluted milk, or with 
 cream and water, three or four times daily. An infant of 
 twelve months can take an ounce of raw beef juice in 
 twenty-four hours. 
 
 Beef extracts (see p. 141) are of no value in infant feeding, 
 and should never be given. 
 
 Meat Broths. — For babes under nine months, five or six 
 ounces of a weak chicken-tea or a veal-and-mutton-tea 
 (p. 381) may be given as a temporary measure in cases of 
 troublesome vomiting or diarrhoea, combined with alternate 
 feeds of albumin water or whey. 
 
 DIET FROM WEANING UP TO EIGHTEEN 
 
 MONTHS. 
 
 Supposing the child has the bottles stopped by the time it 
 is ten months old, it should then be having five or six meals 
 in twenty-four hours — the first at 7 a.m., and the last at 10.30 
 or II p.m. Milk is still the staple food. The infant may 
 have three drinks of milk consisting of about six ounces, 
 with a crust and butter, or bread and butter, and three meals 
 made with some of the cereals, two of these meals being 
 preferably made up of partially digested foods. Shortly 
 after this the midday meal may be replaced with veal, 
 mutton, or chicken broth, or a cup of beef-tea, thickened with 
 crumbs, and a small drink of milk. Later, gravy thickened 
 with bread crumbs or potatoes, the fat of fried bacon in which 
 crumbs are soaked, or a lightly boiled egg beaten up with 
 milk and crumbs, may be given. 
 
DIET UP TO EIGHTEEN MONTHS. 205 
 
 The farinaceous foods, such as an oatmeal gruel or 
 Chapman's entire-wheat flour, are now useful. 
 
 The child should be encouraged to chew crusts and various 
 rusks for the sake of its teeth. Orange juice, grape juice, 
 and roast apple pulped, may also be given. 
 
 Age. 
 
 7 a.m. 
 
 Breakfast. 
 g a.m. 
 
 Dinner. 
 12.30 or I p.m. 
 
 Tea. 
 4.30 p.m. 
 
 Supper- 
 7 p.m. 
 
 " Night- 
 cap." 
 10.30 p.m. 
 
 g months. 
 
 Milk. 
 
 Basin of 
 
 gruel, 
 cream, and 
 drink of 
 milk. 
 
 Allen and Han- 
 bur/s or 
 Savory and 
 Moore's, milk, 
 and juice of 
 orange. 
 
 Milk, 
 crust 
 and 
 butter. 
 
 Allen and 
 
 Han- 
 
 bury's. 
 
 Milk. 
 
 10 months. 
 
 Do. 
 
 Do. 
 
 Milk, and broth 
 skimmed from 
 mutton, veal, 
 or chicken. 
 Cup of beef- 
 tea, or lightly 
 boiled egg, with 
 milk and bread 
 crumbs. 
 
 Milk, 
 bread 
 and 
 butter, 
 sponge 
 cake, or 
 rusk and 
 butter. 
 
 or 
 Robbs's 
 baby 
 biscuit? 
 with milk. 
 
 Milk. 
 
 11 months. 
 
 Do. 
 
 As above, 
 and vary 
 the cereal. 
 Frame 
 food, 
 barley 
 meal gruel, 
 wheat 
 flour. 
 
 As above, and 
 gravy, or broth, 
 thickened with 
 bread crumb or 
 rusk or well- 
 mashed potato. 
 Always milk. 
 
 As above. 
 
 As above, 
 or a 
 gruel. 
 
 Milk. 
 
 12 months. 
 
 Do. 
 
 Porridge, 
 rather thin 
 gruel, 
 cream, and 
 milk. 
 
 As above, 
 giving also 
 pulped roasted 
 apple, or curds 
 and cream. 
 
 As above. 
 
 As above ; 
 follow by 
 a crust 
 and 
 butter. 
 
 Milk. 
 
2o6 THE BOOK OF DIET. 
 
 DIET FROM EiaHTEEN MONTHS TO TWO 
 TEABS. 
 
 The child should now entirely stop the late drink of milk 
 at 10.30 p.m., and, if sleeping well, in the mornings should 
 stop the 7 a.m. milk, but in this case the breakfast wUl have 
 to be about eight o'clock, and a drink of milk before going 
 out should be added to the diet 
 
 About 1 1 pints of milk should be taken in twenty- 
 four hours, and for most children one pennyworth of 
 cream in addition will be useful. The foods above men- 
 tioned must still provide the supplies ; the breakfast should 
 still consist of a cereal well boiled, eaten with cream and 
 milk. . 
 
 At Dinner the child should have, every day, potatoes well 
 mashed in milk or gravy, or roasted apple pulped, or stewed 
 prunes rubbed through a sieve, or a pounded-down banana. 
 A little fish, whiting or sole, steamed and pounded, is very 
 suitable, also breast of chicken boiled or roasted, moistened 
 with chicken broth or bread sauce, or a little turkey, or 
 breast of pheasant, can be allowed. A small quantity of 
 beef or mutton from a roast, with plenty of gravy to a little 
 mashed potato, may be given very occasionally. 
 
 Meat should not be given more than twice a week. It is 
 advisable to plan the dinners so as to give soup three days 
 in the week, fish two days, and possibly chicken or game 
 another day, and the red meat on the remaining day. Meat 
 may be entirely withheld without doing any harm until the 
 child is two years old. 
 
 For Pudding, custard baked or boiled, curds with cream, 
 well-cooked milk puddings, tapioca, farola, semolina, sago, 
 bread crumb given with pulped fruit — for example, apple, 
 piunes, banana, apricot — are the most suitable. Seedy fruits. 
 
DIET UP TO TWO YEARS. 207 
 
 such as strawberries, raspberries, red and white currants, 
 should be avoided. 
 
 Blancmange, flavoured with orange or lemon, or a 
 meringue, gives variety to the puddings. 
 
 Mastication must be encouraged from the earliest time, 
 and to this end toast and butter, rusks, and crisp rolls should 
 always be available for the nursery. Bread and butter, plain 
 biscuits, and sponge cake are allowable. Fruit cakes, new 
 scones, cookies, buns, and pastry are injurious. A little jam, 
 such as red currant jelly, gooseberry jelly, apricot jam, may 
 be given (raspberry and currant not advisable). 
 
 A child should always be allowed a drink of cold water if 
 it is thirsty. Many nurses and parents think it is injurious, 
 but it will do no harm even in early infancy, and children 
 should be encouraged to drink rather than the reverse. 
 
X. 
 
 DIET AT DIFFERENT PERIODS OF LIFE. 
 
 I. DIET DURING CHILD- 
 HOOD, FROM TWO TO 
 SEVEN YEARS. 
 
 The Food Requirements of Chil- 
 dren. 
 Proteins. 
 
 Carbohydrates. 
 
 Fats. 
 
 Cereals. 
 
 Bread and biscuits. 
 
 Vegetables. 
 
 Broths and Soups. 
 
 Meat Foods. 
 
 Puddings. 
 
 Fruits. 
 
 The Fresh Berries. 
 
 Stewed Fruit. 
 
 Sugar, 
 
 MEALS. 
 
 Diet for a "Delicate" Child. 
 
 The Delicate Child from Threat- 
 ened Tuberculosis. 
 
 Diet for a Child of Five Years, of 
 Tuberculous Stock. 
 
 The Delicate Child from Weak 
 Digestion. 
 
 Diet for a " Gouty" Child. 
 Diet for the " Nervous " Child. 
 
 IL DIET DURING SCHOOL 
 LIFE. 
 
 IIL DIET IN MIDDLE LIFE. 
 
 IV. DIET IN OLD AGE. 
 Diet in Old Age. 
 
 Diet. 
 
 Milk and Cream. 
 
 Bread. 
 
 Butter. 
 
 Soups. 
 
 Fish. 
 
 Meat Dishes. 
 
 Vegetables and Fruits. 
 
 Fruit. 
 
 Liquids. 
 
 Stimulants in Old Age. 
 
 V. DIET DURING PREG- 
 
 NANCY. 
 
 Diet during Pregnancy. 
 Diet adopted to modify the Size 
 of the Child. 
 
 VI. RULES FOR DIETARY 
 DURING LACTATION. 
 
Chapter X. 
 
 DIET AT DIFFERENT PERIODS OF 
 LIFE. 
 
 Childhood, School Life, Middle Life, Old Age, 
 Pregnancy, Lactation. 
 
 I, DIET DURING CHILDHOOD, FROM TWO TO 
 SEVEN YEARS. 
 
 A common fault in the feeding of children is giving a diet 
 which consists too largely of soft food-stuffs, which require 
 little or no mastication. Such food-stuffs are usually of a 
 kind which lead to acid fermentation. Serious consequences 
 follow this defective system of feeding. In the first place, 
 the muscles of mastication and the jaws are imperfectly 
 developed, with the result that the post-nasal space is small 
 in size and liable to be further encroached upon by an excess 
 of lymphoid tissue (adenoids), with resulting unfavourable 
 effects on the growth and general nutrition of the child. 
 Secondly, the starchy foods lodge round the teeth and under- 
 go acid fermentation, with resulting dental caries. A first 
 essential in the feeding of children, therefore, is to see that 
 the food is of a nature that demands mastication. At each 
 meal the child should receive one or other of the following 
 articles of diet : baked bread (slice of ordinary bread placed 
 
212 THE BOOK OF DIET 
 
 in a quick oven until it is quite dry and crisp), milk toast 
 (thin slice of stale bread dipped in milk and baked in a slow 
 oven until it is brown), unsweetened rusks, unsweetened bis- 
 cuits, oatcakes, or unfired bread (Christian's, p. 244). After 
 a meal which contains much carbohydrate in the form of 
 cakes, or sweets, the acid in the mouth may advantageously 
 be neutralized by the salts present in a little raw fruit, such 
 as apples, bananas, or nuts. 
 
 From two years of age onwards the normal child has a 
 well-developed digestive apparatus and a keen appetite, and 
 is well able to digest most food-stuffs if given in moderation. 
 The teeth by this time are through the gum, and it is of the 
 greatest importance that the diet should be one which de- 
 velops the art of mastication. The movement of the jaws in 
 mastication in growing children promotes the development of 
 the muscles of the tongue, palate, and naso-pharynx ; it, at 
 the same time, favours the normal development of the nasal 
 and naso-pharyngeal cavities, which is of so great importance 
 for the purpose of respiration and general nutrition. Too 
 much importance, therefore, cannot be devoted to the ques- 
 tion of a proper diet during this developing period. 
 
 The following table gives the average weights and heights 
 of children at different ages. It should be borne in mind 
 that these averages are calculated from tables of the weights 
 and heights of a large number of persons, and though 
 accurate as a general guide, are not necessarily true for 
 each person. A deviation of fifteen per cent, in either 
 direction from the standard is not seriously regarded. Of 
 more importance than the actual weight is the proportion 
 between height and weight. Care must be taken that the 
 patients who are weighed periodically should always be 
 weighed under precisely similar conditions as to scales, 
 clothes, etc. 
 
FOOD REQUIREMENTS OF CHILDREN. 213 
 
 Malis. 
 
 Females. 
 
 Age last 
 birthday. 
 
 Height. 
 
 Weight. 
 
 Age last 
 birthday. 
 
 Height 
 
 Weight. 
 
 
 ft. in. 
 
 St. lb. 
 
 
 ft. in. 
 
 St. lb. 
 
 I 
 
 2 5i 
 
 I 4i 
 
 I 
 
 2 3i 
 
 I 4 
 
 2 
 
 2 8i 
 
 ,2 4i 
 
 2 
 
 2 7 
 
 I III 
 
 3 
 
 2 II 
 
 2 6 
 
 3 
 
 2 10 
 
 2 3i 
 
 4 
 
 3 I 
 
 2 9 
 
 4 
 
 3 
 
 2 8 
 
 5 
 
 3 4 
 
 2 12 
 
 5 
 
 3 3 
 
 2 II 
 
 6 
 
 3 7 
 
 3 2j 
 
 6 
 
 3 6 
 
 2 i3i 
 
 7 
 
 3 10 
 
 3 7i 
 
 7 
 
 3 8 
 
 3 5i 
 
 8 
 
 3 " 
 
 3 13 
 
 8 
 
 3 loi 
 
 3 10 
 
 9 
 
 4 If 
 
 4 4i 
 
 9 
 
 4 of 
 
 3 i3i 
 
 10 
 
 4 3i 
 
 4 iij 
 
 10 
 
 4 3 
 
 4 6 
 
 n 
 
 4 Si 
 
 5 2 
 
 II 
 
 4 S 
 
 4 12 
 
 12 
 
 4 7 
 
 5 6f 
 
 12 
 
 4 7i 
 
 5 6i 
 
 13 
 
 4 9 
 
 5 12J 
 
 13 
 
 4 9f 
 
 6 3 
 
 The Food Reanirements of Children. — The quantity of 
 food required by children is out of proportion to their size 
 and weight, for the following reasons : The rapid growth 
 taking place requires muscle-forming protein material for the 
 constructive processes; the incessant activity calls for an abun- 
 dant supply of energy-producing food — carbohydrates and fat : 
 the loss of heat in children is more rapid than in adults, and 
 an abundant supply of heat-forming food is therefore necessary. 
 The general principles of treatment are as follows : — 
 
 1. An abundant supply of protein, carbohydrate, and fat. 
 
 2. The meals to be given at regular hours, nothing being 
 
 given in the interval. 
 
 3. The diet should be simple, nothing being necessary to 
 
 tickle the palate or stimulate the appetite. 
 
 4. The diet should include a sufiScient amount of hard 
 
 food, so that the habit of proper mastication may 
 be acquired. 
 
214 THE BOOK OF DIET. 
 
 5. Fluid should be taken at the end of meals, special 
 care being taken that the fluid is not utilized to 
 swill down imperfectly masticated food. 
 
 Proteins are best supplied in forms of milk, eggs, and the 
 proteins in the various cereals and legumes. The proteins 
 of red meat and white meat are very appetizing, and much 
 relished by children, but they should be used sparingly. 
 Fish, chicken, and rabbit are preferable to red meats. Meat 
 soups thickened with various cereals and vegetables may be 
 recommended. 
 
 Milk should be the great standby; in the feeding of 
 children the allowance of one to two pints of milk daily, 
 according to age, is not at all too much for a child. Some 
 of this can be taken plain, some mixed with cocoa to make a 
 hot drink, and the remainder used in the cooking of gruels, 
 puddings, custards, etc. 
 
 Eggs are excellent for growing children ; if given every 
 day, a child tires of them, and in some children they cause 
 " biliousness." Very occasionally children cannot take eggs. 
 
 Carbohydrates are mainly supplied in the form of bread 
 in all its varieties, also by the different cereals, and by 
 vegetables properly prepared. 
 
 Fats. — Cream, butter, bacon fat, dripping, suet, yolk of 
 egg, are all forms in which fat can be presented to children 
 in an appetizing form. Fat is a most important element in 
 the food of children at this period of life. Cream and 
 butter are excellent forms of administering fat to growing 
 children. From one to three ounces of cream may be 
 given daily, this being given in the form of creamy milk, or 
 with puddings or stewed fruit. Bacon fat and marrow fat 
 are excellent forms of fat administration. Recipes are given 
 in ch. xxii. 
 
 Cereals. — Almost any kind of cereal may be given for 
 
BREAD AND MEAT FOODS. 215 
 
 breakfast, and a sufficient variety should be given to prevent 
 the child tiring of them. The following may be recom- 
 mended : Oatmeal, whole-wheat flour, as wheaten groats 
 or Artox, hominy, puffed rice; pease flour, lentil flour, 
 maize flour, are also good. 
 
 Bread and biscuits form the staple method of adminis- 
 tering carbohydrates. The bread should never be new. It 
 should be given twice daily as dry, crisp toast, or as baked 
 bread, as these promote mastication. The baker should be 
 asked to supply bread made only from flour which has not 
 been bleached. Dry, crisp rolls are also advisable. New 
 scones and buns are not advisable, but on the second day 
 are very good if toasted. These different bread foods promote 
 mastication, if care be taken to see that the child is not allowed 
 to swill them down with fluid. Plain biscuits should always 
 be available, but rich sweet varieties should only occasionally 
 be given. Plain sponge cake and biscuits are also allowable. 
 All rich cakes with fruit, rich butter pastry, and heavily iced 
 cakes should be withheld. 
 
 Vegetables may be given for dinner, such as plain boiled 
 or mashed potatoes, plain boiled and well-cooked cauUflower, 
 spinach, cabbage, or lettuce rubbed smoothly down and well 
 boiled. 
 
 Brotlis and Soups should not be made too strong, or 
 thickened with meat puree, but meat stock can be added to 
 good vegetable soup made with carrots, turnips, onions, 
 leeks, potatoes, lentils, peas. This may be thickened with 
 barley, rice, tapioca, groats, sago, macaroni, yolk of egg, 
 cream. A nourishing fish soup can be prepared and 
 thickened by adding a puree of the fish. 
 
 Meat Foods. — Fish of the white varieties, boiled, broiled, 
 and fried, are always allowable. Chicken and rabbit may be 
 given twice a week. Beef and mutton boiled and roasted are 
 
2i6 THE BOOK OF DIET. 
 
 quite digestible, but it is generally advisable not to start with 
 red meats until towards the end of this period. 
 
 Puddings should be taken once daily, the most suitable 
 being custards, plain, baked, or boiled; milk puddings of 
 different grains made with or without eggs; jelly (lemon 
 or orange or other fresh fruit) ; curds with cream. Suet 
 puddings are less digestible, and should certainly not be 
 given frequently. 
 
 Fruits are good for children; the fresh juice contains 
 properties which are good for the blood, and it contains 
 sugar in an easily assimilated form. Some fruit should be 
 taken daily. Of fresh fruits, oranges, apples, grapes, bananas 
 may be taken, avoiding the skins and stones. 
 
 The Fresh Berries — raspberries, red and white currants, 
 brambles, etc. — are best cooked and the juice eaten with a 
 pudding. Strawberries should be given very sparingly, as in 
 many children they disagree. 
 
 Stewed Fruit — apples, prunes, rhubarb, apricots, pears — 
 may all be given as an agreeable change to the milk puddings. 
 
 Sugar. — The growing child demands sugar, and usually 
 shows a great craving for it. It is best to supply this in the 
 form of sweet pudding or stewed fruit. Honey, syrup, jam, 
 eaten with bread and biscuits, are also good. A little good 
 chocolate or pure, plain toffee drop can do no harm in 
 moderation, but the indiscriminate partaking of confectionery 
 is prejudicial to the teeth and to the general nutrition. 
 
 It will be convenient at this stage to indicate the special 
 articles of food which may with advantage be withheld from 
 children under seven years of age : — 
 
 Meats. — Sausage, pork, salted fish, corned beef, goose, kidney, liver, 
 stewed meats. 
 
 Vegetables. — Fried vegetables of all varieties, raw or fried onions, raw 
 celery, radishes, lettace, cucumbers, beetroots. 
 
DIET SHEET FOR CHILD. 217 
 
 Bread and Cakes. — All newly baked bread, rolls, scones, buns. All 
 rice cakes containing dried fruits and thick icings. 
 Dessert. — Candies, pies, tarts, pastry of every description. 
 Drinks. — Tea, coffee, wine, beer, cider. 
 
 The following diet sheet is adapted for a child at this 
 period of life. The actual amount of food-stuffs to be given 
 will vary with the age and size of the patient : — 
 
 MEALS. 
 
 If child awake early (6 to 6.30 a.m.). Drink of milk; a 
 piece of dry bread, or plain biscuit. 
 
 Breakfast (8 a.m.). — Milk to drink, or cocoa made with 
 milk. A well-cooked cereal with salt and cream (no sugar 
 or syrup). Toasted bread and butter (with crusts), a little 
 jam. 
 
 This should be a sufficient breakfast for children up to 
 seven years, but if more is found necessary it should not be 
 more than an egg, boiled, poached, or scrambled, or a little 
 fish. A little fresh fruit may be taken after breakfast or 
 during the forenoon. 
 
 Dinner. — Milk to drink and toast to eat (with crusts); 
 and a two-course dinner as follows. As the child gets older, 
 soup and a more liberal supply of vegetables may be added. 
 
 1. Soup well thickened ; milk pudding. 
 
 2. Eggs with a vegetable ; junket. 
 
 3. Fish, potatoes ; suet pudding. 
 
 4. Chicken or rabbit ; stewed fruit. 
 
 5. Roast meat, potatoes ; custard. 
 
 Tea. — Milk, or milk and cocoa; bread and butter, biscuits, 
 plain scone, jam. 
 
 Supper. — Milk and toast and butter, or a cereal (for 
 example, gruel), with some unfired bread (p. 244). 
 
3i8 THE BOOK OF DIET. 
 
 The child should be taught to eat slowly, and to chew the 
 food well. In this connection attention may again be 
 directed to the importance of such articles of diet as crusts 
 of bread, crisp rolls, and the like being given daily, care 
 being taken that the child chews the food and does not 
 merely wash it down with fluid. The importance of this 
 can hardly be overestimated. . The quantity of food depends 
 largely on the appetite of the child. The appetite should 
 not be forced. 
 
 If the food is not all taken, it is well to wait until the next 
 meal. Loss of appetite is often an indication that the 
 digestive organs require a rest. This rule does not apply 
 to sick children. 
 
 Diet for a "Delicate" Child. — There are two common 
 and important causes of "delicacy" in children — namely, 
 (i) the tuberculous tendency and (2) chronic indigestion 
 from weakened state of digestive secretion. These will be 
 separately referred to, also diet for child of gouty parents, 
 and the nervous child. 
 
 The Delicate Child from Threatened Tuberculosis. — In 
 families where there is a marked tendency to tuberculous 
 disease, the question of diet is a highly important one, since 
 much can be done to eradicate the tendency. The special 
 feature about the diet in such cases is the necessity of an 
 increased amount of animal protein food, and more especi- 
 ally meat or raw meat juice. The beneficial effects of a 
 properly planned dietary in these cases are very remarkable. 
 Needless to say, the appropriate diet must be continued for 
 many months, or even for a year or two, if the best results 
 are to be obtained. The following diet sheet is adapted for 
 a child of five or six years of age with a strong hereditary 
 tendency to tuberculosis. 
 
 Diet for a Child of Five Years, of Tuberculous Stock. — 
 
DIET FOR " DELICATE " CHILD. Z19 
 
 This dietary contains a more liberal supply of animal proteins 
 in the form of milk, eggs, meat, and soup than an ordinary 
 diet, the diet including two pints of milk, and meat foods at 
 least three times daily. This point should be insisted on 
 and continued during the growing period. 
 
 Six-thirty a.m. — Milk ; biscuit and butter. 
 
 Breakfast. — Milk ; butter, bread, egg, fish, or bacon. 
 
 Lunch. — Cup of soup (meat stock), or egg flip. 
 
 Dinner. — Soup, with raw meat ; curds and cream ; glass of milk. 
 Pounded meat and vegetable ; stewed fruit cream ; glass of milk. Fish, 
 with sauce, potato ; custard pudding ; glass of milk. Chicken, bread 
 sauce, vegetable ; blancmange cream ; glass of milk. 
 
 Tea. — Milk ; bread and butter. 
 
 Supper. — Good meat soup, thickened with milk ; or egg, or meat 
 puree, or lentil pur^e. 
 
 The Delicate Child from Weak Digestion. — The clinical 
 picture of a child suffering from chronic indigestion is a 
 varied one. The child may be well nourished, but more 
 commonly it shows wasting. Listlessness and a general 
 physical and mental apathy are prominent features, and these 
 are associated with loss of appetite, distaste for ordinary 
 food, and often a distinct degree of anaemia. A derangement 
 of the bowels is usually present, the bowels being constipated 
 or loose, the motions being offeiisive and containing undi- 
 gested food-stuffs. This condition arises from over-feeding 
 or injudicious feeding of long duration. Too liberal indul- 
 gence in starchy foods, with excess of sweets and tea, are 
 commonly noted causes ; these cases are, indeed, frequently 
 merely cases of starch indigestion. In the treatment, the 
 whole digestive tract must get a rest by the administration of 
 only small quantities of the most easily digested foods given 
 in fluid form. The benefits of this treatment are often more 
 quickly obtained by keeping the patient in bed for a few 
 days, and clearing out the bowels thoroughly as a preliminary 
 
220 THE BOOK OF DIET. 
 
 measure. The diet at the outset should consist of peptonized 
 whey, weak beef-tea, a weak mutton, veal, or chicken soup, 
 given in 3- to 4-ounce feeds, with not more than a finger 
 of crisp toast. Skimmed milk, chicken jelly, and meat 
 juice are then added to the diet. Later, ordinary milk is 
 given, and, if well tolerated, it may be fortified by white of 
 egg, plasmon, protein, or sanatogen, and by the addition of 
 simply prepared fish, chicken, or sweetbread. Starchy foods 
 must be added very cautiously, beginning with crisp toast, 
 rusk, or stale bread, and going on to a plain milk pudding or 
 prepared invalid food — Savory and Moore's, Benger's, or 
 " AUenburys." The administration' of extract of malt or 
 maltine is of value in aiding the digestion of carbohydrates, 
 and much benefit is also obtained by administering 10 
 to 20 grains of bicarbonate of soda thrice daily between 
 meals; the latter corrects the "acidity" present in these 
 cases. 
 
 It will be found advantageous in these cases to restrict 
 the diet for some time along the following lines, the carbo- 
 hydrates and fats being specially curtailed. 
 
 Breakfast. — Skimmed milk; fish, ham, or tongue, stale bread, toast, 
 or crisp roll with a little butter. 
 
 Dinner. — A bowl of clear soup ; a good helping of fish, chicken, or 
 meat, green vegetables (no potatoes) ; toast or rusk (no puddings) ; 6 
 ounces diluted milk. 
 
 Tea. — Cup of warm diluted milk with slice of toast, and dry biscuits 
 (no cakes). 
 
 Supper. — Cup of beef-tea thickened with plasmon, and a rusk or slice 
 of toast. 
 
 The above regime can be gradually added to by the 
 addition of plasmon, or sanatogen, added twice or thrice 
 daily to the milk or beef-tea ; also by custard pudding, curds, 
 fruit jelly, stewed fruit without added sugar, meringues; 
 starchy foods may be resumed in the form of the invalid 
 
DIET DURING SCHOOL LIFE. 221 
 
 foods given once daily — for example, for supper — after 
 which a gradual return is made to plain ordinary food. 
 
 Diet for a "Gouty" Child. — In families where there is a 
 marked gouty tendency, the diet of the children should be 
 carefully regulated, since it is certain that with care much 
 can be done to eradicate the tendency. The special points 
 to observe are : — (i) The necessity of bringing up the child 
 very largely on a lacto-vegetarian diet ; red meats of all kinds 
 should be withheld, or, at most, given very occasionally; 
 and (2) Sugar and food-stuffs rich in sugar should be given 
 sparingly. If the child is carefully dieted along these lines 
 during the growing period, he will be much less prone to 
 develop gouty symptoms in later life. 
 
 Diet for the "Nervous" Child. — Sleeplessness, night 
 terrors, chorea, and a general state of mental irritability are 
 characteristic of the nervous child. In such cases, and in 
 all children where there is a family history of nervous dis- 
 orders, careful regard must be paid to the diet. It must 
 essentially be of a non-stimulating character; meats and 
 meat foods must be withheld ; milk, farinaceous foods, fruits, 
 and vegetables forming the dietary. The diet should be of 
 the lacto-vegetarian character described on p. 257. 
 
 n. DIET DUEING SCHOOL LIFE. 
 
 During this stage of life the rapid growth and incessant 
 activity still continue, and to this is now added the brain- 
 work. It thus follows that growing boys and girls require a 
 large amount of nourishing food. 
 
 If a child has been wisely brought up and. has a duly pro- 
 portioned amount of work and play and sleep, his appetite is 
 the best guide to the amount of food required. The appetite 
 of a child that has been pampered, and has not been brought 
 
222 THE BOOK OF DIET. 
 
 up on plain, wholesome food, is not a reliable guide to the 
 amount of food required. 
 
 A very important point in the diet of young subjects is 
 that of not starving the growing child in any one food-stuff. 
 A requisite amount of proteins, fats, and carbohydrates is 
 essential. To stint is very often to starve; therefore, in 
 arranging the diet, the meals should be at regular intervals, 
 three good meals being given daily. A due amount of con- 
 sideration must be given to the whole diet. Abundance of 
 milk, a fair supply of fresh meat, and a liberal amount of 
 vegetables and fruits are the essentials in the dietary of this 
 period. The question of hours is important. Breakfast 
 should be punctual, to allow the child to have time to eat a 
 good hearty meal, and have time before starting for school 
 to get the bowels attended to. Day scholars are very often 
 much upset through neglect of this wholesome rule. The 
 meals should not be bolted, ample time being taken to effect 
 proper mastication of the food. The following dietary may 
 be recommended : — 
 
 The breakfast should be the heartiest meal of the day. Begin with a 
 small plate of porridge and glass of milk ; this followed by an egg or 
 fish, bread and butter, or toast and butter, and tea or coffee largely made 
 with hot milk ; jam or marmalade and oatcake. 
 
 Eleven-thirty a.m. — The following snack may be given if breakfast 
 is a very early meal : A dry biscuit and a drink of milk (not hot 
 scones, buns, or pastry) ; a little fresh fruit — for example, apple, orange, 
 or banana. 
 
 Dinner, in the middle of the day, should consist of soup, meat, 
 vegetables, and pudding. The soup does not require to be made of rich 
 meat stock — lentil, pea, broth, or rice soup are all excellent, giving a 
 good foundation for the meat course. Meat : roast, boiled meat, and 
 stews are the best, served always with potatoes and a vegetable. 
 Pudding should be varied. Suet puddings with fruit or jam, milk 
 puddings, or stewed firuit. A glass of milk may be given with this 
 meal, and as much bread as the child wishes to take. 
 
 Tea should not be later than S-SO p.m., to consist of— Beverage, 
 
DIET IN MIDDLE LIFE. 223 
 
 milk or cocoa (not tea as a rule) ; as much plain bread and toast as the 
 child can eat, plain cake ; sometimes an egg, or fish, or potted meat ; 
 marmalade, jam, or honey. 
 
 Under no circumstances should beer or other alcoholic liquors be 
 given to boys at school. 
 
 in. DIET IN MIDDLE LIFE. 
 
 A young man in enjoyment of good health and leading an 
 active outdoor life may, under the stimulus of appetite and 
 of enjoyment in gratifying it, often exceed considerably in 
 quantity and quality of food without apparent detriment to 
 his general health. But as middle life approaches, if the 
 same liberal regime is continued, the balance of unexpended 
 nutriment soon tells more or less heavily against him ; more 
 especially if, as usually happens, the subject is leading an 
 inactive life as regards muscular exercise. The neglect to 
 adjust a due relation between the " income " as regards food 
 and the "output" as regards energy and the state of the 
 excretions cannot go on for an indefinite period without 
 signs of mischief appearing in some quarter. If the subject 
 is predisposed to corpulence the unemployed material in the 
 food is stored up in the form of fat in the subcutaneous 
 tissue and intestinal organs, and the owner is handicapped 
 by a weight which makes active movement difficult and the 
 respiration unduly embarrassed on exertion. Not one man 
 in fifty lives to a good old age in this condition. Such 
 a man must therefore select a diet that agrees with his 
 " constitution " rather than one which simply agrees with his 
 stomach, and if he would avoid an apron of fat with its 
 attendant disadvantages he will restrict judiciously the fats 
 and carbohydrates in the dietary (see ch. xix.). Obesity 
 can almost invariably be controlled by a sound system of 
 feeding. In other subjects the failure to adjust the balance 
 
224 THE BOOK OF DIET. 
 
 between intake and output is revealed by the occurrence of 
 so-called bilious attacks, or recurring attacks of rheumatism 
 or gout. 
 
 The gourmet endeavours to get rid of the accumulated 
 excess of aliment in his system by various devices — for 
 example, special exercises, Turkish baths, and annual visits 
 to a spa. These admirable methods of treatment would be 
 less frequently necessary if individuals realized that these 
 diseases are merely the natural result of errors in feeding. 
 It should be kept in mind that just as human brains differ 
 vastly in power and activity, human stomachs show equal 
 variations in their capacity and power to digest. The 
 natural power to digest is small in some people, if judged by 
 the standard requisite to digest the large excess of food that 
 is often taken by some people in middle life and after. But 
 this limitation, it should be noted, is not without its im- 
 portant compensation. A stomach which is relatively 
 delicate as judged by this standard, and which can just 
 do the needful work for the system and no more, is in 
 reality a good friend to its owner, as it prevents the gross 
 excesses in feeding, with their attendant serious evils, which 
 are so well exemplified in the owner of the strong stomach, 
 who appears for the time being to pay no penalty for his 
 dietetic indiscretions. 
 
 We must keep in view the important consideration that 
 although broad rules of diet may be laid down as applicable 
 to different classes of people in general, no accurate appli- 
 cation to the individual is possible without a knowledge of 
 his daily habits as well as to some extent of his personal 
 peculiarities. The amount of fresh air, the physical exercise 
 indulged in, the amount of brain work undertaken, are all 
 important factors requiring to be considered. A man en- 
 gaged in hard manual labour requires as a rule about 40 per 
 
DIET IN OLD AGE. 325 
 
 cent, more nourishment than a man of equal size and 
 weight leading an indoor, sedentary life. A light diet is of 
 special value to brain workers. It does not require much 
 force to digest, nor much muscular exercise to assimilate. 
 Cereal foods, such as well-made breads in variety, and vege- 
 table produce, including fruits, should form a large part of 
 the diet, with the addition of eggs and milk, and little meat 
 foods other than fish, fowl, and game. Red meats should 
 not be taken more than once a day. For those engaged in a 
 sedentary occupation, and more especially if much brain 
 work is involved, the middle day meal can with advantage 
 be selected from fruit, bread and cheese, and milk if desired. 
 If afternoon tea is taken, it should be restricted to one or 
 two cups of tea, with wafers of toast or light cake, but solid 
 food is better withheld. The arrangement of meals will 
 necessarily vary according to the work and social circum- 
 stances of the individual. 
 
 IV. DIET IN OLD AGE. 
 
 Diet in Old Age. — Increasing years are associated with 
 diminishing activity and a lessening demand for energy. 
 Less nourishment must therefore be taken in proportion as 
 age advances, or the individual will suffer. If a man of 
 sixty continues to take the same abundant breakfast, sub- 
 stantial lunch, and heavy dinner which he indulged in at 
 the age of thirty or forty, serious illness will result. He 
 may accumulate fat which will lead to serious heart mis- 
 chief, or he may develop various symptoms of gout or 
 rheumatism which will be in turn associated with evidence 
 of kidney weakness and marked liability to apoplexy. The 
 tissues in later life have less power to eliminate, and the 
 excretory activity of the kidneys diminishes with increasing 
 
 8 
 
226 THE BOOK OF DIET. 
 
 years. The amount of food therefore consumed in old age 
 must be proportionate to the lessened demand of the tissues, 
 and to the diminished powers of elimination. The total 
 intake of food must be reduced. For the same reasons a 
 man of seventy requires less food than a man of sixty years 
 of age, and an octogenarian less than a man of seventy. It 
 is often difficult to get the relatives of an old man to believe 
 that it is not advisable to " support " the weight of years by 
 liberal feeding. The attempts to strengthen the old man by 
 giving extra nourishment in the form of strong beef-teas, egg 
 flips, and the like cannot be too strongly deprecated. Such 
 liberal feeding merely goes to overcharge the blood with 
 impurities, and to accelerate the decay of the tissues. Given 
 a fair constitution, the use of a physiological diet in old age 
 promotes a comfortable life, and is attended by a freedom 
 from serious trouble which is of the greatest advantage both 
 to the individual and to his relatives. It will be convenient 
 to give the guiding rules for the dietetic management of a 
 person of seventy years of age. Care has to be taken in the 
 following directions : — 
 
 1 . To restrict the total amount of food. 
 
 2. To make the diet simple and nutritious, avoiding 
 
 excess of animal food. 
 
 3. To pay special attention to the form of administration 
 
 of carbohydrates — old persons are specially prone 
 to flatulence. 
 
 Diet. — The food should be given at short intervals, say 
 four to six times in twenty-four hours ; the diet should be 
 simple ; by this it is to be understood that not only is 
 the quantity of food taken to be gradually diminished in 
 proportion to decreased activity of body and mind, but that 
 not more than two or three different forms of food should be 
 
DIET IN OLD AGE. 227 
 
 served at any one meal. There is no objection to variety in 
 the choice of foods. All food must be in a form admitting 
 of easy mastication. 
 
 Any system of diet must be varied according to the 
 circumstances arid personal idiosyncrasies of the individual, 
 but the following arrangement of meals can be recom- 
 mended. If the patient is markedly obese, the diet must 
 be restricted and modified along the lines laid down for 
 " Obesity " in ch. xix. 
 
 Six a.m. — Cup of tea freshly made ; nothing to be eaten with it. 
 
 Breakfast (S.30 a.m.) — A small cup of tea or coffee ; bread-stuff should 
 not be hot rolls, or indigestible new bread ; eggs or fish cooked in 
 various well-known ways. 
 
 Lunch (1 or 1.30p.m.). — Fish and a farinaceous pudding, or fish and 
 biscuits and cheese. It is, in most cases, better to reserve the meat or 
 fowl to the evening meal. 
 
 Four p.m. — A cup of freshly made tea. 
 
 Dinner (7 p.m.). — Should generally commence with a little soup, a 
 vegetable pur^e, or a good fish soup (vide infra). Many elderly 
 subjects are better without soup. Fowl or game, red meat only 
 occasionally, and one dish of vegetable pudding of a light, &rinaceous 
 variety, or stewed firuit. 
 
 Ten p.m. — A cup of good consomm^, or beef-tea or chicken tea, with 
 a thin slice of toasted bread, is a very good thing for old persons just as 
 they get into bed. 
 
 Milk and Cream. — Cream is a capital substitute for 
 other forms of fatty food, and should be taken with tea and 
 pudding. 
 
 Milk, if it can be digested, should always form a part of 
 the dietary of the aged; the tendency should be to increase 
 the amount of milk used as the vegetables and fruits are 
 diminished. Milk is, of course, used in the cooking of 
 gruels and farinaceous foods. As a beverage, milk can be 
 taken with cocoa or coffee, or warmed and taken with a 
 little saline or effervescing water. 
 
228 THE BOOK OF DIET. 
 
 Bread. — White or brown bread should always be toasted, 
 and some forms of bread are found to be more digestible 
 than others — for example, a " pan " loaf. The toast should 
 be thoroughly toasted through, and quite brittle; two to 
 three slices crisply toasted should be sufficienf. Dry biscuits 
 and rusks have also special value in the diet of the aged (see 
 also p. 387). 
 
 Butter. — Fresh butter is the most wholesome of all fat 
 foods, one ounce being taken in the twenty-four hours. 
 
 Soups. — The light forms of consomme, vegetable purees, 
 and fish soup are all appreciated when taken in small 
 quantity. Chicken, veal, and beef teas may all be used for 
 the light supper meal at night. Rich animal purdes, hare 
 soup, kidney soup, ox-tail, and turtle all throw too much 
 strain on the digestive glands and should be avoided. 
 
 Fiah. — Fish is allowable for old people. The oily fishes 
 — such as salmon, herring, mackerel — are the only ones that 
 are apt to disagree, unless taken in small quantities. In 
 addition to the usual methods of boihng, frying, and baking 
 fish already described, a variety of dishes may be made 
 from this class of food that are found to be appetizing 
 as well as quite satisfying. 
 
 Meat Dishes. — Chicken and tongue are useful in the dietary 
 of the aged. 
 
 Vegetables and Fruits. — Old people are very apt to give 
 up vegetables, owing to their flatulent properties. This 
 practice is not a good one, for, if persisted in, some minor 
 symptoms of scurvy not infrequently develop. Everything 
 depends on the form in which the vegetables are adminis- 
 tered, and on the amount and nature of the other ingredients 
 of the meal. 
 
 A small quantity of potato should be taken every day if 
 possible, and also a certain amount of well cooked vege- 
 
DIET IN OLD AGE. 229 
 
 tables. Spinach, stewed lettuce, stewed or baked tomatoes, 
 vegetable marrow, cucumber, boiled or stewed celery, sea- 
 kale, asparagus, leeks, the flower of cauliflower, large Spanish 
 onions, and French beans are all suitable. Uncooked 
 vegetables as partaken of in salads are not very satisfactory, 
 since they are apt to cause fermentation. The same holds 
 good for cabbage, greens, brussels sprouts, turnips, parsnips, 
 and old carrots. For methods of preparation of the vege- 
 tables see p. 385, and ch. xxii. 
 
 Fruit taken in small quantity is also permissible. It is 
 best to take it cooked, either stewed or baked, and eaten 
 with cream. 
 
 In stewing fruit, if cane sugar is added by the cook, the 
 resultant product is very apt to turn acid. It is therefore 
 better to neutralize the acidity with an alkali rather than 
 to attempt to mask the flavour with sugar. Thus, to each 
 pound of fruit add as much bicarbonate of soda as will 
 lie on a shilling. The bitterness of the fruit will be gone, 
 and the natural flavour of the fruit will become apparent, 
 which is usually quite sweet enough. If this simple method 
 be adopted, many old people will find that they can enjoy 
 stewed fruit without the annoyance of acidity or heartburn. 
 If there is a desire for sweetness, saccharin or saxin may take 
 the place of sugar. 
 
 Lig.uids. — Very weak tea is generally best for breakfast, 
 with a good proportion of milk and cream. This should be 
 drunk at the conclusion of the meal. At lunch a cup of 
 coffee and milk, or cocoa and milk, may be taken, or a glass 
 of water may be taken after the meal is finished. 
 
 Stimulants in Old Age. — The question of the advisability 
 or not of giving stimulants to old people depends largely on 
 the previous habits of each individual. In the case of those 
 who have not been accustomed to liquor in any form, no 
 
230 THE BOOK OF DIET. 
 
 advantage is to be gained by recommending it — they are 
 better without it. For those who have been accustomed to 
 indulge in a little wine or spirits, a small amount of alcohol 
 may be advisable daily. This should be given with the chief 
 meal of the day. A tablespoonful of whisky in a little water 
 or table-water is probably the best form in which the 
 stimulant may be administered. There is no reason why a 
 glass of sound wine of any variety should not occasionally be 
 taken in place of the whisky, but it is not advisable to take 
 wine daily — this almost inevitably leads to manifestations of 
 " rheumatism " or deranged digestion. 
 
 V. DIET DURING PREGNANCY. 
 
 Diet during Pregnancy. — A good mixed dietary is the one 
 best adapted for the normal pregnant woman. If the bowels 
 are kept regular, and if the patient takes the requisite amount 
 of fresh air and exercise, no special dietary precautions are 
 called for. Too much importance cannot be laid on the neces- 
 sity of preventing constipation, and on the value of fresh air 
 and exercise for the parturient woman. In many pregnant 
 women, however, it is advisable to modify the diet. The 
 necessity for this is shown by the presence of certain 
 symptoms or physical signs in the patient which indicate 
 the existense of a special strain on the kidneys and other 
 organs of excretion. Thus, morning sickness in an ex- 
 aggerated degree, albuminuria, and dropsy are serious 
 symptoms in pregnancy, and their presence calls for very 
 special attention being directed to the diet, which should be 
 under the direction of the medical attendant. In these 
 circumstances the lightest possible diet, one that throws the 
 least strain on the kidneys and other glands, must be given. 
 Such a regime is a milk diet. In severe cases it may 
 
DIET DURING PREGNANCY. 231 
 
 be necesssry to have recourse to an exclusive milk regime ; 
 in less severe cases, a diet of milk, bread, farinaceous foods, 
 and fruits may suffice, while in the milder forms of derange- 
 ment all that is necessary is that the patient should avoid 
 red meats and rich dishes of all kinds, and live on the 
 lacto-vegetarian diet described on p. 237. The quantity of 
 nourishment must not exceed what is usually required by a 
 healthy woman j the meals should be taken at regular 
 intervals ; and all indigestible articles of food, and any that 
 are known to disagree with the patient, should be avoided. 
 The morning sickness of pregnant women is not markedly 
 affected by diet ; small, simple meals at frequent intervals are 
 the best. 
 
 In the later months it is necessary to take food in smaller 
 quantities and more frequently, since over-distension of the 
 stomach causes discomfort, owing to the size and position of 
 the uterus. " Longings " for particular foods, so far as they 
 are kept within reasonable bounds, may be gratified ; but 
 there is no evidence that the refusal to satisfy unreasonable 
 caprices has any effect on the physical or mental development 
 of the child. 
 
 Diet adopted to modify the Size of the Child. — The 
 trend of modern thought, experience, and to a certain 
 extent scientific research, tends to show that diet can to 
 a certain extent modify the maternal and foetal tissues 
 in such a way as to make the labour more easy, and 
 to increase the probability of a viable child being born. 
 The consideration of this is beyond the scope of this 
 work, and for it the reader is referred to the author's larger 
 work. 
 
232 THE BOOK OF DIET. 
 
 VI. RULES FOR DIETARY DURING LACTATION. 
 
 The importance of sound health in the mother is very 
 great. She must live a regular, well-ordered life — getting up 
 in the morning for breakfast, going about the house, and 
 taking exercise in the fresh air. She is in no sense an 
 invalid, but has to remember that she is not free to do 
 exactly as she likes. It is advisable that she should, when- 
 ever possible, have a daily rest for one and a half to two 
 hours, to make up for the broken nights, and she should, 
 while nursing, go to bed at a reasonable hour — ten or 
 eleven o'clock. 
 
 The diet is very important. A mistake many people make 
 is to take more food and more meals than are necessary. 
 Feeding can easily be overdone, with the result that the 
 infant's digestion is upset. 
 
 Three good meals a day should be the rule. At breakfast — 
 in addition to the ordinary meal of tea or coffee, eggs, bacon, 
 roll, toast, butter, and a preserve — take half a plate of well- 
 made oatmeal porridge or gruel, with cream and half a pint 
 of milk. Nothing further should be taken till the lunch, 
 when a substantial two-course meal may be taken (the full 
 children's dinner is generally sufl5cient). 
 
 For afternoon tea, take with the tea half a pint of milk. 
 
 For dinner, again, take a good meal (always consuming 
 some red meat freshly cooked). If three or more courses 
 are taken, milk is not required; but if meat and pudding 
 only are taken, probably it will be as well to take a glass of 
 milk. 
 
 Before going to bed a cup of weak cocoa and milk — 
 Horlick's malted milk, hot milk, gruel, and milk should be 
 taken. Many articles of food are condemned for nursing 
 women, but really any food that does not give the mother 
 
DIET DURING LACTATION. 233 
 
 indigestion may be allowed. If the milk does not agree, the 
 mother might try the " soured milk,'' and in other cases she 
 may be able to continue the strain of nursing by taking some 
 malt twice daily; for this homax may be recommended as 
 being easily taken. The taking of beer, stout, porter, or 
 wine is quite unnecessary and unadvisable. 
 
 8a 
 
XL 
 VEGETARIANISM. 
 
 OBJECTIONS TO VEGE- 
 TARIANISM. 
 
 SOURCE OF 
 STITUENTS 
 RIANISM. 
 
 Proteins. 
 
 Pulses. 
 
 Animal Fats. 
 
 Nnt Cream Butters, 
 
 Cereals. 
 
 FOOD CON- 
 IN VEGETA- 
 
 Fruitarian Cakes. 
 Gelatine. 
 Beverages. 
 Vegetarian Cheese. 
 
 Lacto-Vegetarian Diet ; Uncooked 
 Foods. 
 
 ADVANTAGES AND DISAD- 
 VANTAGES OF VEGETA- 
 RIANISM. 
 
Chapter XL 
 VEGETARIANISM. 
 
 Objections to Vegetarianism — Source of Food Con- 
 stituents — Advantages and Disadvantages of 
 Vegetarianism. 
 
 Vegetarianism is a term loosely applied to different varieties 
 of restricted dietaries that have one point in common — 
 namely, the exclusion of flesh 'foods from the diet. The 
 strict vegetarian lives solely on vegetables grown above ground, 
 and fruits. The fruitarian or nutarian lives on milk, fruits, 
 nuts, and vegetables. The purin free or uric acid free dietary 
 allows mUk, cheese, cream, butter, white of eggs, vegetables, 
 fruits, and cereal foods, but excludes tea, coffee, cocoa, yolk 
 of egg, pulses, and flesh. The lacto-vegetanan diet allows 
 certain animal foods — for example, milk and its products, 
 eggs ; also vegetables, pulses, cereals, fruits, sweets, tea, coffee, 
 and cocoa. A variety of this vegetarian diet is one that 
 is restricted to uncooked foodstuffs. 
 
 It is possible by restricting ourselves to a vegetarian 
 diet to supply all the food elements — namely, proteins, fats, 
 and carbohydrates — that are required by the body. 
 
 Vegetable foods differ widely, but as a rule they contain a 
 much smaller amount of protein, a larger proportion of starch 
 and sugar, and a smaller amount of fat than animal foods. 
 
238 THE BOOK OF DIET. 
 
 Some vegetable foods — for example, nuts — contain much fat. 
 Proteins in a vegetarian diet are derived mainly from 
 vegetables, milk, and eggs. Those derived from vegetables 
 are more difficult to digest, and are on the whole less easily 
 absorbed than those derived from animal food. It is advis- 
 able here to refer to the more important objections that are 
 commonly raised to a system of vegetarianism, and to the 
 data on which these are based. 
 
 OBJECTIONS TO VEGBTARIANISM. 
 
 In the first place, it is generally urged that in a vegetarian 
 diet the question of the intake of a sufficient proportion of 
 nitrogenous foods is a practical difficulty ; thus in the text- 
 books it is stated that, owing to the composition of vegetable 
 foods, in order to get the requisite amount of proteins in the 
 diet, an amount of vegetable food-stuffs far in excess of body 
 requirements has to be taken. In fairness to the advocates 
 of vegetarianism it must be admitted that there is now little 
 or no force in this argument. The advances in the knowledge 
 of the construction of vegetarian dietaries in recent years 
 have been very considerable; and by making use of the 
 manufactured foods now available, it is certainly possible to 
 frame an exclusive vegetarian regime, containing an adequate 
 amount of proteins, fats, carbohydrates, and salts, in which 
 there is no excess or bulk of vegetarian food-stuff. A second 
 objection commonly raised must now be referred to. It is 
 urged that there is evidence that the want of sufficient 
 animal protein as opposed to vegetable protein in the dietary 
 leads to disease. In answer to this it may be said that, so 
 far as healthy individuals are concerned, provided the proper 
 amount of protein is given, it does not materially matter 
 whether it is derived from beef steak or from lentils. A third 
 
VEGETAEIAN FOOD CONSTITUENTS. 239 
 
 objection still has to be dealt with — namely, the unappetizing 
 nature of a vegetarian regime. There is much force in this 
 objection. Animal protein is, to most people, much more 
 appetizing than vegetable protein, and use and wont has led to 
 the adoption of a mixed protein dietary. Since we have seen 
 above that, provided the right amount of protein is taken, 
 vegetable protein has no advantage over animal protein, there 
 is no scientific reason for withholding animal protein food 
 from healthy people who desire it. We will now give some 
 practical details adapted for those who wish to adopt a 
 vegetarian regime. 
 
 SOURCE OF FOOD CONSTITUENTS IN 
 VEGETARIANISM. 
 
 Proteins. — The strict vegetarian and fruitarian has to 
 have recourse to many artificially prepared products in 
 order to get the necessary supply of proteins in a fairly 
 concentrated form. Nuts and the pulses supply the pro- 
 teins, and these furnish the vegetarian meat courses. The 
 manufacture of nut meats has been one of the greatest 
 developments in extending the vegetarian bill of fare. Every 
 year sees a number of new and improved preparations put 
 upon the market, 
 
 Mapleton (2 Dolphin Street, Ardwick, Manchester) prepares a variety 
 of nut and other vegetable meat pastes, put up in glass moulds, almond 
 nut meat, savoury nut meat ; and they also make nut meat from walnut, 
 white and brown almond (with or without pea nut), grated and blended 
 with certain cereals. These preparations can be used to make cutlets, 
 steamed shapes, etc. 
 
 Chapman (Health Food Stores, Eberle Street, Liverpool) makes five 
 or six varieties of tasty and appetizing meats, put up in air-tight glass 
 moulds. Lentose (vegetable brawn) and walnut meat are especially to 
 be recommended. They are fully seasoned, and may be used hot or cold. 
 
240 THE BOOK OF DIET. 
 
 and are excellent when sliced and lightly fried, and served with tomato 
 sauce or gravy. They cost gd. or lod. per lb. A book of recipes can 
 be obtained from the makers. 
 
 The London Nut Food Company (465 Battersea Park Road, London) 
 also supply several Svarieties — meatose, vegota, and nut vego ; they have 
 distinctive flavours and are suited to different tastes. The Food Reform 
 nut meat is made chiefly from pine kernels ; it is said to be hardly 
 distinguishable from gelatine of veal. 
 
 Protose, maltose, nuttolene, made by the International Health 
 Association, Legge Street, Birmingham, are also of a high standard. 
 Protose has a distinct meaty flavour, and is very good in stews, pies, 
 fritters, sandwiches, etc. ; cost, is. per lb. 
 
 A pure vegetable albumin, roborat (Vegetarian Society, Deans- 
 gate, Manchester), is now obtainable, and claims to contain 94 per cent, 
 albumin, and is tasteless. It is the protein of wheat extracted and 
 concentrated, and is especially useful in invalid dietary, and in helping 
 to enrich the food of those who are otherwise unable to take the necessary 
 amount of food. It can be added to any food in powder form, or, better 
 still, by dissolving it by cooking for a few minutes in water. It can also 
 be obtained made up with cocoa or chocolate. Emprote is another con- 
 centrated vegetable protein manufactured from the proteins and salts of 
 pure milk, wheat, and fruit. It is a valuable preparation, which may be 
 added to all sorts of dishes to increase the otherwise low protein value 
 of the diet. It is practically tasteless, and soluble. Vegetarians use 
 plasmon in a similar way. 
 
 Vegetable extracts, exactly resembling the meat extracts in appearance, 
 are useful for soups and gravies. They are mainly prepared from grain 
 by special ■ malting processes, and are wonderfully like the best meat 
 extracts in flavour. These are : wintox and nutrogen (Winter's), 
 making a soup very like beef-tea ; carnos, made by the Camos Company ; 
 and marmite, a vegetable food extract which lays claim to possess the 
 same nutritive value as a well-prepared meat extract, and costs about 
 IS. id. for a four-ounce pot, prepared by Marmite Food Extract 
 Company, Mincing Lane, London. Good vegetable soups in tins and 
 cubes are also available, and are not expensive — for example, Heinz's 
 tomato soup, Chiver's soups (lentil, tomato, haricot, and pea). Eustace 
 Miles issues two varieties of dried blocks which make excellent soup 
 when dissolved — namely, savoury protein soup and protein mulligatawny. 
 These both contain a very large amount of vegetable protein, and quite 
 suffice for an adequate meal. 
 
PULSES— ANIMAL FATS. 241 
 
 Pulses. — The pulses may be used fresh or dried, whole 
 and ground into flour ; green peas, broad beans, French 
 beans, cooked in the ordinary way, or served with poached 
 or scrambled eggs, are excellent. The large variety of dried 
 pulses are very nutritious — lentils, red or German peas split, 
 dried green and giant green peas, can be used for soup, 
 stews, or cutlets. Brown beans, haricot beans, and butter 
 beans, midget butter beans, are used in a similar manner. 
 Vegetable soups made with any of the pulses are excellent ; 
 German lentils and brown beans produce a very good brown 
 soup. 
 
 The Animal Fats are replaced by oil from nuts, and 
 these are largely used by vegetarians for table butter 
 and for cooking purposes. There are now a number of 
 first-rate fats to suit different tastes and purposes, some 
 having very much the appearance and consistency of lard, 
 others closely resembling prepared suet, while yet others 
 are not unlike dairy butter. These are used for frying, 
 for suet puddings, for pastry, and for table use. One most 
 like dairy butter is Mapleton's butter, sent out in two 
 quaUties, table and cooking qualities. Albene is a hard 
 white fat, and serves all the purposes for which lard and 
 dripping are used. Cocoa-nut butter, of the London Nut 
 Food Company, can also be used for cooking. Pine 
 kernels and vegsu are good substitutes for suet. Most of 
 these fats are put up in i and 2 lb. tins, and cost about 
 8d. or 9d. per pound. 
 
 The Nut Cream Butters retain the nut flavour. Maple- 
 ton's walnut cream butter and almond cream butter are 
 generally liked. The nut butter of the International Health 
 Association is made from cooked nuts only, and may be used 
 in soups and stews for thickening, or when diluted forms a 
 nut milk. The same firm also prepares an almond butter for 
 
242 THE BOOK OF DIET. 
 
 table use which is specially adapted for those with weak 
 digestions.* 
 
 The Cereals are largely used by vegetarians for porridge ; 
 and, in addition to the well-known oatmeal, Quaker oats, and 
 barley meal, one may mention artox flour, a whole wheat 
 meal which makes most excellent porridge, as well as scones 
 and pastry. Banana oats is a recent preparation, and is 
 appetizing to some palates ; it is easily prepared, and is put 
 up in 3d. packets, with directions. Banana flour is like rice 
 flour, and is useful for puddings. Robinson's patent groats, 
 Manhu whole-meal flour, and pure malted barley meal 
 also all make excellent porridge. Kornules is another 
 good grain food ; it is a pure wheat product in granular form, 
 and is ready cooked, and so can be used to prepare a hasty 
 meal. Grape nuts are also a favourite dish with many 
 vegetarians. 
 
 The so-called breakfast foods consist generally of cereals 
 alone, and are predigested, and so heated as to be easy of 
 digestion. Shredded wheat biscuits, granose flakes, toasted 
 wheat flakes, Ralston's Food and avenola, are combinations of 
 cooked grains, and make excellent porridge; all are satis- 
 factory foods. Nut cream rolls and nut cream biscuits are 
 made from whole meal, or treated with nut butter, and are 
 other forms in which cereals are utilized in the dietary of 
 vegetarians. 
 
 Fruitarian Cakes are also useful adjuncts to the vegetarian. 
 There are many varieties, but they are alike in being com- 
 posed of uncooked fruits and nuts, freed from stones and 
 skins, but otherwise in their natural state. They are com- 
 pressed into small cakes or slabs. Pitman Company, Bir- 
 
 * Nut kernels may also be used freshly ground in a small nut mill, and 
 used as an addition to fruit and vegetable salads and in the making of 
 sandwiches. 
 
BEVERAGES. 243 
 
 mingham, prepares about one and a half dozen varieties of 
 these cakes, and will supply 1 2 cakes for 8d. They prepare 
 a cyclist's luncheon for 6d., consisting of fruitarian cake and 
 banana biscuits. The London Nut Food Company have 
 several dainty fruit and nut cakes covered with chocolate. 
 Mapleton, Manchester, have a large number of cakes ; pear, 
 with walnut and apricot, may be specially recommended. 
 
 Gelatine. — In the dietary of the vegetarian, gelatine is 
 replaced by agar-agar, a product derived from a Japanese 
 seaweed. (Chapman, Liverpool, prepares table jellies made 
 from this.) 
 
 Beverages. — Tea, coffee, cocoa, and chocolate are all 
 permissible to the vegetarian ; but to avoid the stimulating 
 effects of the xanthin in tea and coffee, many vegetarians 
 take some of the cereal toffees now obtainable. These strongly 
 resemble coffee in appearance and flavour, are refreshing, and 
 free from caffeine. They are prepared by a roasting and 
 grinding process from various grains — for example, postum, 
 prepared by the Grape Nut Company; caramel cereal, 
 prepared by Mapleton, Manchester. These, while similar in 
 nature and composition, differ somewhat in flavour, so that 
 various tastes can be suited. They can be prepared as 
 ordinary coffee, but are the better of a few minutes' boiling. 
 Banana coffee is a pleasant beverage, with a flavour not 
 unlike that of ordinary coffee. 
 
 Vegetarian Cheese is made from nut milk, and is practi- 
 cally identical with ordinary soft cream cheese. Recipes for 
 vegetarian soups, farinaceous foods, savouries, and egg dishes 
 will be found in ch. xxii. 
 
 Lacto- Vegetarian Diet : Uncooked Foods. — Brief mention 
 may here be made of a system of dietary of a largely vege- 
 tarian character, of which the distinctive feature is the use of 
 uncooked food. The advocates of this system, first intro- 
 
244 THE BOOK OF DIET. 
 
 duced by Christian, believe that the vital principles of 
 food are aflfected by cooking, and they give effect to this 
 belief in practice. The diet consists largely of fruits, 
 nuts, and especially Christian's protein nuts, pine ker- 
 nels specially treated; also milk, raw eggs, uncooked 
 vegetables, and a specially unfired bread made from a 
 mixture of grains pressed, and some cereals. The distinctive 
 feature of this dietary is the necessity of thorough mastica- 
 tion ; in this respect the diet will certainly satisfy the most 
 ardent disciple of Fletcher. The author has had the 
 interesting experience of partaking of an " uncooked dinner,'' 
 prepared by an expert in this system of feeding, and it is certainly 
 surprising to find that a palatable and very sustaining menu 
 can readily be prepared. A rigid diet of this nature is not a 
 practical one, however, except for an enthusiast. There are 
 certainly two points in its favour — (i) the absolute necessity of 
 mastication, and (2) the possible advantages associated with 
 the presence of vital principles unaltered by cooking ; there 
 is no doubt that a little of this system could with advantage 
 be introduced into ordinary dietaries both in health and 
 disease. A word of special commendation may be paid to 
 the unfired bread, which is an excellent preparation. 
 
 ADVANTAGES AND DISADVANTAGES OF 
 VEGETARIANISM. 
 
 Probably the greatest advantages which accrue from the 
 adoption of a vegetarian regime lie in the fact that such a 
 dietary is a most valuable corrective of over-eating. There 
 is no doubt that the vegetable food-stuffs are less appetizing 
 than animal foods, and accordingly the vegetarian feeder is less 
 exposed to over-indulgence, with its attendant unfavourable 
 
ADVANTAGES AND DISADVANTAGES. 245 
 
 results. The system of diet adopted by the strict vegetarian 
 and fruitarian is not to be commended ; the lacto-vegetarian 
 regime, on the other hand, is a most useful form of diet 
 therapy in many diseased states. Its value is none the less 
 pronounced because its beneficial eifects may be, in many 
 cases, to a material extent dependent on its negative property 
 of ensuring moderation in feeding. 
 
 Such a diet has special advantages in the upbringing of 
 the children of typically gouty parents j it is also most useful 
 in the treatment of many disorders of the renal, cardiac, and 
 vascular systems. Its use tends to lower blood-pressure and 
 diminishes the strain on certain important glandular organs 
 intimately concerned in the processes of general nutritious 
 excretion — notably the kidneys and thyroid gland. Its long- 
 continued use in certain cases also influences favourably the 
 secretion of mucin from the glands in various mucous mem- 
 branes, and hence it is of value in chronic catarrh of the 
 mucous membranes — notably the nose, bronchial tubes, 
 and uterus (dysmenorrhcea and menorrhagia). It is also 
 useful in some forms of rheumatism, gout, and chronic 
 nervous disorders, provided due attention is paid to the 
 quantity and quality of the vegetarian foods, so as to prevent 
 abnormal fermentation processes. On the other hand, we 
 must recognize that there are not a few cases met with 
 in practice in which patients have either dieted themselves, 
 or taken on medical advice a more or less rigid vegetarian 
 diet, to the serious detriment of their general health, and a 
 corresponding aggravation of their disease. Some more or 
 less strict vegetarian diets occasionally used, including nuts, 
 are difficult of digestion, and therefore of poor nutritive 
 value; and occasionally they profoundly derange primary 
 digestion, inducing diarrhoea or constipation, anaemia, and 
 profound disturbance of general health. Reviewing the 
 
246 THE BOOK OF DIET. 
 
 subject as a whole, it may be said that in healthy subjects, 
 and more especially young subjects under forty years of age, 
 a lacto-vegetarian diet has no advantages over the more 
 conventional mixed dietary, taken in equal moderation and 
 submitted to the process of thorough mastication ; in later 
 life, however, in health it is a wise rule gradually to more and 
 more restrict the rich animal protein foods, and approximate 
 to a lacto-vegetarian regime ; and in the diseased states 
 referred to, the therapeutic advantages of a carefully planned 
 more or less strict lacto-vegetarian diet are very great indeed. 
 
XII. 
 NUTRITIOUS MEALS AT SMALL COST. 
 
 CHEAP AND NUTRITIOUS 
 TWO - COURSE DINNERS 
 FOR FAMILY OF SEVEN. 
 HOMBLY Measures. 
 
 Soup with Pudding. 
 
 Vegetarian Dinners. 
 
 Fish Dinner. 
 Meat Dinners. 
 
 NOURISHING AND ECO- 
 NOMICAL ONE - COURSE 
 DINNERS. 
 
Chapter XII. 
 
 NUTRITIOUS MEALS AT SMALL 
 COST. 
 
 Cheap and Nutritious Two-course Dinners — 
 Nourishing and Economical One-course Dinners. 
 
 The question of supplying diets which are both cheap and 
 nourishing is a very important one. To a man and his wife 
 with three or four children and an income of j£i a week, 
 or less, the question of how best to expend the sum required 
 for the necessary food-stuffs is, or ought to be, a very vital 
 one. There is, unfortunately, no doubt that inadequate 
 attention is paid to this point, with the result that not a little 
 of the malnutrition seen in the children of the poorer classes 
 at the present time is due to ignorance rather than to actual 
 poverty. This is very clearly brought out by the recently 
 issued report for 1910 of Sir George Newman, Chief Medical 
 Officer of the Board of Education. This report not only dis- 
 closes the fact that a very large proportion of the children under 
 the care of the Board are suffering from diseased conditions 
 of various kinds, all of which are calculated to interfere with 
 the conduct of education, and many with the ultimate attain- 
 ment of sound physical development ; but it discloses what is 
 more important still — the fact that a considerable percentage 
 of children are also suffering from a greater or less degree of 
 malnutrition. In plain English, they are half starved. The 
 report leads to the conclusion that it is too widely diffused to 
 
250 THE BOOK OF DIET. 
 
 be attributable to poverty in more than a small proportion of 
 cases ; a more probable explanation seems that afforded by 
 the extraordinary ignorance of English women of the indus- 
 trial classes concerning food values, cooking, and general 
 economy of dietetics. Passing from malnutrition and disease, 
 the report indicates that 40 per cent, of children in schools 
 suffer from decay of the teeth — a fact that may be regarded 
 as of equal importance to the health and fitness of the next 
 generation as the prevention of tuberculosis. 
 
 Further, additional interest and importance now attaches 
 to the subject of cheap and nutritious foods in view of the 
 Provision of Meals Act, 1906, which empowers educational 
 authorities to supply school children with meals, the cost of 
 which is met out of the rates, or in part by voluntary subscrip- 
 tions. Some idea of the extent to which this power has been 
 exercised will be learned from the fact that in 1909-10 the 
 cost to the rates of the meals so provided by the Education 
 Board was ;^i34,io5. As the principles to be observed in 
 the feeding of a family of six or seven, where the income is 
 a very small one, are similar to those applicable when a large 
 number of children have to be fed out of the rates, it is pos- 
 sible to gain information of value for the family from the 
 results of the experience recorded in the past year or two by 
 various educational authorities. These will be referred to 
 shortly. It may be laid down that the essentials to be con- 
 sidered are the following : — 
 
 1. The food must be nourishing and ample in amount. 
 
 2. The food must be as cheap as possible consistent with i. 
 
 3. The food must be of a nature that can be readily cooked 
 
 with the limited facilities available in a one or two 
 roomed house. 
 
 4. In children, satisfactory rate of growth, increased vigour, 
 
 and more efficient education must result. 
 
CHEAP AND NUTRITIOUS FOODS. 
 
 251 
 
 The most useful, cheap, and nutritious foods may be 
 tabulated as follows : — 
 
 Proteins. 
 
 Fats. 
 
 Carbohydrates. 
 
 Peas. 
 
 Margarine. 
 
 Bread and bread foods 
 
 Lentils. 
 
 Cheese (cheaper varie- 
 
 Potatoes. 
 
 Beans. 
 
 ties). 
 
 Jam. 
 
 Oatmeal. 
 
 
 Treacle. 
 
 
 
 
 Meat (cheaper cuts). 
 
 
 
 Liver. 
 
 
 
 Skimmed milk. 
 
 
 
 Herring, ling, haddock. 
 
 
 
 The relative nutritive value of the chief of these foods may 
 be shortly stated : — 
 
 Peas (dry) 
 
 Proteins. 
 
 Fats. 
 
 Carbo- 
 hydrates. 
 
 22.6 
 
 1-7 
 
 S3-2 
 
 Beans 
 
 23.1 
 
 2.2 
 
 53-6 
 
 Lentils 
 
 24.8 
 
 1.8 
 
 54- 7 
 
 Oatmeal 
 
 10.9 
 
 4-5 
 
 59- 1 
 
 Bread 
 
 6-S 
 
 I.O 
 
 Si-S 
 
 Potatoes 
 
 1.2 
 
 19. 1 
 
 
 Meat 
 
 21.0 
 
 i-S 
 
 ... 
 
 A study of the above table shows that peas, beans, lentils, 
 and oatmeal are, in virtue of the large amount of all three 
 chief food ingredients present, highly nourishing foods, and 
 they have the extra merit of cheapness. For example, a bowl 
 of thick lentil soup, containing a quarter of a pound of lentils, 
 with a slice of bread, costing about three farthings, contains 
 much more nourishment than half a pound of meat and a 
 slice of bread, costing about fourpence. 
 
 An illustrative cheap system of dietaries is here given : — 
 
 Breakfast. — 
 
 Porridge and skimmed milk. 
 
252 THE BOOK OF DIET. 
 
 Dinner. — Selected from the following : — 
 Soups from (i) Peas, beans, or lentils. 
 
 (2) Sheep's head, flavoured with rice, or barley, or 
 
 vegetables. 
 (3] Fish soap, made from cod's head or trimmings. 
 
 Meat course selected from : — , 
 
 (1) Liver, tripe, neck of foreign meat, mince made up 
 
 with bread crumbs and potatoes. 
 
 (2) Fish, either haddock fried in batter, haggis with 
 
 potato, ling or John Dory fried in batter or made 
 into fish-and-potato pie. 
 
 (3) Bread with skimmed milk, margarine or dripping 
 
 toast, cheap skimmed milk cheese. 
 
 Supper. — Selected from : — 
 
 Bread and butter, or porridge and skimmed milk. 
 
 The most important meal of the day is the dinner meal. 
 In the case of very necessitous children it is possible to give, 
 if necessary, at least one-half of the total daily food value 
 required at this meal. This may be given in the form of 
 a two-course dinner or a one-course meal. An excellent 
 series of two-course dinners was worked out in detail in 
 1907 by Dr. Ralph Crowley in conjunction with Miss 
 Marion Cuff for the City of Bradford Education Committee. 
 Their report gave details of seventeen suggested two-course 
 dinners, of which about one-half contain meat, adapted 
 for a family of seven — father and mother and five children 
 of average age of ten years — the cost of food material 
 (in 1907) ranging from i.id. to 2jd. per head. The 
 average food value of these dinners in protein and fat is 
 as follows : — 
 
 Protein. Fat. 
 
 29 grams (i oz.). 18 grams (f oz.). 
 
 Six of these dietaries are here given, in full detail : — 
 
HOMELY MEASURES. 
 
 253 
 
 CHEAP AND NUTRITIOUS TWO-COURSE DINNERS 
 FOR FAMILY OF SEVEN. 
 
 Cost ranging from i.id. to 2|d. per head. 
 
 Cost — s. d. 
 
 1. Soup and pudding ... ... ... g 
 
 2. Yorkshire cheese pudding, gravy ... 11 
 
 3. Cheese and lentil savoury, pudding ... i i 
 
 4. Fish dinner, pudding i 5 
 
 5. Meat dinner, pudding i 5 
 
 The quantities stated in the recipes would be ample 
 for a good dinner meal for a family consisting of father, 
 mother, and five children, the average age of the children 
 being about ten years. The following notes on homely 
 measures may be useful : — 
 
 Homely Measures. 
 
 When no scales or weights or measures are at hand, it is 
 useful to know the proportions of flour, sugar, rice, sago, currants, 
 sultanas, etc. 
 
 One slightly rounded teaspoonful 
 
 = 
 
 ioz. 
 
 ,, ,, ,, dessert-spoonful 
 
 = 
 
 4 .. 
 
 „ ,, „ tablespoonful 
 
 = 
 
 I ,, 
 
 One flat teacupful 
 
 = 
 
 ilb. 
 
 One flat breakfast-cupful or half- pint basin 
 
 = 
 
 4 .. 
 
 Bread crumbs : two flat tablespoonfuls 
 
 = 
 
 I oz. 
 
 Golden syrup or jam : one tablespoonful 
 
 = 
 
 2 .. 
 
 Butter or other fat : one tablespoonful 
 
 = 
 
 I » 
 
 , , , , a piece about size of a hen's egg 
 
 = 
 
 li „ 
 
 In mixing liquids : — 
 
 
 
 One teacupful 
 
 = 
 
 ipt. 
 
 One breakfast-cupful or tumbler 
 
 = 
 
 i » 
 
254 
 
 THE BOOK OF DIET. 
 
 The cost of the dinners is worked out from 
 
 the foods 
 
 costing the following retail rate : — 
 
 
 Baking powder 
 
 8d. lb. 
 
 Lentils 
 
 2|d. lb. 
 
 Cabbage 
 
 ijd. ea. 
 
 Margarine 
 
 4d. „ 
 
 Carrots 
 
 id. „ 
 
 Meat (free from 
 
 
 Cheese 
 
 7d. lb. 
 
 bone) 
 
 6d. „ 
 
 Cornflour 
 
 6d. „ 
 
 Milk 
 
 ijd. pt. 
 
 Currants 
 
 4d. „ 
 
 Milk powder . . . 
 
 5d. lb. 
 
 Eggs 
 
 16 for IS. 
 
 Nutter suet 
 
 7id. „ 
 
 Fish 
 
 4d. lb. 
 
 Oatmeal 
 
 2d. „ 
 
 Flour (seconds) 
 
 IS. 5d. St. 
 
 Onions 
 
 id. „ 
 
 Flour (whole 
 
 
 Pearl barley ... 
 
 2d. „ 
 
 meal) 
 
 IS. 7d. „ 
 
 Peas, dried 
 
 2d. „ 
 
 Fruit (in season) 
 
 2d. lb. 
 
 Potatoes 
 
 gd. St. 
 
 Ginger powder 
 
 IS. 2d. „ 
 
 Rice 
 
 2d. lb. 
 
 Golden syrup ... 
 
 2|d. „ 
 
 Sugar 
 
 2fd. „ 
 
 Haricot beans 
 
 
 Sultanas 
 
 6d. „ 
 
 (brown and white) 2d. „ 
 
 Tea 
 
 IS. 4d. „ 
 
 Jam 
 
 3id. „ 
 
 Turnip 
 
 id. „ 
 
 Lemons 
 
 id.ea. 
 
 
 
 I. Soup with Pudding. — Brown haricot soup ; dumplings ; 
 bread ; baked jam roll. Total cost about gd., or i^d. per head. 
 
 Brown Haricot Scop. 
 
 li oz. flour. 
 
 Flavouring to taste (see note below). 
 
 Pepper and salt. 
 
 4 pints water. 
 
 I lb. brown beans. 
 i lb. onions. 
 i lb. carrots. 
 
 i lb. milk powder (from skimmed 
 mUk). 
 
 Method. — Soak the beans overnight, then wash and put them in a pan 
 with water, and bring to the boil. If possible, pass them through a sieve 
 and return them to the pan. Add the carrots and onions, cut small, and 
 cook until all are tender. Half an hour before serving add the suet 
 dumplings (see below). A few minutes before serving add the milk 
 
HOMELY MEASURES. 255 
 
 powder and flavourings. Mix the flour with a little cold water to a 
 smooth paste, and add it to the soup. Stir quickly until it boils. Boil 
 three minutes longer ; season and serve. 
 
 Note. — The milk powder is added to increase the value of the soup. 
 That obtained from fiill cream milk can be used for puddings and in tea. 
 It keeps better than condensed milk. Ketchup, or Yorkshire relish, or 
 celery salt may be used alone or in combination. They greatly improve 
 the flavour. 
 
 Suet Ddmplings. 
 
 6 oz. flour. I \ teaspoonful salt. 
 
 \ teaspoonful baking powder. | 3 oz. suet (nutter or beef). 
 
 Method. — Mix the flour, baking powder, and salt ; rub in the suet ; 
 mix with water to a stiff paste. Divide into equal pieces, shape into 
 balls, and add them to the soup for thirty to forty minutes before 
 serving. 
 
 Baked Jam Roll. 
 
 i lb. flour. J teaspoonful salt. 
 
 J teaspoonful baking powder. 6 oz. margarine. 
 
 I teaspoonful castor sugar. Water to mix. 
 
 2 oz. jam. 
 
 Method. — Mix the dry ingredients, and rub in the fat. Mix with water 
 to a stiff paste, and roll out once only. Spread the centre of the paste 
 with jam, and fold over two or three times. Place in a greased tin ; bake 
 in a quick oven for about twenty minutes. 
 
 (The pastry looks much nicer if brushed over with milk and lightly 
 sprinkled with castor sugar before baking.) 
 
 2. Vegetarian Dinner {a). — Yorkshire cheese pudding, 
 with bean gravy; buttered ricej bread. Total cost, iid., 
 or i|d. per head. 
 
 Yorkshire Cheese Pudding and Gravy. 
 
 1 pint milk. 
 
 2 eggs. 
 Salt. 
 
 J lb. flour. 
 
 J lb. cheese. 
 
 Margarine or dripping for the tin. 
 
 Method. — Mix the flour and salt. Break and add the eggs one at a 
 time. Gradually add half the milk, stirring steadily ; beat well. Add 
 
256 THE BOOK OF DIET. 
 
 the rest of the milk, and allow it to stand. Grate the cheese and add it 
 to the batter. Pour the batter into a tin or pie-dish containing the hot 
 fat, and bake in a hot oven from thirty to forty minutes until set. 
 
 For the Bean Gravy. 
 4 oz. brown beans. Yorkshire relish (to flavour). 
 
 A small onion. Celery salt, pepper and salt to taste. 
 
 Bit of carrot. ij pints of water. 
 
 Buttered Rice. 
 6 oz. rice. l 2 oz. margarine. 
 
 2 oz. sugar. | A little salt. 
 
 Water to boil. 
 
 Method. — To a saucepan of- boiling water add one teaspoonful of salt 
 to rice ; boil quickly without the lid until tender. Strain off the water 
 (keep it for soup or gravy) ; add the margarine and sugar, and serve 
 very hot. 
 
 3. Vegetarian Dinner {b). — Cheese and, lentil savoury, 
 with bean gravy; bread; milk pudding and stewed fruit. 
 Total cost, IS. id., or i^d. per head. ^ 
 
 Cheese and Lentil Savoury. 
 
 i lb. cheese. 5i oz. lentils. 
 
 3 oz. bread crumbs. ij oz. margarine. 
 
 4 oz. onions. Parsley, pepper, and salt. 
 Melhod.—yf3.sh and pick over the lentils ; peel and chop the onions ; 
 
 cook them in a little water with the lentils, stirring frequently. Grate 
 the cheese, put in a basin with the partly cooked lentils and onions, add 
 the bread crumbs, pepper and salt to taste, and about one tablespoonful 
 of finely chopped parsley. Moisten with bean gravy (recipe, see above), 
 and mix all to a soft paste. Put the mixture in a greased tin or 
 pie-dish ; place the fat in small pieces over the top, and bake in a hot 
 oven until firmly set and a good brown colour. Serve hot with bean 
 gravy. 
 
 Milk Pudding. 
 
 2 pints milk. | 2 oz. sugar. 
 
 4 oz. rice. I A little grated nutmeg or lemon. 
 
HOMELY MEASURES. 257 
 
 Method. — The pudding may be boiled or baked. 
 
 Soiled. — If a double saucepan is available, put boiling water in the 
 under part of the pan ; put the milk, rice, sugar, and flavouring into the 
 upper pan, and cook until soft and creamy. Serve with stewed fruit or 
 jam. 
 
 Baked. — Put the milk, rice, and sugar into a pie-dish, grate nutmeg 
 over the top, and cook for a long time in a very slow oven. 
 
 Notes. — (a) If skimmed milk is used, fe,t should be added to the pud- 
 ding to replace the lost cream, (b) Instead of rice the following can be 
 used in the same proportions — semolina, ground rice, sago, or tapioca. 
 (c) If lemon rind is used for flavouring, cut in very thin slices. Cloves, 
 bay leaves, or vanilla can be used. 
 
 Stewbd Fruit. 
 
 One and a half pounds of rhubarb, or any fruit in season that is cheap. 
 
 Method. — Put the water and sugar on to boil, wash the fruit and add 
 to the syrup. Simmer very gently until tender, and remove the pan 
 from the fire before the fruit breaks up. Lemon rind improves rhubarb 
 and apples. Cloves may be put with stewed apples. 
 
 Dried fruit, as figs or prunes, should be well washed, then soaked in 
 water overnight. Use the water for making the syrup. 
 
 The amount of sugar and water required will vary according to the 
 fruit used. 
 
 4. Fish Dinner. — Fish-and-potato pie ; bread ; green peas ; 
 lemon sauce; blancmange and jam. Total cost, is. sd., or 
 z\d.. per head. 
 
 FlSH-AND-POTATO PlE. 
 
 2 lbs. fish (without bone). 
 
 3 lbs. potatoes. 
 Pepper and salt. 
 
 J oz. margarine. 
 
 ^ tablespoonful chopped parsley. 
 
 Lemon sauce. 
 
 Method. — Peel and cook the potatoes ; steam or gently boil the fish 
 and break it up into small pieces, removing any bone that may have 
 been left in it. Put into a basin, and mix with some of the sauce into 
 a soft paste ; season well and add the parsley. Put the hot potatoes 
 into a deep bowl and mash them thoroughly, adding a little milk and 
 margarine, also pepper and salt. Put the fish mixture into a pie-dish, 
 and place small pieces of fat over the top. Bake in a hot oven to a 
 golden brown. Serve with the rest of the lemon sauce and the green peas. 
 
 9 
 
258 THE BOOK OF DIET. 
 
 Lemon Sauce. 
 
 2 oz. margarine. 
 
 2 oz. flour. 
 
 Half the juice of a lemon. 
 
 i pint of water that the fish was 
 
 cooked in. 
 Pepper and salt. 
 
 ^ pint of milk. 
 Method. — Melt the margarine in a pan, and add the flour ; blend 
 them together, but do not allow to brown. Heat the milk and water 
 (or fish stock) and add to the flour and fat, stirring quickly. Stir until 
 it boils, and boil for three minutes ; add seasoning to taste and the juice 
 of half a lemon. Use some of the sauce to mix with the fish, and serve 
 the remainder with the pie. 
 
 Green Peas. 
 
 J lb. dried green peas. \ oz. margarine. 
 
 I oz. castor sugar. Water to boil, and a sprig of mint. 
 
 ^ oz. baking soda. Pepper and salt. 
 
 Method. — Soak the peas overnight in water to which half the soda 
 (dissolved) has been added. Wash them and boil gently until tender in 
 water with the rest of the soda, adding the sugar and mint. Take off the 
 skins which rise during cooking ; strain oflf the water. Add the margarine 
 and seasoning, and eat hot. 
 
 Blancmange and Jam. 
 
 I J pints milk. 2 oz. cornflour. 
 
 I oz. sugar. A few drops essence of almonds, or 
 
 4 oz. jam. lemon juice. 
 
 Method. — Mix the cornflour and sugar with a little cold milk to a 
 smooth, creamy paste. Heat the rest of the milk and add it to the 
 cornflour, stirring quickly. Return all to the pan and stir until it boils ; 
 allow it to boil for three minutes, add the flavouring, then pour into a 
 wet basin or mould. Turn out when cold, and serve with the jam. 
 
 S. Meat Diimer (a). — Hashed beef and gravy j savoury balls ; 
 boiled rice — as a vegetable ; stewed fruit. Total cost, is. 5d., 
 or 2;Jd. per head. 
 
 Hashed Beef. 
 
 i^ lbs. beef (without bone). 
 \ lb. carrot. 
 \\ pints water. 
 Pepper and salt. 
 
 \ lb. onions. 
 \ lb. turnip. 
 I oz. flour. 
 Gravy. 
 
2 OE. nutter suet. 
 Pepper and salt to taste. 
 A little water to mix. 
 
 HOMELY MEASURES. 259 
 
 Method. — Cut the meat in small pieces, put it in a pan with cold 
 water and a little salt, and bring slowly to the boil. Feel and slice the 
 vegetables, and add them to the pan. Cook all very gently together 
 until tender ; do not allow it to boil fast. Add the savoury balls (see 
 below) about half an hour before serving. Mix the flour with a little 
 cold water, and add to the stew to slightly thicken the gravy. Season 
 to taste and serve hot, the rice being served as a vegetable. 
 
 Savoury Balls. 
 
 3 oz. flour. 
 
 3 oz. bread-crumbs. 
 
 Sweet herbs and parsley. 
 
 \ teaspoonfiil baking powder. 
 
 Method. — Mix the flour and baking powder ; shred and rub in the 
 suet. Add the bread crumbs, sweet herbs, chopped parsley, and season- 
 ing. Mix with water to a stiff paste. Divide into equal portions, and 
 shape into balls. Cook in the stew from twenty to thirty minutes. 
 
 (A well-beaten egg added to the water for mixing will enrich the balls. 
 This is not reckoned in the cost.) 
 
 Boiled Rice. 
 6 oz. rice, salt, boiling water. 
 
 Method. — Have a pan of boiling water, add a dessert-spoonful of salt. 
 Sprinkle in the rice, and keep it boiling quickly without the lid for eight 
 to ten minutes. Then test it, and if not tender continue to cook until 
 there is no hard centre in the grains of rice. Strain and dry well before 
 serving. (Allow time for thoroughly drying the rice before serving. The 
 grains should be well cooked, but separate. ) 
 
 Do not throw away the water in which the rice has been boiled ; it 
 contains nourishment, and is good for making soup or gravy. 
 
 6. Meat Dinner {b). — Meat-and-potato pie; bread; milk 
 
 pudding and stewed fruit. Total cost about is. 7d., or afd. 
 
 per head. 
 
 Meat-and-Potato Pie. 
 
 i^ lbs. beef (without bone). 
 \ lb. onions. 
 I oz. flour. 
 Pepper and salt. 
 
 3 lbs. potatoes, 
 ij pints water. 
 I oz. margarine. 
 A little milk. 
 
26o THE BOOK OF DIET. 
 
 Method. — Peel and cook the potatoes. Cnt the meat in pieces, and 
 put it in a pan with water and a little salt ; bring slowly to the boil. 
 Cook gently for ten minutes ; then take out the meat, chop it finely or 
 pass through mincing machine. Peel and chop the onions, add them to 
 the meat, also the pepper and salt and some gravy. Mix all together 
 and place in a pie-dish. Turn the potatoes into a basin, mash them 
 well, adding a little margarine or dripping, some milk, and seasoning. 
 Place in the pie-dish, over the meat. Stroke over with a fork, and place 
 the rest of the fat in small pieces over the top. Put the pie in a hot oven 
 to cook a golden brown. Make a gravy to serve with the pie. (This 
 is a good way of using scraps of cold meat and cooked potatoes.) 
 
 These meals are perhaps better adapted for famiUes with 
 an income of 253. weekly and upwards, as, in addition 
 to the expense, the trouble involved in their cooking is 
 in many instances beyond the facilities available in the 
 restricted house and firing accommodation of the very 
 poor. 
 
 Before leaving the subject of nutritive and economical 
 two-course dinners, a word of caution should be added. 
 When a two-course dinner consisting of soup and pudding is 
 relied on as an ample meal, especially for children, care must 
 be taken to see that the proper amount of nourishing food is 
 given in each course. The author recently analyzed three 
 two-course dinners which were supposed to be planned on 
 the Bradford system (^protein, 29 grams; fat, 18 grams); 
 analysis showed that the nutritive value of the meals was 
 low, the composition of the meals being as follows : — 
 Proteins. Fats. 
 
 20.6 grams. 1.8 grams. 
 
 The deficiency was accounted for by the soup being too 
 " thin," the puddings also being deficient in nutritive value. 
 
ONE-COURSE DINNERS. 261 
 
 NOURISHING AND ECONOMICAL ONE-COUBSE 
 DINNERS. 
 
 The question of a good one-course dinner is an important 
 one. In many of the houses of the poor the cooking facilities 
 — one small open grate — are not well adapted for providing 
 a two-course meal if such were otherwise available ; and in 
 connection with the feeding of large numbers of school 
 children there is certainly economy of time and labour, and 
 possibly of expense, in a one-course as compared with a two- 
 course meal. Experience has shown that a one-course meal 
 at low cost can be made as nourishing and attractive to 
 children as a two-course regime at the same outlay. It is 
 of interest in this connection to refer to the nutritive value 
 and cost of a series of five one-course dinners recently sup- 
 plied, on my recommendation, by the Edinburgh School 
 Board. A detailed statement is of value, as it enables the 
 reader to see the advantages and defects of each of the 
 dietaries. The nutritive value of the food was determined by 
 analyzing the total amount of food taken by the "average" 
 child in a school in one of the poorer districts of Edinburgh. 
 I am aware that in the strict sense there is no such thing as 
 an " average " child, just as there can be no " average " 
 family ; but still it is possible to establish what may prove 
 at any rate a useful standard which may be practically 
 applied. Any such standard must, of course, be applied 
 intelligently, due allowance being made for those conditions 
 of the concrete problem which differ from those which were 
 presupposed in fixing the standard. The meals in question 
 were, with the possible exception of No. 5, greatly enjoyed by 
 the children. Analysis of the five meals gave the following 
 
262 
 
 THE BOOK OF DIET. 
 
 results, the meals and the figures for cost being kindly given 
 by the officials of the Board. 
 
 Edinburgh School Board Ohb-course Dinners. 
 
 I. Lentil soup 
 
 3. Meat soup and potatoes 
 
 3. Plum pudding 
 
 4. Scotch broth 
 
 5. Porridge and hard biscuit 
 
 Average . . 
 
 Protein. 
 
 Fat. 
 
 Carbo- 
 hydrate. 
 
 Cost per 
 head. 
 
 29-5 
 18.S 
 3S.4 
 28.3 
 
 34.5 
 
 37.1 
 
 3-7 
 9-4 
 30.3 
 8.1 
 4-1 
 
 9.0 
 
 112. 6 
 67.2 
 
 151.4 
 71.0 
 
 105.3 
 
 Z03 
 
 & s. d. 
 o| 
 001 
 14 
 001 
 of 
 
 I.2d. 
 
 (per hd.) 
 
 A study of the figures in the different columns is very 
 instructive. The average amount of proteins, 27.1 grams, 
 fat, 9.0 grams, and carbohydrates, 102 grams, may be taken 
 as a reliable standard for a highly nutritious material, erring, 
 if anything, in a deficiency in fat. If we compare the indi- 
 vidual menus, we find that 
 
 No. I is a very nourishing dinner, obtained at small cost. 
 
 No. 2 is of considerably lower nutritive value, and is out 
 of proportion expensive. 
 
 No. 3 is a rich, highly nourishing meal, and is proportion- 
 ately dear ; it is only advisable as an occasional meal. 
 
 No. 4 is a good dinner, obtained at moderate cost. 
 
 No. s is also a good meal, a little below the average in 
 nutritive value; this can be rectified by slightly 
 increasing the amount of milk. 
 
 A highly nutritious, cheap, and palatable day's menu may 
 be summarized as follows. When calculated for a family of 
 father, mother, and five children the price works out at 15s. 6d. 
 
A DAY'S MENU. 263 
 
 per week, which may be regarded as the minimum rate at 
 which a family of that size can be adequately fed. 
 
 Breakfast — Porridge and milk. 
 Oatmeal i oz. ~) 
 
 Treacle I ,, | Protein. Fat. Cost. 
 
 Milk 4 pt. }■ 19-S 20-0 i-zd. 
 
 Bread 2 oz. | 
 
 Margarine i ,, ) 
 
 Dinner — One course. 
 Framed from Table ) 
 
 2, vrith notes Nos. > 30.0 lo.o 1.4A. 
 
 I to 5 on p. 262. ) 
 
 Tea — Bread and milk. 
 Bread J lb. ^ 
 
 Margarine f oz. >- 21.5 19.0 1. 2d. 
 
 Milk i pt. J 
 
XIII. 
 HOW DOES DIET CAUSE DISEASE? 
 
 Effects of Underfeeding. 
 Effects of Ill-balanced Feeding. 
 Injurious Effects of Overeating. 
 
 Auto-intoxication (self- poisoning). 
 Strain on Kidneys and Circula- 
 tion. 
 
 9a 
 
Chapter XIII. 
 HOW DOES DIET CAUSE DISEASE? 
 
 It is now widely recognized among the medical profession 
 that a faulty system of feeding is the direct or indirect cause 
 of a number of chronic diseases of everyday life. The fault 
 may consist in — 
 
 1. Underfeeding. 
 
 2. Ill-balanced feeding. 
 
 3. Overfeeding. 
 
 It is beyond the scope of the present work to discuss in 
 detail the dietetic treatment of diseased states; these are 
 fully dealt with in the author's work on " Food and Feeding 
 in Health and Disease." We are here only concerned with 
 certain general principles, and with the dietetic treatment of 
 some everyday ailments. 
 
 Tlie Effects of Underfeeding are seen as a result of an 
 insufificient diet ; this may arise from want of food, as in the 
 undersized, starving children in the slums, or may be due to 
 lack of knowledge among people of the industrial classes 
 as to the principles and practice of sound feeding. It is 
 no uncommon thing to find children of the working 
 classes fed on a starvation diet that is relatively expensive 
 (see also p. 249). 
 
 The Effects of Ill-balanced Feeding are seen in anaemia, 
 
268 THE BOOK OF DIET. 
 
 induced by a diet consisting largely of tea and bread, to the 
 exclusion of the necessary animal or vegetable proteins ; in 
 scurvy, from a dietary deficient in fresh fruit and vegetables ; 
 also in rickets, from a deficiency of fats, proteins, and salts, 
 with an excess of carbohydrates. Scurvy rickets is another 
 condition met with in children fed too exclusively on 
 sterilized milk and proprietary foods, to the exclusion of 
 good fresh foods. 
 
 The Injurious Effects of Overeating are of far-reaching 
 importance. It has been said that more harm results from 
 overeating than from overdrinking. There is no question 
 that over-indulgence of the appetite is the most important 
 factor in the development of many serious diseases. 
 
 The daily amount of food required for the maintenance of 
 good health by a man of average size and weight doing a 
 moderate amount of muscular work is as follows : — 
 
 Proteins 90 to z 20 grams, or approximately 3J ounces. 
 
 Carbohydrates 400 to 500 ,, „ „ 18 „ 
 
 Fats 50 „ „ „ It „ 
 
 If expressed in meals this works out as follows : — 
 
 Breakfast. 
 2 slices of thick bread and butter. 2 eggs. 
 
 Dinner. 
 I bowl of potato soup. 
 Large helping of meat with fet. 
 4 moderate-sized potatoes. 
 I thick slice of bread and butter. 
 
 Tea. 
 Glass of milk and 2 thick slices of bread and butter. 
 
 Supper. 
 2 thick slices of bread and butter and 2 ounces of cheese. 
 
 There are, however, a large number of people, not en- 
 
AUTO-INTOXICATION. 269 
 
 gaged in active muscular work, who take a diet greatly in 
 excess of the above. There are many people who regularly 
 take a one or two course meat meal for breakfast, a large 
 two or three course luncheon which is virtually a dinner 
 meal, a good afternoon tea, and a good dinner in the 
 pvening, including a large amount of meat and meat foods. 
 
 The composition of such a diet is approximately as 
 follows : — 
 
 Proteins i6o to 200 grams, or approximately 5 onnces. 
 
 Carbohydrates SJo to 700 „ „ ,, 24 „ 
 
 Fats... ._ ... 100 to 150 ,, ,, „ 4 „ 
 
 What does a diet of this amount involve? The tissues 
 can only make use of a certain amount of food, and all in 
 excess of that becomes waste matter which has to be got rid 
 of through the kidneys, bowels, and skin, or else is stored up 
 as a poison in the tissues, which will reveal itself by illness 
 sooner or later. Overeating induces disease in one or other 
 of two ways — 
 
 1. By setting up auto-intoxication of intestinal origin. 
 
 2. By the strain on the kidneys, heart, and blood-vessels, 
 
 induced by excess of waste products in the blood. 
 These must be more fully referred to. 
 
 Auto-intoxication. — The presence of excess of food in 
 the stomach and bowels leads to development of un- 
 favourable bacterial action of the micro-organisms normally 
 present in the digestive tract, as a result of which the food is 
 improperly digested, and products of digestion which have 
 poisonous properties are absorbed into the system. A con- 
 dition of chronic self-poisoning or auto-intoxication is thus 
 established. This intestinal self-poisoning is responsible for 
 a large group of diseases, which include many cases of anaemia, 
 indigestion, headaches, asthma, neuritis, diseases of blood- 
 
270 THE BOOK OF DIET. 
 
 vessels, rheumatism, gout, and other conditions. This auto- 
 intoxication sometimes results from excessive fermentation of 
 carbohydrate foods, this being seen chiefly in young girls and 
 women who live too exclusively on bread, bread foods, tea 
 and jam ; or it arises from abnormal decomposition of the 
 proteins, such as is liable to occur in those who take three 
 rich meat meals a day. It will be obvious that the dietetic 
 treatment of these cases of auto-intoxication is of the first 
 importance. The "fermentation" cases should be treated 
 with a diet chiefly protein in character, the diet being care- 
 fully planned, the food given at regular intervals, and no 
 food of any kind given between meals. In cases arising 
 from excessive use of meat foods — putrefaction cases — a 
 lacto-vegetarian regime is advisable (p. 294). 
 
 Strain on Kidneys and Circulation. — There are many 
 people who have, unfortunately for themselves, a digestion 
 sufficiently good to enable them to apparently digest and 
 absorb a diet which is considerably in excess of what is good 
 for them. Such subjects may ridicule the idea that their 
 diet is in the least prejudicial to them, because they have no 
 symptoms of ill-health, but, on the contrary, may feel in 
 perfect condition. 
 
 Unfortunately, subjective sensations are not always a 
 reliable guide to the state of one's health. Serious and 
 chronic disease of the kidneys, heart, and blood-vessels may 
 exist for years without revealing itself by any apparent 
 disturbance of health; but the breakdown comes sooner 
 or later, and often with dramatic suddenness. There comes 
 a time when the long-continued strain on the kidneys, heart, 
 and blood-vessels becomes greater than the tissues can stand, 
 and at this juncture one of two things happens. The man of 
 fifty years or thereabout who regarded himself as fit and well, 
 has a stroke, with fatal results, or is more or less crippled by 
 
STRAIN ON KIDNEYS, ETC. 271 
 
 the results of cerebral haemorrhage or heart failure. The 
 alternative is that the man becomes prematurely old, his 
 vigour fails, his appearance changes for the worse, he be- 
 comes short of breath, and on examination it is found that 
 his kidneys have begun to give out, and he is never the same 
 man again. He has chronic nephritis or Bright's disease, 
 which has been developing, unknown to him, for a long 
 time. It is no exaggeration to say that these are everyday 
 clinical pictures. It is equally true to say that in a great 
 many cases they are the outcome of prolonged unphysio- 
 logical feeding, from indulgence in excess notably in animal 
 protein foods. It is not for a moment contended that this 
 is the only cause of these conditions in all cases, but at the 
 same time there is no doubt whatever that it is the most 
 important cause in a large number of cases ; and as pre- 
 vention is always easier than cure, it is well that attention 
 should be forcibly drawn to it The reader is here referred 
 to ch. X., which gives an account of the principles to be 
 attended to in the feeding in later years of life. 
 
 Attention should be directed to an important factor which 
 contributes to the harmful effects of overeating — namely, the 
 lack of proper drinking. A large number of people drink too 
 little fluid, with the result that the natural poisons in the 
 body are not properly dissolved and washed out of the 
 system. A slight excess of food above the actual require- 
 ments of health will be attended by no unfavourable results 
 if the organs of excretion — the bowels, kidneys, and skin — 
 are kept judiciously active. Careful regulation of the 
 bowels, the drinking of from one to two pints of water or 
 alkaline water daily on an empty stomach, and the wise use 
 of baths will do much to prevent any harmful results arising 
 from a slight excess of food. 
 
 A word may be said as to the use of alcoholic stimulants. 
 
272 THE BOOK OF DIET. 
 
 It is a common experience to find that those who overeat, 
 and especially those who take excess of stimulating animal 
 food, are prone to take too freely of alcoholic stimulants. 
 I do not mean to say that they indulge in any way to excess, 
 in the popular sense of that term, but there is no doubt that 
 the frequently recurring extra stimulation of the heart, blood- 
 vessels, and kidneys associated with the taking of wine 
 and liquors in addition to an excessive amount of food- 
 stuffs is an important factor in determining the final break- 
 down. 
 
 The following general rules may be laid down as suitable 
 for general application. Attention to these rules would go 
 far to lessen overeating, and diminish the risks of continual 
 over-indulgence. 
 
 1. Three good meals a day are enough for any one. 
 
 2. Meat should not be partaken of more than once, or at 
 
 most twice, daily ; it should be reduced in amount 
 in later years. 
 
 3. Thorough mastication of the food is of the first impor- 
 
 tance; this promotes proper digestion of the food 
 and lessens the risk of indulgence to excess. 
 
 4. The amount of food should be proportionate to the 
 
 amount of exercise. 
 
 5. An ample supply of fluid in the form of drinking-water 
 
 should be taken ; most people drink too little water, 
 or take it at the wrong time. 
 
 6. Attention should be closely directed to the functions 
 
 (i) of the bowels, by use of aperients if necessary; 
 and (2) of the skin, by means of baths. 
 
xrv. 
 
 DIET IN FEVERS. 
 
 Milk and its Derivatives. 
 
 Meat Infusions, Juices, Extracts, 
 
 etc. 
 Vegetable Flavouring. 
 Gelatine. 
 Farinaceous Foods. 
 
 Sugars. 
 Fruit Juices. 
 Beverages. 
 Tea and Coffee. 
 Stimulants. 
 General Serving of Food 
 FOR Invalids. 
 
Chapter XFV. 
 DIET IN FEVERS. 
 
 Practically all fevers are of infective origin. They result 
 from the action of microbes which have invaded the tissues, 
 and which have produced toxins or poisons which circulate 
 in the blood, increase the temperature of the body, and 
 induce increased combustion and rapid breaking down of 
 the tissues. Minor degrees of fevers are seen as the result 
 of a slight chill, sore throat, or slight bronchial catarrh ; 
 these result from a slight infection of the system from the 
 germs which normally abound in the nose, throat, or bron- 
 chial tubes. A greater degree of fever is seen in pneumonia, 
 acute rheumatism, scarlet fever, typhoid fever, and other 
 diseases, the fever being, as a rule, proportionate to the 
 degree of infection. As a consequence of the increased 
 combustion of the tissues that occurs in fevers, there is 
 an excessive excretion of urea, the increased solids being 
 often present in the form of a brick-dust-like deposit in the 
 urine. The fever induces a disturbance of the digestive and 
 absorptive glands, which is accompanied by loss of appetite 
 and distaste for food. The tongue becomes parched and 
 dry, and the bacteria normally present in the mouth increase 
 in numbers and accumulate at the roots of the teeth, in- 
 ducing fermentative changes which aggravate the fever, and 
 
276 THE BOOK OF DIET. 
 
 at the same time increase the patient's distaste for food. It 
 is, therefore, specially important to attend to the toilet of the 
 mouth. Regular cleaning of the mouth and teeth with an 
 antiseptic mouth wash at least thrice daily checks fermen- 
 tative processes, and enables the patient to take his food to 
 the best advantage. On account of the great tissue waste 
 that occurs in fevers, careful feeding from the outset of the 
 disease is of the greatest importance for the maintenance of 
 the patient's strength, for increasing his resistance to the 
 toxins which have induced the fever, and for shortening the 
 convalescence. 
 
 The principles to be attended to are as follows : — 
 
 1. An abundance of fluid must be given. This relieves 
 the dry and parched sensation in the throat and fauces, 
 washes out through the kidneys the waste matter produced 
 by the increased combustion in the tissues, and promotes the 
 elimination of the toxins. 
 
 2. The food must be of a nature which can be readily 
 digested and absorbed ; with suitable feeding the wasting is 
 less, the patient does not become so reduced, and conse- 
 quently the convalescence is more rapid. 
 
 3. An adequate supply of albuminous, of carbohydrate 
 food, and of gelatine must be given to neutralize the in- 
 creased breaking down of the tissues resulting from the 
 fever. Fats should be avoided, as the power of digesting 
 fats is greatly interfered with in fevers. 
 
 The diet must be selected from the following substances — 
 namely, milk, whey, eggs, meat teas, meat infusions, meat 
 juices, meat extracts, soups, meat jellies, calf's-foot jelly, 
 grape sugar, starches, fruit juices, fruit soup, and beverages 
 of low nutritional value. This diet may be suitably varied 
 by changing the flavouring substances. 
 
 Food, in all cases of pyrexia, should be administered ir 
 
MILK AND ITS DERIVATIVES. 277 
 
 the fluid form, the quantity small, from three to four ounces 
 at a time, and given at short intervals (every one and a half 
 or two and a half hours) during the day. At night, if the 
 strength is being well maintained, simple drinks to quench 
 the thirst are all that is required ; by this arrangement the 
 digestive organs obtain rest. 
 
 Milk and its Derivatives. — Milk is the staple article of 
 diet during the early stages of a fever. From two to three 
 ounces of milk, diluted as recommended later, may be given 
 every one and a half hours. If this does not disagree, the 
 amount may be increased. From three to four pints of milk 
 are readily taken by most adult patients. It is almost always 
 necessary to dilute the milk, the amount of dilution depending 
 on the digestive powers of the patient. The diluted milk 
 may be given hot or cold. 
 
 The following methods may be adopted : — 
 
 1. Simple dilution with boiling water, clear or thick barley- 
 water (ch. xxii.), toast or rice water, in the proportion of equal 
 parts. 
 
 2. Dilution with an efiervescent water — milk and Vichy or 
 Vals water, equal parts, or milk one part with two portions 
 of potash, soda, or ApoUinaris water. 
 
 3. Dilution and mixture with an alkali. This method 
 is advisable if there are pain and flatulence after the simply 
 diluted milk. The addition of 10 grains of soda bicarbonate 
 and ro grains common salt, added to equal parts milk and 
 water, often prevents pain and lessens the constipation. 
 Lime-water in the proportion of one part lime-water to three 
 parts of milk is useful if there are pain and a tendency to 
 diarrhcea. Repugnance to milk can be overcome by modify- 
 ing the flavour of the milk ; for example, tea can be infused 
 with boiled milk, or a very weak cocoa made with AUen- 
 bury's milk cocoa can be specially recommended for this. 
 
278 THE BOOK OF DIET. 
 
 Horlick's malted milk made with milk is very palatable. A 
 small amount — for example, half a teaspoonful of a meat 
 extract, such as bovril,. 0x0, lemco, or vigoral — added to a 
 cup of warm milk or milk and water is an excellent way of 
 varying the flavour. 
 
 4. Modifications of milk. Occasionally cases occur where 
 diluted milk is not digested, and whey will then be found 
 useful. Its nutritive value may be increased by the addition 
 of strong beef-tea, raw-meat juice, egg- water, or plasmon. 
 A number of useful receipts will be found in ch, xxii. The 
 fermented milks, koumiss and kephir, can sometimes be 
 retained by an irritable stomach when everything else is 
 rejected. 
 
 Eggs. — Eggs form another permissible food, but ought 
 not to be allowed too fireely. They may be given as a drink, 
 either alone or in combination with milk, or may be used to 
 fortify other nourishment. The lightest form of egg drink is 
 an egg beaten up, added to three ounces of very hot water, 
 strained, and flavoured with vanilla essence or cinnamon, and 
 slightly sweetened. Another form of egg drink, more stimu- 
 lating and nourishing, is described on p. 54, where milk 
 and sherry are added to the egg. Egg flip is the white 
 of egg added, when well beaten up, to milk or cream, and 
 flavoured. A switched egg may also be added to a cup of 
 tea or coffee. A whole egg, beaten up with three times as 
 much water, strained, and added to light broth or clear 
 soup, is also very nourishing. 
 
 Caution. — Do not add the egg to boiling soup, or it will 
 curdle. Albumin water (p. 53) added to a clear soup or to 
 a cup of bovril is nourishing and very pleasant. 
 
 Meat Infusions, Juices, Extracts, etc. — This group of 
 foods is largely administered, and its usefulness is uni- 
 versally admitted. In the selection of a beef-tea, it is far 
 
MEAT PREPARATIONS. 279 
 
 better to use a carefully prepared home-made beef-tea than 
 any of the expensive patented beef-teas and meat juices, 
 which are purchased at a great cost in the belief that they 
 are strengthening. In another chapter (p. 38) full directions 
 are given for the preparation of " teas " (beef, mutton, and 
 veal and chicken). There are two methods described; 
 Method I is preferable for fever patients, as the flavour is 
 less concentrated. When the " tea " has been made in the 
 closed jars, as described under Method 2, it is rather strong 
 for most fever patients. Proprietary beef extracts may be 
 given if satisfactory home-made meat teas are not available ; 
 they may be thickened as described below, and vegetable 
 flavouring can be obtained by adding boiling water which 
 has been flavoured with vegetables. 
 
 Special attention should be given to the means of 
 thickening the teas (p. 382) with tapioca, bread crumbs, baked 
 flour, arrowroot, oatmeal, and yolk of egg, the last mentioned 
 being specially pleasant to a patient who is convalescent. 
 The nutritive value of the food may be greatly increased by 
 the addition of one or more of these substances. 
 
 Vegetable Flavouring can also be added by cooking vege- 
 tables with the meat and straining carefully, without in any 
 way injuring the digestibility of the food. Beef juices and 
 essences, whether home-made or proprietary preparations, 
 are not nearly so suitable for fever patients as the well- 
 diluted teas and extracts referred to above. 
 
 Gelatine. — Gelatine is not a tissue builder, but it is the 
 means of saving the albuminous waste from the tissues. 
 From this point of view gelatine cannot be too strongly 
 recommended. Gelatine may be administered in the form 
 of soup from jellied stock — consomme — or may be given 
 as a meat jelly, calf's-foot jelly, or as a sweet jelly. For 
 methods of preparation see ch. xxii. 
 
28o THE BOOK OF DIET. 
 
 Farinaceous Foods. — Farinaceous foods in the form of 
 starches and sugar can be given in moderation. The 
 starches may be given as (i) thin oatmeal or barley gruel, 
 carefully strained, and flavoured as desired with salt or sugar 
 (ch. xxii.) ; (2) arrowroot and farola, used in the same way ; 
 or (3) clear soup and beef-tea, slightly thickened with 
 arrowroot, ground rice, or baked flour (see infra), con- 
 somme with sago or semolina (p. 382). Partially digested 
 starch is given in the form of prepared invalid foods (ch. xxiL) 
 made from Benger's, Savory and Moore's, or " AUenburys " 
 foods, etc. 
 
 The sugars can be given in the form of (i) malt extract, 
 granulated j this can be dissolved in warm water, milk, or 
 effervescing water. It is pleasant to take, and supplies grape 
 sugar and maltose, both partially digested sugar. (2) Grape 
 sugar by itself can be procured from the chemist, and is 
 strongly to be recommended ; it is used added to fari- 
 naceous foods, and also to sweeten beverages. 
 
 Fruit juices also contain easily digested sugar, and 
 the juice of grapes and oranges is quite permissible and 
 is much appreciated. It is, however, necessary to note 
 that the skins and stones of grapes should be carefully 
 removed, and in oranges only the juice and pulp should 
 be eaten. 
 
 Fruit soups. — These are very pleasant, and much to be 
 recommended. Prepare by boiling fresh or dried fruits 
 with water, with the addition of grape sugar and squeeze 
 of lemon juice. When quite soft they are pressed and 
 the juice strained. This is eaten cold. 
 
 Beverages. — An abundance of fluid in the form of water 
 or refreshing drinks should be allowed; if a little ice 
 is added to these drinks, they are very acceptable to fever 
 cases. 
 
SERVING OF INVALID FOODS. 281 
 
 Several suggestions for pleasant drinks are given in the 
 chapter on "Recipes," p. 397. 
 
 Tea and Coffee freshly made with boiling milk and water 
 equal parts is quite allowable and often craved for by the 
 patient. 
 
 Stimulants are seldom necessary or advisable in fever; 
 they should only be given under medical supervision. 
 
 General Serving of Food for Invalids. 
 
 The manner in which the food is served is of great 
 practical importance. A meal served in a careless, slovenly 
 manner may disgust the patient and seriously retard con- 
 valescence. 
 
 Everything should be served as daintily as possible, the 
 dishes, glasses, and tray-cloth being thoroughly clean. To 
 most invalids the meals are the events of the day, and too 
 much care cannot be exercised to ensure that all the details 
 should be done in as attractive a way as possible. Patients 
 should not, as a rule, be consulted as to their meals, but 
 there should be an endeavour to ascertain beforehand what 
 the patient likes. Any particular fancy as to sweetness or 
 otherwise should be remembered. Untouched food should 
 never be left in an invalid's room, but should be put aside in 
 a cool place ; and no food should be cooked or prepared in 
 the invalid's presence if it can be done elsewhere. Food 
 should never be tasted in presence of the patient, and it 
 should not be cooled by being blown upon, as this naturally 
 disgusts the patient. 
 
 In the case of helpless patients who cannot feed them- 
 selves, nourishment may be given by the spoon or the 
 feeding-cup. When the patient is very helpless, a useful 
 device is to pull out the cheek, by inserting the finger 
 
282 THE BOOK OF DIET. 
 
 between the gum and the cheek, and then introduce the 
 fluid nourishment slowly at one side. A teaspoon is the 
 most convenient size of spoon for child-feeding, and a 
 dessertspoon for the adult. As to drinking-cups, the shape 
 made with three handles is very convenient for the patient 
 to use when feeding himself; but when the services of a 
 nurse are required, a small boat-shaped feeding-cup with a 
 curved spout, and about three inches of rubber tubing 
 attached, is the most useful. In the case of the latter, great 
 care must be taken to maintain thorough cleanliness of the 
 apparatus in use. 
 
 In feeding with a spoon or a feeding-cup, it is certainly 
 easier for the patient to have the head raised, if this is 
 permissible; the nurse in these cases passes the left arm 
 under the pillow on which the patient is lying, and gently 
 raises the head. 
 
XV. 
 LIGHT DIETS. 
 
 A MILK DIET. 
 Skimmed Milk Cure. 
 Whey Cure. 
 
 Koumiss and Kephir Cures. 
 Soured Milk or Buttermilk Therapy. 
 
 A FLUID DIET. 
 
 LIGHT SOLID FOOD. 
 
 LACTO-VEGETARIAN DIET. 
 
 Breakfast. 
 
 Lunch and Dinner. 
 
 URIC ACID FREE DIETARY. 
 
 MEAT AND HOT WATER 
 (Salisbury Diet). 
 
Chapter XV 
 LIGHT DIETS. 
 
 In many acute diseases, other than fevers referred to in 
 the preceding chapter, and also in certain chronic ailments 
 unaccompanied with fevers, a light diet is indicated. By 
 that we mean a diet which is simple, easily digested and 
 absorbed, one which is adapted to the temporarily enfeebled 
 state of the digestive juices. A light diet is also indicated in 
 the later states of acute fever, prior to returning to ordinary 
 feeding. The following examples of light dietary are 
 frequently recommended by medical men : — 
 
 1. A milk diet; 
 
 2. A fluid diet. 
 
 3. Light solid food, or " light diet." 
 
 4. Lacto-vegetarian regime. 
 
 5. Uric acid free diet. 
 
 6. Meat and hot water diet. 
 
 A MILE DIET. 
 
 This consists in the administration of three to five pints of 
 milk in the twenty-four hours. This should be given in 
 measured quantity every four hours. It may be given 
 diluted. In exceptional cases, in which milk cannot be 
 
286 THE BOOK OF DIET. 
 
 well digested, whey, skimmed milk, or koumiss may be 
 advantageously given. In the case of patients on a milk 
 regime, the milk must not be looked on as a drink, but 
 should be given as a food at regular intervals and in 
 regulated amount. If necessary, ample fluid should be 
 given in the form of water, alkaline water, or other thirst 
 quenchers described in ch. xxii. 
 
 Skimmed Milk Cure. — A diet of skimmed milk has very 
 special value in cases where it is desired to rest the digestive 
 organs to enable them to recover from an exhausted and 
 irritable condition. It is useful in cases of intestinal indi- 
 gestion and chronic catarrh of the small and large bowel 
 (colitis). The diet at first is restricted to skimmed milk, 
 which should be freshly prepared, and given in conjunction 
 with mineral water. To begin with, from four to six ounces 
 should be given every two and a half hours, the amount 
 being gradually increased until ten to twelve tumblerfuls are 
 taken daily. If desired, the milk may be flavoured with 
 weak tea or coffee, and a pinch of salt may be ad- 
 vantageously added. After four to six days of this regime, 
 during which time the patient is confined to bed, the diet 
 may usually be increased by the addition of stale bread, dry 
 toast, or a malted invalid food. Solid food is best withheld 
 for one to two weeks, when a little lean, raw, scraped beef 
 may usually be added to the dietary. To begin with, patients 
 lose weight on this regime, and they may complain of drowsi- 
 ness or general weakness. The urine is increased in amount, 
 is of low specific gravity, and of a pale, slightly greenish tint. 
 Constipation may be a feature, and is best treated by adding 
 fruit to the diet — for example, prunes or stewed apples, once 
 daily in the forenoon. In some patients diarrhoea and 
 vomiting are set up, this being remedied by reducing the 
 amount of milk, or lengthening the interval between meals, 
 
MILK DIET. 287 
 
 and the addition of sodium citrate or lime water to the milk. 
 In favourable cases the state of the digestion and of the 
 intestinal excretion rapidly improves on this regime, enabling 
 the patient to return in a few weeks to a light, convalescent 
 dietary. 
 
 Whey Cure. — Whey is practically an aqueous solution of 
 milk sugar. A whey cure is advocated in some cases of 
 chronic indigestion. It consists in the administration of 
 from twenty to forty ounces of whey daily, which is taken 
 warm either alone or with a mineral water. It is given in 
 combination with a vegetarian and fruit regime. In cases of 
 abdominal plethora, as much as eight to ten tumblerfuls may 
 be given daily with a diet of fruit and vegetables. It is 
 sometimes combined with a grape cure. When taken in 
 large amount it sometimes induces diarrhoea and colic. 
 
 The Koumiss and Kephir Cures. — The general properties 
 of koumiss and kephir are given on p. 45. Koumiss 
 contains from one to two per cent, of alcohol. It is more 
 easily digested and more completely absorbed than ordinary 
 milk, and can be taken in large amounts. It is diuretic, 
 gently laxative, and, like other milk cures, lessens intestinal 
 putrefaction in virtue of the lactic acid which it contains. 
 On an average from two to four quarts are taken daily, but 
 much larger quantities are taken at the special "cure" 
 resorts in Russia where the method is in vogue. The 
 koumiss is given in combination with nourishing food of a 
 protein nature — carbohydrates, fruits, and saccharine foods 
 being specially restricted. Lime water is added if diarrhoea 
 is present. This koumiss cure is largely employed in Russia 
 in the treatment of pulmonary tuberculosis. In this country 
 the special value of koumiss lies in its being a valuable milk 
 preparation, which can be taken by many patients with whom 
 plain milk and its other modifications disagree. 
 
288 THE BOOK OF DIET. 
 
 Soured Milk or Buttermilk Therapy. — In the last year 
 or two a valuable method of treatment by means of soured 
 milk and other methods of administering selected lactic 
 germs has been brought to the notice of the profession by 
 the distinguished French bacteriologist, Eli MetchnikofiF, of 
 the Pasteur Institute, Paris. 
 
 It is well known that lactic acid is a powerful anti- 
 putrefactive agent When milk turns sour — that is to say, 
 when the milk sugar has undergone lactic fermentation 
 with the formation of lactic acid — it can then resist putre- 
 faction for a long time. This fermentative property, first 
 shown by MetchnikofF, induced him to employ cultures of 
 the lactic germs in order to produce nascent lactic acid 
 in the bowels. 
 
 In the process of curdling, milk is rendered more easily 
 digested, as a large proportion of the casein is rendered 
 soluble. Curdled milk is therefore both a food and 
 a medicine. 
 
 Certain cases of chronic intestinal catarrh, pernicious 
 anaemia, subacute and chronic nephritis, rheumatism, and 
 gout are very strikingly benefited by the administration of 
 soured milk and other methods of administering lactic 
 germs. The treatment is of special value in cases of auto- 
 intoxication resulting from abnormal putrefaction of proteins ; 
 it has little value in cases due to excessive fermentation of 
 starchy foods. 
 
 It may be given as buttermilk, which is the residual milk 
 left after churning and removing the fat ; or as soured milk, 
 which differs from buttermilk in that the fat has not been 
 removed ; or in the form of one of the many commercial 
 preparations of lactic bacilli at present in the market — for 
 example, Lacto-Bacilline, Sauerin, Lactigen, Trilactine, 
 which are added to the milk for the preparation of an 
 
SOURED MILK THERAPY. 289 
 
 artificial soured milk. Unfortunately these preparations 
 cannot be implicitly relied on, as it has been found that they 
 sometimes contain no active lactic acid bacillij 
 
 When a freshly made buttermilk from a good source is 
 obtainable, this is probably, on the whole, the safest method 
 of administration. Here again, however, we have to bear in 
 mind its uncertain composition. The "strain" of germs 
 used in the preparation of commercial buttermilk is, as a 
 rule, renewed every three weeks ; as the strain gets at- 
 tenuated, there is a corresponding increase in the number 
 of other bacteria present in the milk, and the presence of 
 these may interfere with the action of the lactic germs 
 present. In the same way, if milk has been doctored by 
 the addition of preservatives, the curdling may be prevented 
 even although the lactic bacilli are active. There are also 
 specially prepared buttermilk preparations in the market 
 made from the Bulgarian bacillus — for example, fermen- 
 lactyl, made by the Aylesbury Dairy Company. Bulgarian 
 soured milk chocolates (Rowntree's), and a cheese containing 
 lactic bacilli in large numbers (Lactic St. Ivel cheese), are 
 other forms in which the lactic germs are given. Under the 
 influence of the administration of an active preparation of 
 lactic acid bacilli in suitable cases, a very notable improve- 
 ment in the state of the stools is brought about ; these lose 
 their fetor and become formed, presenting a marked contrast 
 to the extremely fetid, pultaceous stools originally present. 
 It will readily be understood that lactic acid producing 
 germs is more likely to have a beneficial effect when the 
 diet is kept simple. 
 
 10 
 
ago THE BOOK OF DIET. 
 
 A FLUID DIET. 
 
 This includes milk, beef-tea, chicken and mutton broth, 
 and fruit juice, described under "Fever Diet" (p. 273). 
 The milk and the thin beef-teas are now to be thickened ; 
 light soups, egg drink, and various jellies being mainly given. 
 
 The thickening of milk should be done with the more 
 easily digested starches either in the form of some invalid food 
 (Benger's or Savory and Moore's, etc., p. 160 and ch. xxii.), 
 or from a well-cooked simple gruel, or a malted gruel (ch. 
 xxii.). Bread-stuffs are to be given in small quantities ; thin 
 slices of toast, crusty part of a Vienna roll, sweetened or un- 
 sweetened rusks, toasted sponge finger biscuits, rice biscuits 
 may be recommended. Stale bread from pan loaves, or 
 veda, hovis, or bermaline are also allowable when given 
 in thin pieces and when the bread is not too new. 
 
 Suggested Diet. 
 
 Seven a.m. — A small cup of milk, warmed with freshly made tea. 
 
 Eight-thirty a.m. — Milk, 8 ounces, and thick barley water (ch. xxii.). 
 Half slice crisp toast. 
 
 Eleven-thirty a.m. — Calf s- foot jelly or chicken jelly, 2 ounces. 
 
 Otiep. m. — Thick beef-tea (p. 383). A few grapes (juice and pulp only). 
 
 Four p.m. — Cup of hot milk, or diluted with freshly made tea. Thin 
 slice bread and butter. 
 
 Six-thirty p.m. — Cup of invalid food (Benger's or Allenburys, 
 p. 160). 
 
 Nine p.m. — Cup of thin beef-tea (Method i, p. 382) or chicken tea. 
 
 The above fluid diet may be made slightly richer as 
 follows ; — 
 
 (5.) 
 
 Seven a.m. — Milk and hot water and freshly made tea. 
 
 Eight-thirty a.m. — Malted gruel or water gruel eaten with cream 
 — a saucerful. 
 
" LIGHT DIET." 291 
 
 EUvm-thirty a.m. — Milk, 8 ounces, with pancreatized cocoa 
 (AUenbuiys), and a plain biscuit. 
 
 One p.m. — Thick beef-tea (p. 383). A small dish of curds or a blanc- 
 mange). 
 
 Fout p.m. — Cup of tea, milk and cream, slice bread and butter, one 
 sponge biscuit. 
 
 Six-thirty p.m. — Boiled custard, sweetened, or made with meat extract 
 (p. 411), with biscuit. 
 
 Nine p.m. — Chicken soup, restorative or veal jelly (ch. xxii.). 
 
 LIGHT SOLID FOOD. 
 
 Consists in the light, nutritive, and more easily digested 
 food-stuflfs ; what is commonly known as a " light diet." 
 
 This includes in addition to the foods, allowed under 
 "fluid" diet, lightly cooked eggs, either plain, boiled, 
 poached, or scrambled, or in the form of a custard souffle 
 or omelet (pp. 404, 405), or combined as in milk puddings 
 with a farinaceous food. As the digestion improves a more 
 liberal allowance of solid food may be given, including 
 fish (white varieties), sweetbreads, chicken, turkeys, game, 
 pigeons, and rabbit. The red meats are allowed afterwards, 
 and may be given in the form of beef quenelles, beefsteak 
 minced (not mince collops), eye of a tender-loin chop, a 
 small underdone fillet of beef, a slice from undercut of a 
 lightly cooked sirloin of beef, slice of roast mutton. 
 Vegetables and stewed fruits are also allowed. 
 
 The following are the most suitable vegetables : Spinach, 
 boiled lettuce, baked tomatoes (skinned), asparagus (steamed), 
 celery (stewed), seakale, young leeks, Portugal onions, 
 cauliflower, and vegetable marrow. The best methods of 
 cooking these vegetables are described on p. 385. They 
 can be served with a well-made white sauce. With regard 
 to fruit, what has been said under fevers on p. z8o here 
 
2g2 
 
 THE BOOK OF DIET. 
 
 applies. Stewed fruit is better than raw fruit, and all the 
 skin should be carefully removed. The seed fruits — for 
 example, raspberries, currants, brambles, and figs — should 
 not be given. I now append suggested diets of a graded 
 character, suitable for patients with normal digestion re- 
 covering from an acute illness; and also two diets of the 
 same light nature, but rather more restricted both as to 
 number of meals and kind of food, suitable for patients 
 with weakened digestive capacity. 
 
 Table of Four suggested Light Diets. 
 
 Seven a.m. — 
 
 Cup of tea, freshly made. Half- 
 slice bread and butter. 
 Breakfast. — 
 
 Saucsrful of gruel with cream. 
 Small cup of tea. Crusty roll 
 and butter. 
 Eleven a.m. — 
 Cup of clear beef or chicken tea. 
 Strip of toast. 
 Dinner (1.30 p.m.). — 
 Steamed whiting. Half slice 
 bread. Milk pudding (semo- 
 lina or ground rice). Milk, 
 6 ounces. 
 
 Four-thirty f. m. — 
 Milk and soda or milk and 
 freshly made tea, bread and 
 batter, sponge cake. 
 Six-thirty p.m. — 
 Savoury custard. 
 
 11. 
 
 A lightly boiled egg. Cup of 
 tea or milk. Toast, roll and 
 butter. 
 
 Milk and potash, biscuit. A 
 little fruit. 
 
 Chicken roast with bread sauce. 
 Vegetable — cauliflower, stewed 
 vegetable marrow. No pota- 
 toes. Apples roasted or apple 
 cream, eat with cream. Milk, 
 6 ounces. 
 
 Afternoon tea, avoiding rich 
 cakes and pastry. 
 
 Oysters (ch. xxii.), omelet (fish), 
 or a souffli (ch. xzii. ). Glass of 
 milk or Horlick's malted milk. 
 
LIGHT DIET.' 
 
 293 
 
 Nine p.m. — 
 A meat infusion (beef, mutton, 
 chicken, or veal), or cup of 
 thin invalid food. 
 
 III. 
 
 Breakfast. — 
 Steamed fish, whiting or sole. 
 Tea, bread, toast, butter, and 
 a little jelly. 
 Eleven a. m. — 
 Milk and potash, or clear soup. 
 A little ftuit. 
 Dinner (1.30 p.m.). — 
 Sweetbread or tripe (ch. xxii.). 
 Vegetable — tomato (stewed 
 pulp only), or spinach. 
 Stewed fruit passed through 
 sieve, a baked custard, or a 
 milk pudding. 
 Four-thirty p.m. — 
 Same as No. II. 
 Six-thirty p.m. — 
 Poached egg on toast, spinach. 
 Curds and cream. Milk and 
 potash or milk and peptonized 
 
 IV. 
 
 Fried bacon (streaky Wiltshire), 
 Tea or coffee, milk, toast, 
 bread, etc. Butter and jam. 
 
 Egg flip or soup, or milk and 
 potash and a little fruit. 
 
 Fillet of beef or mutton chop, 
 gravy, but no made-up sauce. 
 Vegetable or a few potato 
 chips. Sweet jelly or blanc- 
 mange. 
 
 Same as No. II. 
 
 Fish. Milk pudding. Milk and 
 potash. 
 
 Light Diet suitable for Weakened Digestion. 
 
 Seven a.m. — Give nothing except 6 ounces of hot water, unless 
 patient has had a bad night, in which case give 8 ounces of equal 
 parts milk and water. 
 
 Eight-thirty a.m. — Fancreatized cocoa made with milk, 8 ounces, 
 bread and butter or toast and butter. 
 
 One p.m. — Soup, 8 ounces, from vegetable stock thickened with milk 
 and cream or a weak meat broth — all the vegetables strained. Light 
 milk pudding — custard or blancmange. Milk diluted with water or 
 Seltzer, 8 ounces altogether. 
 
 Four p.m. — Milk, 8 ounces, flavoured with freshly made tea, cream, 
 sponge biscuit or rusk, or thin slice bread and butter. 
 
294 THE BOOK OF DIET. 
 
 Seven p.m. — As at lunch, soup and pudding, or a lightly boiled or 
 scrambled egg. 
 Nine-thirty p.m. — Milk, 8 ounces, with Horlick's malted milk. 
 
 Light Diet of a Dry Character. 
 
 Breakfast. — Tea or coffee weak with milk, quantity restricted to 4 or 
 5 ounces ; a slice of crisp toast and butter ; a fillet of fish, or a boiled or 
 poached egg. 
 
 One- thirty p.m. — The chief meal of the day should consist of two 
 courses only, the fluid taken to be not more than 4 ounces: Fish, 
 meat, and one vegetable ; or, fish and light pudding ; or, meat and one 
 vegetable, with light pudding. 
 
 Five p.m. — One small cup of freshly made tea, preferably China, with 
 cream and sugar. 
 
 Seven p.m. — ^A one-couree meal course may be: Beef juice mince 
 (ch. xxii.) ; fish with toast ; chicken or game pur^e, rusk ; savoury 
 custards (Bovril or cheese) ; egg in some form, omelet or a souffl& 
 Avoid &rinaceous foods at this meal and restrict fluid to 4 ounces. 
 
 Nine-thirty p.m. — Hot water, 6 ounces. 
 
 LACTO-VEaETABIAN DIET. 
 
 Vegetable food-stufifs are on the whole less appetizing than 
 animal foods, and accordingly the vegetarian feeder is less 
 exposed to over-indulgence with its attendant unfavourable 
 results. A lacto-vegetarian diet if carefully selected is to be 
 regarded as a form of light diet, and is useful in some 
 diseased conditions. In later life it is a wise rule to restrict 
 more and more the rich animal foods that can be taken with 
 impunity in earlier years, and have recourse to a largely 
 meat free diet (see p. 225). 
 
 There is often difficulty in planning the meals for a lacto- 
 vegetarian dietary, and the following may be helpful : — 
 
 Breakfast. — ^This meal can consist of oaten or wheaten 
 porridge, or any other cereal; whole-meal bread and white 
 
URIC ACID FREE DIETARY. 295 
 
 bread, scones, rolls, butter, eggs cooked in any form, jams, 
 marmalade. 
 
 Lunch and Dinner. — The soups must be made from 
 vegetable stock (p. 386), and thickened with various forms 
 of cereal brown or white roux, tapioca, sago, barley, rice, 
 milk, eggs, and the various forms of vegetables. Farinaceous 
 foods and savoury dishes, pulses and nut meats, eggs in 
 various forms, and preparations with cheese take the place 
 of meats and entrees. Vegetables and salads, puddings, 
 fruits, and cheese are all permissible. 
 
 URIC ACID FBEE DIETARY. 
 
 A special form of light diet is that known as a uric acid 
 free dietary. This dietary has been recommended for gout, 
 renal disease, headaches, and various chronic diseases. This 
 system is based on the theory that these diseases are due to 
 the retention of uric acid in the system. It is now known 
 that this theory is erroneous, the uric acid being a result 
 rather than a cause of the diseases in question. A uric acid 
 free diet is, however, a form of light diet, and as such is of 
 value in special cases. A short account is here given of the 
 various food-stuifs which contain uric acid or purin, and of 
 the advantages and defects of this system of feeding. 
 
 Meat and meat extracts contain a large amount of purin s ; 
 similarly, certain glandular organs, such as the pancreas and 
 liver, are rich in purins. They are also present, though in 
 smaller amount, in many vegetable foods (for example, 
 beans, lentils, and oatmeal), and they are relatively abundant 
 in some accessory articles of diet, notably tea and coffee. 
 
 Milk, white bread, and potatoes contain practically no uric 
 acid or other purins. Similarly, cream, butter, fats, eggs. 
 
age THE BOOK OF DIET. 
 
 apples, grapes, figs, dates, and raisins are purin free. 
 Macaroni, cheese, and nuts are in the same category. In 
 comparison with foods containing purins, we, therefore, see 
 that purin-free foods are on the whole much less appeti2ing, 
 and on that account are less likely to be taken to excess. A 
 typical purin-free dietary is as follows : — 
 
 Breakfast. — One pint of milk ; bananas ; apples ; pears ; plums, 
 fresh, dried, or cooked ; any other fresh fmit. (Eaten to any extent for 
 which there is appetite.) 
 
 Lunch. — Vegetable sonp made with milk ; potatoes with butter, oil, 
 or milk ; two ounces of cheese, eaten with potatoes and any other 
 vegetables in season ; stewed fruit or tart ; fresh fruit ; one pint of milk 
 drunk during the meal. 
 
 Dinner. — Much as lunch : one pint milk ; one ounce cheese. 
 
 Any variety of vegetables and fruit in season. If potatoes 
 and fruit are taken in large quantity, less milk and cheese 
 will be required. 
 
 In order to get the best results from treatment, the transi- 
 tion from an ordinary diet to a purin-free dietary should not 
 be efifected too quickly. At the outset there may be slight 
 difficulty in digesting certain foods, and constipation may be 
 a troublesome feature. These difficulties are not as a rule 
 difficult to overcome. It is of the first importance to enjoin 
 thorough mastication of the food. 
 
 The advantages may be summarized as follows : It is 
 a simple diet; its adoption prevents overeating; it restricts 
 intestinal putrefaction and so prevents auto-intoxication from 
 the products of imperfectly digested protein foods; it has 
 the further advantage of being a "special system," and on 
 that account is followed more rigidly and therefore more 
 successfully than other dietaries framed along more con- 
 ventional lines. These advantages give this system of 
 feeding a distinct place in therapeutics. Its undoubted 
 
SALISBURY DIET. 297 
 
 value is probably explained along the lines just referred to 
 rather than by regard to any specific action associated with 
 the absence of uric acid in the dietary. 
 
 The disadvantages of the diet must be referred to. Some 
 patients find the regime very unattractive, and as a result 
 the amount of food taken, and especially the amount of 
 protein food, falls below the necessary standard, and ill- 
 health results from a continuation of the diet. In others 
 its too rigid adoption may induce diarrhoea and other 
 gastro-intestinal disturbances, with resulting deterioration in 
 health. 
 
 MEAT AND HOT WATER (Salisbury Diet). 
 
 At first sight it appears strange to include a meat and 
 water diet in a section on light dietaries. It is in reality, 
 however, a simple diet, which, if not maintained too long, 
 is easily digested and unattended with any unfavourable 
 results. 
 
 Many years ago a hot water diet, commonly known as the 
 Salisbury treatment, was recommended by Dr. Salisbury for 
 the treatment of chronic gout, obesity, chronic gastro- 
 intestinal derangements, and other disorders of nutrition, 
 which were attributed by Salisbury to abnormal carbo- 
 hydrate fermentation. In its strict form the treatment 
 consists in the daily administration of one to three pounds 
 of meat, with three to five pints of hot water, for a period of 
 four to twelve weeks. The slightly nauseating taste of plain 
 hot water may be overcome by the addition of ginger, lemon 
 juice, or weak tea, and in cases associated with intense thirst 
 the addition of a little nitrate of potash makes the water a 
 more efficient thirst quencher. If constipation is present, 
 a teaspoonful of magnesium sulphate can be added to the 
 
 lOc 
 
298 THE BOOK OF DIET. 
 
 water. The chief article of diet is finely minced steak, 
 which allows the patient to get the maximum of nitrogeneous 
 food with the minimum of digestive work. At first the 
 patient begins with lean meat or beef in mince or cakes. If 
 unable to assimilate solid food, other preparations — Carnrick's 
 liquid peptonoids, peptonized home-made beef-teas and 
 essences, Wyeth's beef juice, Brand's beef juice, 0x0, and 
 carnine Lefranc — may be used instead. Gradually the 
 patient begins to take lean mutton cakes and the white meat 
 of chicken. The white of an egg, raw, lightly boUed, or 
 poached, is also allowed. The following directions will be 
 found useful in the preparation of the cakes. 
 
 Lean Meat Cakes.- -The beef should be taken from well-grown 
 animals, and steaks cut from the centre of the round are the best for 
 this purpose. The beef-pulps can be prepared in the following manner : 
 all the fat, fascia, and connective tissue and bone are removed, and the 
 meat is placed on a board or in a chipping tray, and is shredded down 
 with a blunt knife ; the pulp is then scraped together with a spoon — the 
 result is that all the tough fibrinous parts remain behind. The scraped 
 pulp is lightly moulded by the hand into cakes from J to I inch thick, 
 and slowly boiled over a clear fire free from smoke. When cooked, 
 serve on a hot plate with a little butter and season to taste with pepper 
 and salt. The flavouring may be varied by using Worcestershire or 
 Halford sauce, mustard and horseradish, or lemon juice. A small 
 quantity of dry celery is also permissible. From 4 to 6 ounces of meat is 
 the maximum that can usually be taken at a meal at the outset of the 
 treatment ; later 8 to 10 ounces or more may be taken by some patients. 
 Four meals should be taken daily. 
 
 Great care and consideration are called for both in the 
 recommendation of this diet and the best means of giving 
 effect to it. A modified Salisbury dietary (see infra) is of 
 great value in some cases of indigestion and chronic auto- 
 intoxication associated with it. A regime like the following 
 will be found of great value in such cases : — 
 
MODIFIED SALISBURY DIET. 
 
 299 
 
 Modified Salisbury Diet. 
 
 Seven a,m. — 
 i pint or more hot water. 
 
 Eleven-thirty a.m. — 
 
 I . pint or more of hot water, 
 flavoured with lemon if desired. 
 
 Three p.m. — 
 \ pint or more of hot water. 
 
 Six p.m. — 
 \ pint hot water. 
 
 Eight-thirty a.m. — 
 4 to 6 oz. meat rissoles. 
 2 Kalari biscuits (p. 336), with a 
 
 little butter. 
 Small cup of very weak tea. 
 
 One p.m. — 
 Breakfast-cupful of beef-tea with 
 
 J lb. scraped meat (see beef 
 
 pur^e, ch. xxii.). 
 Thin slice of baked bread or 
 
 dinner toast (p. 388). 
 Half a dozen oysters as above, 
 
 (see also ch. xxii. ) ; or, 
 Consoinm6 with custard (ch. 
 
 xxii. ), or consopim^ with egg 
 
 (ch. xxii.), with baked bread 
 
 or toast. 
 
 Four-thirty p.m. — 
 
 Breakfast-cupfiil of skimmed 
 
 milk, to which is added a 
 
 full tablespoonful of camine 
 
 Lefranc or other meat juice ; 
 
 or, 
 Plain egg flip (p. 54), flavoured 
 
 with cinnamon in place of 
 
 sugar. 
 Unsweetened rusk or crisp 
 
 biscuits. 
 
 Seven-thirty p.m. — 
 4 to 6 oz. meat rissoles or mince, 
 followed by an egg jelly (ch. 
 xxii.) in which the sugar is re- 
 duced in amount ; or, a blanc- 
 mange made with milk in 
 place of cream (ch. xxii.). 
 
300 THE BOOK OF DIET. 
 
 The above regime should be maintained for ten days to a 
 fortnight, after which additions in the form of steamed fish, 
 chicken, malted breads, green vegetables, jellies, and fruit 
 can be slowly made. The return to ordinary farinaceous 
 foods must be made very gradually, preferably starting with 
 the invalid foods (p. i6o). 
 
 While the nutritive value of this diet is comparatively 
 small, it amply suffices for the short time in which the diet 
 is necessary. Its use effects a profound improvement in the 
 state of the intestinal excretions, and a corresponding 
 improvement in digestion as a whole. 
 
 A meat diet is specially recommended in tuberculous 
 affections. In 1889, C. Richet and Hericourt experimentally 
 proved the value of a raw meat diet in tuberculosis in dogs, 
 and showed that the benefit was derived from the muscle 
 juice and not from the muscle fibre — zomotherapy. A re- 
 cently introduced muscle juice, carnine Lefranc, is a valuable 
 meat-juice preparation. It has an agreeable taste ; it keeps 
 well, and may be given in doses of from 1 to 4 ounces dau'y 
 in any fluid except beef-tea. 
 
XVL 
 
 INDIGESTION. 
 
 PRACTICAL RULES IN THE 
 TREATMENT OF INDI- 
 GESTION. 
 
 Small Meals. 
 
 A sufficient amount of Time should 
 be allowed between Meals. 
 
 Avoid sitting down to Food im- 
 mediately after hard Physical or 
 Mental Work. 
 
 Suitable Types of Food- 
 Simple Light Soups. 
 Meats. 
 
 White Varieties of Fish, 
 Sauces. 
 Fat. 
 Bread. 
 
 Sweet Dishes. 
 Tea or Coffee. 
 
 CONSTIPATION. 
 
Chapter XVI. 
 INDIGESTION. 
 
 Symptoms — Causes — Practical Rules in 
 Treatment — Constipation. 
 
 Under the vague term indigestion there is comprised a 
 number of disorders which have one feature in common — 
 the inability to digest ordinary food in the painless, 
 unconscious manner characteristic of health. When discom- 
 fort instead of a sense of well-being accompanies digestion, 
 the term indigestion or dyspepsia is applied to the condition. 
 The symptoms commonly associated with indigestion are ; — 
 
 1 . Variations in the appetite — loss of appetite, distaste 
 
 for food, feeling of emptiness, or abnormal craving 
 for food. 
 
 2. Pain or discomfort in the region of the stomach, 
 
 either immediately after food or from two to three 
 hours after a meal. This may take the form of a 
 simple feeling of distension, severe gnawing, or 
 acute pain. 
 
 3. Acidity and waterbrash. The former is the eructa- 
 
 tion of an irritating acid secretion which stings the 
 throat, usually inducing a sensation of heat in the 
 pit of the stomach (heartburn) ; the latter is the 
 vomiting of a clear watery fluid. 
 
304 THE BOOK OF DIET. 
 
 4. Bad taste in the mouth, especially in the mornings. 
 
 Flatulence and eructations are common and trouble- 
 some symptoms. A feeling of sickness (nausea) or 
 actual vomiting is also frequently present. 
 
 5. General physical and mental depression, headache, 
 
 sleeplessness, and palpitation are general symptoms 
 commonly seen in cases of indigestion. 
 
 6. The tongue is deranged; it is usually flabby and 
 
 dirty, with a coating of whitish or yellowish-white 
 fur. 
 
 The more common causes of indigestion are : — 
 
 1. Dietetic errors. This may take the following form: — 
 
 (a) Improper food, a diet containing too large a 
 
 proportion of a particular kind of food — 
 e.g. meat, fat, vegetables, or tea. 
 
 (b) Excess of food or too little food. 
 
 (f) Irregularity in meals. Too short or too 
 
 long intervals between meals, 
 ((i) Hurried meals, with imperfect mastication of 
 
 food. 
 («) Excess of fluid with meals — such as tea, soup, 
 
 beer, etc.; also alcoholic stimulants taken 
 
 between meals. 
 (/) Faulty meals — e.g. meat teas. 
 
 2. Constitutional conditions — such as tuberculosis, 
 
 anaemia, gout, rheumatism. 
 
 3. Mental emotions — for example, worry and overwork. 
 
 4. Contributory — e.g. excess of tobacco, decayed teeth, 
 
 and constipation. 
 
 Principles in the dietetic treatment : In the slighter cases 
 all that is required is to correct the defects in the dietary, 
 which may be ascertained from a careful inquiry into the 
 
TREATMENT OF INDIGESTION. 305 
 
 dietetic history of the patient. Tea must be reduced or 
 eliminated from the dietary, sweets should be cut off, bread 
 and starchy foods must be reduced, and all indigestible 
 articles of food should be avoided. In cases where meat 
 foods have been taken three or four times daily, these must be 
 reduced, and a lacto-vegetarian regime substituted (p. 294). 
 If these points are attended to, and three simple meals a day 
 prescribed, recovery soon takes place. 
 
 In the more severe cases the above will not suffice. Here 
 complete rest in bed for some weeks is essential, and the diet 
 from the outset has to be adapted to the digestive capacity of 
 the patient It may be necessary to begin with a diet of 
 I, 2, or 3 pints of milk in twenty-four hours, which may 
 require to be given diluted or peptonized. As the state of 
 digestion improves, beef-tea, bread, and milk puddings are 
 cautiously added to the dietary. In some cases it is useful 
 to add some extract of malt — for example, maltina, extract of 
 malt, homax. If the symptoms persist in spite of treatment 
 carried out carefully along these lines, it may point to the 
 conclusion that the case is one of actual disease of the 
 stomach or bowel, necessitating surgical treatment. 
 
 The only other point to which it is necessary to draw 
 attention is to cases in which flatulence is the predominant 
 feature. In these cases it is essential to specially restrict the 
 vegetables and pulse foods. An appropriate regime will be 
 found on p. 294. 
 
 FBACTICAL RULES IN THE TREATMENT OF 
 INDIGESTION. 
 
 I. Small Meals, slowly and deliberately eaten, are the 
 first essential. The meals should be small, and very moderate 
 in quantity. A diet should be selected that gives the necessary 
 
3o6 THE BOOK OF DIET. 
 
 nourishment with the least labour to the stomach (see p. 285). 
 Thorough mastication is of paramount importance. Particular 
 attention should also be directed to the state of the teeth. 
 
 2. A sufficient amount of Time should be allowed 
 between Meals to permit of complete digestion of one meal 
 before the next is taken. When on a fluid diet (for example, 
 p. 285), and only very small quantities being taken at a time, 
 the meals must be taken more frequently — for example, every 
 two and a half to three hours ; but when solid food is taken, 
 four to five hours should elapse before the next meal. This 
 is specially important in dyspepsia in elderly subjects. 
 
 3. Avoid sitting down to Food immediately after hard 
 Physical or Mental Work, and do not return to work 
 immediately after a meal. 
 
 4. A few notes on the most suitable types of food may be 
 added. 
 
 It is exceedingly important that the food of the dyspeptic 
 should be carefully and skilfully cooked. Simple light soups, 
 unthickened, may be sometimes taken in small quantity. Of 
 the meats, the shorter fibred and more easily digested meats 
 and fish should be selected. Chicken, turkey, pheasant, 
 partridge, sweetbread, tripe, and mutton are better than beef, 
 goose, duck, wildfowl, veal, or pork. Lamb and rabbit are 
 not so digestible as is often assumed. The white varieties 
 of fish — for example, sole, whiting, plaice, flounder — are the 
 best, and fish is best grilled, plainly boiled, or steamed. 
 Plainly cooked — for example, roast or grilled — meats are the 
 best; no made-up dishes should be taken. Vegetables 
 should be smoothly mashed or reduced to the form of 
 purees. Potatoes and other root vegetables are better 
 avoided. For cooking, if the meat is tender, grilling is the 
 best method ; underdone roast is also good. 
 
 As to Sauces, it is best for dyspeptics to avoid rich sauces 
 
SUITABLE TYPES OF FOOD. 307 
 
 entirely J and when butter is required, as with fish, to use 
 plain fresh butter. 
 
 Fat in some forms is difficult to digest. Grilled fat 
 bacon eaten with dry toast is easily digested, tasty, and a 
 good form of fatty food. When taken with bread and 
 yolk of egg it makes a nutritive and compact meal. Bread- 
 stuffs saturated with butter — such as buttered toast, hot 
 scones, muffins, pastry — are not easily digested, the satura- 
 tion with fat preventing the gastric juice getting at it, with 
 the result that these foods undergo abnormal fermentative 
 changes. 
 
 Some varieties of bread are indigestible, but often when 
 complained about it is found that the patient is taking too 
 much. A digestible bread is one that is not new, which 
 breaks short, is open, and crumbs easily (pan loaf) ; scones 
 and whole-meal bread are often very troublesome for people 
 with feeble digestive powers (see " Bread," p. 387). 
 
 Sweet Dishes are apt to undergo acid fermentation, and 
 unripe acid fruits and nuts, potatoes, and all root vegetables 
 should be avoided. A list of starch-free puddings is given 
 on p. 433. 
 
 Tea and Coffee do not always cause indigestion, but are apt 
 to do so in some persons. If they do cause indigestion they 
 should never be taken with or soon after food, but a cup of 
 freshly made tea or coffee three or four minutes after a meal 
 will not infrequently be found to promote the final stage of 
 stomach digestion. No food, however, should be eaten at 
 the same time. Light China teas are much less likely to 
 cause dyspepsia than the stronger Indian kinds. The mixed 
 meal known as a " meat tea " should never be taken, as the 
 tannin in the tea combines with the albumin in the meat, 
 interfering with its digestion. (See also p. no.) 
 
3o8 THE BOOK OF DIET. 
 
 CONSTIPATION. 
 
 A few words may be said about the dietetic treatment of 
 constipation. 
 
 Green vegetables, oatmeal, and whole-meal bread should 
 enter largely into the diet of constipated subjects. Fruits 
 are also of great value, more especially figs, prunes, dates, 
 apples, pears, oranges, and peaches. Fruit should be taken 
 once or twice a day ; it may be taken fresh or stewed, and it 
 is best taken on an empty stomach tiie first thing in the 
 morning. Fat is useful as a lubricant, and the patient should 
 be encouraged to take plenty of butter and cream. A little 
 marmalade, honey, or treacle taken at breakfast has a useful 
 aperient action. A common fault in the dietary of con- 
 stipated subjects is a deficiency in fluid, and patients should 
 therefore be encouraged to drink two or three pints of fluid 
 per day, one tumblerful of hot or cold water being taken the 
 first thing in the morning. Excess of meat and excess of tea 
 are factors in the development of constipation, and the 
 amount of these must be restricted. There are many factors 
 at work in the development of constipation, and these 
 require attention as well as the diet. Lack of exercise, too 
 sedentary habits, matutinal hurry, are important con- 
 tributory causes. Defective education of children as to the 
 requirement of the regular habit of going to stool is often the 
 primary cause; this can to some extent be corrected by 
 cultivating regularity in habit in later life. In looking for 
 recovery from constipation in long-standing cases it is essen- 
 tial to point out to the patient the necessity of patience, 
 and the long-continued use of a diet adapted to the 
 condition. Massage and suitable exercises are important 
 aids in treatment. 
 
XVII. 
 GOUT AND RHEUMATISM. 
 
 I. GOUT. 
 
 Introduction, 
 
 Cause. 
 
 Suitable Foods :— 
 Meats — Fish — Milk and Milk 
 Products — Eggs — Carbohydrates 
 — Vegetables. 
 
 Beverages. 
 
 II. CHRONIC RHEUMATISM 
 AND RHEUMATOID AR- 
 THRITIS. 
 
 The Result of Intestinal Fermenta- 
 tion. 
 
 The Result of Intestinal Putre- 
 Action. 
 
Chapter XVII. 
 GOUT AND RHEUMATISM. 
 
 I. GOUT. 
 
 It has been truly said that if a sprightly writer wished to 
 make fun of the medical profession, nothing would give him 
 a better opportunity for the exercise of his sarcasm than the 
 extreme variety and the very opposite character of the regime 
 which this, that, and the other medical authority have laid 
 down for the dietetic treatment of the gouty state. Some 
 recommend a diet mainly vegetarian in character; others 
 find salvation in meat and hot water ; and, apart from these 
 two extremes, when we have regard to the numerous articles of 
 food and drink in daily use, we find very few that are not as 
 stringently forbidden by some writers as they are highly 
 commended by others. The reason for this is readily found 
 in our ignorance of the exact nature of the disease. We 
 know that gout is a constitutional disease whose natural 
 history includes a liability to rapid and apparently inexplic- 
 able variations, often, fortunately, of the nature of ameliora- 
 tion or complete disappearance of symptoms. If these 
 natural variations occur coincidentally with the use of some 
 supposed therapeutic measure, medical or dietetic, there is a 
 risk of the observer wrongfully ascribing the benefit to the 
 therapeutic agent employed, where it is in reality due to the 
 
312 THE BOOK OF DIET. 
 
 self-righting power of nature. He becomes what has been 
 aptly termed the victim of misinterpreted sequences. While 
 the causation of gout is not exactly known, brief mention 
 may be made of the view as to its origin most widely held at 
 the present day. In opposition to the views formerly held, 
 there is now general agreement that uric acid is not the cause 
 of gout, any excess of uric acid that may be present in the 
 urine now being regarded as merely an incident in the 
 disease. 
 
 Gout is essentially a disorder of the metabolism of the 
 protein elements of the food. In its etiology there are two 
 main factors — (i) a particular diathesis or soil, and (s) a 
 superadded infective element. It is now some ten years 
 since the writer first advocated the view that there is an 
 infective element in gout, the source of the infection being 
 the digestive tract. This view is now very widely held, 
 although it cannot be said to have been fully proved. For 
 practical purposes, however, it may be taken as assured that 
 all gouty subjects are, in virtue of their diathetic tendency, 
 specially prone to a particular type of auto-intoxication 
 (self-poisoning) which is responsible for various gouty 
 symptoms. 
 
 Derangement of the digestive system plays an exceedingly 
 important r61e in the development both of acute and chronic 
 gout, and these derangements usually depend either on 
 immoderate eating or drinking, or on the ingestion of articles 
 of diet especially unsuited to the individual. The question 
 of diet is therefore the paramount one, and we have now to 
 consider the influence of different food-stuffs on the disease. 
 
 Meats. — The most recent observations indicate that the 
 commonly accepted view that a meat diet is associated with 
 an increase in the uric acid excretion is an erroneous one ; 
 and on the whole it may be taken as definitely proved that, 
 
GOUT. 313 
 
 as a rule, a gouty subject may take a measured quantity of 
 meats in an easily digested form. In the use of meats it is 
 not only important that these should be taken in a form 
 which is easily digested and absorbed, but that they should 
 not be accompanied by an undue admixture of other food- 
 stuffs. In those cases where meat is unsuitable we must 
 look for the cause of any injurious effects more in its quality 
 and in the form in which it is administered. We must, 
 however, bear in mind that a rich meat diet — that is, meat 
 twice or thrice daily — is an acid food; its tendency to 
 acidity may in favourable cases be rectified by the consump- 
 tion of alkaline table waters. 
 
 With regard to the different kinds of meat foods, white 
 meats — for example, fish and chicken — are more suitable 
 than red meats owing to their more ready digestibility, and 
 also, in the case of fish, to the smaller proportion of nitrogen 
 present in equal bulk. High game and very fatty meats 
 should be avoided. The confirmed gouty subject is wise 
 to limit his consumption of red meats to one meal in the 
 day, or even less, and, further, to make as a routine a selec- 
 tion of the red and white meats, similar to that here 
 indicated : — 
 
 Breakfast. — Avoid kidneys, steak, liver, and all made-up dishes, 
 and only take one solid — for example, fish of any kind (except 
 salmon and fatty fishes), one or two eggs, or bacon and egg; one 
 breakfastcupful of freshly-made tea, with not more than one piece of 
 sugar ; toasted bread, Vienna rolls, or other bread (not too new or 
 doughy), with butter ; marmalade or jam to be taken only in very 
 small quantity, and even then not to be taken every day. 
 
 Lunch, — To be mainly vegetarian. Selections from the following : 
 tomatoes, cooked or raw ; macaroni, dressed in various ways ; salads, 
 celery, cauliflower au gratin ; bread, brown bread, Vienna rolls, or 
 any form of unsweetened biscuit ; small piece of mild cheese, if desired ; 
 small quantity of fruit — one of the following : oranges, raisins, apples, 
 figs, dates, walnuts. 
 
314 THE BOOK OF DIET. 
 
 Afternoon Tea. — One or two small cups of tea, with a thin slice of 
 bread and butter, or a piece of very light cake. Very little solid should 
 be taken, and especially no rich cakes. 
 
 Dinner. — The dinner to consist of three courses, to which fruit can 
 be added, if not taken to lunch. The diet to be arranged on the 
 following plan : — 
 
 I. 
 
 2. 
 
 3- 
 
 4- 
 
 5- 
 
 Soup. 
 
 Fish. 
 
 Soup. 
 
 Fish. 
 
 Soup. 
 
 Meat. 
 
 Meat. 
 
 Entrte.* 
 
 Meat. 
 
 Fish. 
 
 Pudding. 
 
 Savoury. 
 
 Pudding. 
 
 Pudding. 
 
 Savoury. 
 
 Fruit. 
 
 
 Fruit. 
 
 
 
 Care has to be taken that, on the nights when meat is taken, the soup 
 should be of a lighter character — for example, clear brown, rice, or fish 
 soup. Similarly, on nights 2 and 4, the fish should be of the lighter kind 
 — for example, whiting, haddock, or sole. On the fifth night the soup 
 can be richer — for example, oxtail or kidney, with a light fish ; or the 
 soup may be light, and the fish more rich — for example, turbot, halibut, 
 or skate. No more than two vegetables are to be allowed, and then in 
 sparing amount — a sauce to be reckoned as a vegetable. (Half an 
 ounce of whisky, in not more than half a tumblerful of water, is the only 
 safe beverage for constant use.) 
 
 A few practical points may be mentioned about the 
 culinary aspects of soups, meats, and fish. It is impossible 
 to overestimate the importance of this subject ; the want of 
 recognition of its importance is, in the writer's opinion, one 
 of the causes of the very diverse differences of opinion 
 entertained as to the beneficial or noxious influence of 
 various dietetic substances. 
 
 The great fault to be found with soups that are served is 
 that they are heavy, and contain too many ingredients. The 
 average soup is made up with as many good things as 
 possible, some to make it more nourishing, others to make it 
 more palatable. This is all very well for the healthy, but 
 where, as in gout, the digestive functions in the tissues and 
 * Sweetbread, tripe, chicken, rabbit. 
 
GOUT. 315 
 
 alimentary canal are readily disturbed, simple soups are 
 required. 
 
 The following highly nitrogenous soups are not, as a rule, 
 suitable for the gouty: turtle, mock turtle, hare, kidney, 
 oxtail, mulligatawny. If they are indulged in, the rest of 
 the food and drink consumed at the same meal must be 
 carefully limited. 
 
 Cocky-leeky, giblet, and hotch-potch are almost stews, 
 and should be considered as a meat course. In not a few 
 cases all of these highly nitrogenous soups are contra- 
 indicated. 
 
 Roast beef and mutton bones boiled with vegetables, and 
 the fat carefully removed, make a good stock from which 
 soup can be made for the gouty. Excellent soup can also 
 be made from the water in which meat or fish has been 
 boiled. 
 
 The various vegetable purees — spinach, artichoke, tomato, 
 carrots, green peas, etc. — are excellent for this class of 
 patient. (For vegetable soup stock, see p. 386, and ch. xxii.) 
 They are sufificiently sustaining to prevent a feeling of hunger, 
 and if well digested give a fair amount of nourishment. In 
 the case of soups made from the pulses, their high nutritive 
 value should influence the rest of the meal, and in some 
 cases they are better avoided. 
 
 Made-up meats are not suitable for the gouty, owing to 
 the greater toughness of fibres induced by the second 
 cooking, and also by the admixture of rich sauces of various 
 kinds which are usually added for palatability. Meats should 
 be tender and simply prepared. The best ways of preparing 
 are (in order) — broiling, steaming, roasting, boiling, baking, 
 stewing, and frying. The last mentioned should be avoided, 
 especially in the case of beef and mutton. Although lamb and 
 veal possess less extractives than other meats, and are on 
 
3i6 THE BOOK OF DIET. 
 
 that ground commendable, yet the gelatinous nature of the 
 fibres makes them more difficult of mastication, and there- 
 fore less digestible. If allowed, this danger must be pointed 
 out with a view to obviating it. Tripe, sweetbreads, kidney, 
 and liver may be allowed for occasional use. Salted meats 
 are rendered more indigestible in the preparation, and 
 should, therefore, be avoided. Bacon and ham are more 
 digestible than pork. With regard to game, white flesh is 
 more suitable than brown, and water-birds are more fatty 
 than other game. 
 
 Fish. — Fish are well calculated to form a large pro- 
 portion of the dietary of the gouty. They contain on an 
 average one-third less nitrogen than an equivalent amount 
 of ordinary meat, and usually contain little or no fat. 
 Fat fishes (salmon, mackerel, eels, pilchards, red mullets) 
 are equal in nitrogenous value to an equal amount of 
 moderate fat beef. 
 
 Milk aoid Milk Products. — As in the case of various other 
 foods, there is much difierence of opinion as to the value or 
 necessity of a diet composed largely of milk, milk products, 
 and vegetables. In many cases a course of a strict milk diet 
 is the most suitable, particularly in young and otherwise 
 healthy subjects, but it is much less suitable for adults and 
 elderly subjects. Milk is highly nutritious, and when it is 
 easily digested, and no undue fermentation processes are 
 induced by its use, a limited course of milk diet is to be 
 commended, the amount and duration being regulated by 
 the effects on the digestive system and by the attitude of the 
 patient towards it. With the active and fixed habits of adult 
 life a meat-free diet is very rarely practicable, and is very 
 seldom called for. 
 
 Cream, forming as it does the most appropriate form of 
 fatty food in the dietary of the aged, likewise constitutes an 
 
GOUT. 317 
 
 excellent form of fat administration in gouty subjects. It 
 should preferably be taken with milk pudding or stewed fruit 
 in an otherwise simple meal, or it may be used in the 
 preparation of chicken cream, fish cream, or in various 
 combinations with vegetables, when it takes the place of 
 butter. 
 
 Skimmed milk is more digestible than ordinary milk in all 
 cases where fat is not readily digested, but in recommending 
 it as a beverage or food, regard must be paid to the amount 
 of proteins and lactose present in it. 
 
 Whey is a useful article in many cases. It is a 
 pleasant and stimulating drink, with a certain food value 
 from the lactalbumin, lactose, and mineral matter present. 
 In some cases whey with cream makes an admirable 
 combination. 
 
 Cheese. — There is no reason why cheese should be for- 
 bidden. The ill effects frequently attributed to it arise 
 from the manner in which it is taken, at the end of a meal 
 already excessive and badly assorted. Being a rich, albu- 
 minous food, and varying in the proportion of fat present 
 according to the variety of cheese, it should not be taken in 
 large quantity ; it should be well masticated, and it should 
 be carefully distributed through the various vegetables or 
 breadstufTs of the meal. 
 
 It is well to recommend patients who are very fond of 
 cheese to partake of one of the softer varieties, as, although 
 less digestible, they are much less likely to be taken to 
 excess (see p. 44). 
 
 Eggs. — Eggs are an excellent dish for the gouty, and 
 should form one of the staple breakfast dishes. They also 
 constitute a very appropriate food constituent for the children 
 of gouty parents, in whom the consumption of meat, and 
 especially red meats, should be limited. 
 
3i8 THE BOOK OF DIET. 
 
 Carbohydrates, and especially those of the sugar group, 
 are, as a class, to be regarded as more potent noxious agents 
 than meat. A good rule with regard to them is to reduce 
 the amount and simplify their form. 
 
 Sugar foods and dietetic accessories — for example, jams, 
 marmalade, sugar, sweet cakes — are only to be partaken of 
 occasionally, and in small quantity. 
 
 With regard to the strict vegetarian diet so eloquently 
 advocated by Haig and others, the good effects undoubtedly 
 derived in many instances depend, in the writer's opinion, 
 on the simplicity of the whole diet, with the limited quantity 
 of the chief nitrogenous ingredients, these being the two 
 primary essentials in the dietetic treatment of confirmed 
 gout. The following illustration may be given (Haig) : — 
 
 Breakfast. — One pint of milk, bananas, apples, pears, plums (fresh, 
 dried, or cooked), any other fresh fruit. Ad libitum. 
 
 Lunch. — Vegetable soup, made with milk ; plate of potatoes (with 
 butter, oil, or milk) ; two ounces of cheese, eaten with potatoes and any 
 other vegetable in season ; stewed fruit or tart ; fresh fruit ; one pint of 
 milk drunk during the meal. 
 
 Dinner. — Much as lunch; one pint of milk ; one ounce of cheese. 
 
 A close analysis of this diet, which is recommended for a 
 person in health, shows that it is not so simple as at first 
 sight apparent; and while a diet for the gouty framed on 
 very similar lines is undoubtedly a very beneficial method of 
 treatment in some cases, in others it is altogether unsuitable. 
 
 Vegetables. — Popular belief, partly supported by medical 
 opinion, condemns potatoes, but, if used in moderation and 
 cooked and served with due precaution, there is no reason 
 for prohibiting them, except in those special cases where 
 they are definitely determined to be unsuited to the digestive 
 capacity. When new and moist they are indigestible ; the 
 best form is a well-boiled, mealy potato in its skin, or the 
 
GOUT. 
 
 319 
 
 same put through a potato-masher. A thoroughly well- 
 baked potato is also good. When fried, or roasted in 
 mutton dripping, or mashed with milk and butter, they are 
 unsuitable in most cases. The other root vegetables — for 
 example, turnips, carrots, parsnips, radishes, beetroots (also 
 rich in sugar), artichokes, also cabbages, curly greens, 
 brussels sprouts, broccoli, and the green of cauliflower — 
 should only be taken in small amount on account of their 
 tendency to induce flatulence. The following are more 
 suitable : spinach, flower of cauliflower, savoys, endive, 
 lettuce, watercress, kale, leeks, onions, celery, cucumber, 
 vegetable marrow, green peas, French beans. Asparagus 
 has been condemned by some writers on account of the 
 nucleins in the young shoots ; also tomatoes and sorrel on 
 account of the acids present ; but, as most typically gouty 
 subjects can partake of them freely, it is probable that these 
 objections have only theoretical importance. 
 
 The green vegetables above mentioned can be freely 
 partaken of in the form of salads, provided oily dressings 
 and hard-boiled eggs are avoided. Mushrooms and truffles 
 and other fungi are quite permissible in small quantities. 
 The pulses (lentils, peas, beans, haricot beans) are not, as a 
 rule, advisable, because it is not an easy matter to make the 
 patient realize that their nutritive value is such that their use 
 must influence markedly the amount and quality of the 
 other articles consumed. 
 
 With regard to puddings, the simpler the better. Milk 
 puddings, such as rice, sago, semolina, ground rice, etc., 
 should be made without eggs in many cases. Suet puddings 
 of all kinds are as a class to be avoided, but if made largely 
 with bread-crumbs in place of flour, well boiled, and unaccom- 
 panied by a heavy sauce, they may be taken. A list of 
 starch-free puddings is given on p. 433. If custards and 
 
320 THE BOOK OF DIET. 
 
 omelets, sweet or savoury, are taken, the nutritive value 
 of the eggs must be recognized. Jellies, blancmanges, 
 lemon sponge, and creams may be taken in very sparing 
 amount, and, as with other foods, discretion is necessary. 
 Fruits of all kinds in themselves are permissible, but must 
 be taken with caution, especially in later adult life, and it is 
 well to bear in mind the old saying — " Fruit is golden in the 
 morning, silver at midday, and lead at night." Much 
 depends on the amount of sugar used in the cooking, 
 and the accessories used at table. Crystallized fruits are 
 quite unsuitable on account of the large amount of sugar pres- 
 ent. For the same reason, special care has to be taken with 
 regard to dried fruits, such as plums, raisins, dates, and figs. 
 
 Beverages. — To the confirmed gouty subject the question 
 of what he may drink is sometimes a more important one 
 than of what he may eat. 
 
 Like the question of diet, it is impossible to lay down 
 definite rules applicable to the disease. Everything depends 
 on the age of the patient, his constitution, his previous 
 history as to consumption of fluids of different kinds, the 
 nature of the symptoms, and the reaction of the tissues to 
 various fluids. Specially is this so with the use of alcoholic 
 stimulants. While there is no doubt that the subjects of 
 inherited gouty tendencies are better without any form of 
 liquor, this is sometimes not so in the case of the patients 
 more or less habituated to the use of stimulants. In judging 
 of the suitability of the various liquors, we must have regard 
 to the usual methods of preparation of the individual 
 beverages — for example, beer, claret, champagne, etc. — and 
 to their common defects as recognized by experts in the 
 trade (see p. 115 «/ seq). The decision as to what any given 
 subject can take may only be arrived at after careful study 
 of the history, diet, and state of muscular activity in each 
 
GOUT. 321 
 
 case. There is no doubt that malt liquors and sweet wines 
 are much more injurious than other Hquors. 
 
 The sweet wines include champagne, Madeira, port, 
 sherry, malmsey, and Tokay; also porter, ale, and cider. 
 Burgundy, Bordeaux, Rhine, and Moselle are almost void of 
 sugar, and are therefore more suitable. The greater acidity 
 of Burgundy and the Rhenish wines makes them, on the 
 whole, less suitable than claret and Moselle wine. 
 
 German beer — for example, lager — can frequently be taken 
 with impunity when even one glass of the British beers will 
 induce some acute disturbance. 
 
 The free consumption of water can be safely recommended 
 to many, but not to all, gouty subjects. In the case of stout 
 adult plethoric subjects it may be advisable to restrict its use 
 to early morning and late evening. The water is, as a rule, 
 best taken on an empty stomach. Tea, coffee, and cocoa, 
 when suitably prepared, may be taken in moderate amount, 
 but idiosyncrasies in their use are often encountered. Cocoa 
 disagrees with some gouty subjects, while with others the 
 daily consumption of coffee is soon followed by some diges- 
 tive disturbance, and in these cases special restrictions are 
 called for. The amount of sugar allowed should be small. 
 All sweet beverages should be restricted or cut off, more 
 especially if they are, in addition, aerated. The daily adminis- 
 tration of an alkaline or mineral water is a point of great 
 importance in the management of many gouty cases. 
 
 The following general rules may be laid down : — 
 
 1. When a hereditary tendency exists in children, habits of 
 extreme sobriety in eating and drinking should be cultivated, 
 and the diet should be mainly a milk, vegetarian, and light 
 meat one. (See also p. 221.) 
 
 2. When the disease is established there is no routine 
 treatment, and the details will not be the same in any two 
 
 II 
 
322 THE BOOK OF DIET. 
 
 cases. Attention should, however, be directed in turn to the 
 following : — 
 
 (a) The diet and state of the digestive tract. 
 
 {b) The amount and nature of the exercise indulged in. 
 
 (c) The functional activity of the skin and kidneys. 
 
 3. The quality of food should be determined by the amount 
 of active exercise. Three meals a day only to be taken, and 
 those to be of a simple character. 
 
 4. When in doubt as to which set of food constituents to cut 
 off, begin with the carbohydrates, and especially the sugar 
 substances. In not a few cases the latter may require to be 
 completely cut off, and in every instance special care must 
 be exercised in the admixture of carbohydrates with the 
 fats and meaty foods. 
 
 5. Thorough mastication of the food is all-important, and 
 strict attention to the evacuation of the bowels a necessity 
 (with the addition of an occasional saline). 
 
 6. Fluids and Beverages. — (a) Alcohol in any form is better 
 avoided, except in subjects who are more or less habituated 
 to its use, in which case the liquor taken should be the one 
 which is known by the patient to be least detrimental to him. 
 On no account should drinks be mixed. All sweet wines and 
 malt liquors should be avoided, unless the patient is satisfied 
 from careful observation that these are not prejudicial to him. 
 The stimulant should be taken in a measured quantity and 
 with meals. 
 
 {b) The free use of the alkaline table waters is to be com- 
 mended, care being taken that an excessive amount of fluid 
 is not taken mth the meals. 
 
 {c) A tumblerful of hot water at night and an occasional 
 course of mineral waters taken on an empty stomach are 
 useful ehminants. 
 
CHRONIC RHEUMATISM. 323 
 
 n. CHRONIO BHEUMATISM AND RHEUMATOID 
 ARTHRITIS. 
 
 Chronic rheumatism manifests itself at diflferent periods of 
 life, and in a variety of ways. It may take the form of stiff- 
 ness and pain in the affected tissues, which may become 
 swollen, the pain and stiffness being worse in the morning 
 and disappearing in whole or in part with exercise. It may 
 take the form of a troublesome lumbago, neuritis, or sciatica. 
 In other cases it affects chiefly the muscular and fibrous 
 tissues, notably in the neck, thighs, and calves of the legs, 
 and is then characterized by the presence of localized areas 
 of swelling, pain, and tenderness in the affected parts. In 
 whatever form the disease manifests itself, it arises from the 
 absorption of and deposit in the tissues of the rheumatic 
 poison, which is probably microbic in origin, the source in 
 many cases being the digestive tract. 
 
 Rheumatoid arthritis is a special form of rheumatism which 
 attacks young people, adults, and elderly subjects, and its 
 onset may be acute, subacute, or chronic. It affects many 
 joints, notably those of the hands, feet, and knees. The 
 exact causation of this disease is also unknown, but there is 
 good reason for believing that it too is of bacterial origin, the 
 main sources of the infection being the digestive tract, 
 including the mouth and throat, and the genito-urinary tract. 
 In support of the fact that the digestive tract is in many 
 cases the source of the toxaemia, both in rheumatism and 
 rheumatoid arthritis, we have the fact that the stools are 
 frequently deranged, being for the most part ill-formed and 
 extremely foetid. In some cases constipation is a prominent 
 feature, and we know that by correcting this by means of 
 diet and other measures there is a corresponding improvement 
 in the symptoms, and frequently an arrest or cure of the 
 
324 THE BOOK OF DIET. 
 
 disease. The diet must be altered in a manner which will 
 lead to a more satisfactory state of the intestinal contents, as 
 revealed by the passage of healthy stools. 
 
 The diet appropriate to any given case can only be deter- 
 mined after a careful inquiry has been made into the past 
 history of the case. There is good reason to believe that a 
 diet which is rich in meat and other rich albuminous food- 
 stuffs promotes the multiplication of the intestinal bacteria in 
 a manner favourable to the development of rheumatism. 
 Hence it is important in many cases to reduce the amount 
 of meat, and more especially red meat, and further, to see 
 that the meat when given is given in a simple and easily 
 digested form. There are some cases, however, which are 
 beneficially treated in the early stages of the disease by 
 a protein dietary, the protein being given in a simple and 
 easily digested form (see " Protein Dietary," pp. 299, 326). 
 We also know that a diet which is rich in vegetables, 
 and especially green vegetables, leads to the formation of 
 organic acids in the intestinal tract which exercise a re- 
 straining influence on the bacteria in the bowel. On these 
 grounds a lacto-vegetarian diet is often the most suitable. 
 (See p. 327.) Great care has, however, to be taken in the 
 selection of this diet, because of the flatulence and other dis- 
 turbances that may be induced by a too largely vegetarian 
 regime. Again, we know that the digestive secretions are, 
 as a rule, weakened in this disease, and hence the diet must 
 be framed in such a way as to throw the minimum strain on 
 the digestive functions while supplying ample nutritious 
 material for the needs of the tissues. Hence the diet should 
 be simple, the proteins, fats, and carbohydrates all being 
 presented in a form which is easily digested and assimilated. 
 
 Excess of sugar, etc. — such as is. involved in taking four 
 or five cups of tea daily with much sugar — also marmalade, 
 
CHRONIC RHEUMATISM. 325 
 
 jams, sweets, and chocolate, may induce rheumatism, through 
 the bacterial fermentation set up in the digestive tract ; excess 
 of sugar and acids in fruits may similarly induce the con- 
 dition. No hard and fast rules can be laid down. In the 
 investigation of rheumatic cases, careful attention must be 
 directed to the dietary of the patient for a long time prior to 
 the development of rheumatic symptoms. Has the patient 
 indulged too freely in animal "protein" foods? — for example, 
 indulging in a rich red meat diet twice or thrice daily. Has 
 he been in the habit of taking a large amount of sugar, in the 
 form of sugar in his tea, jam, fruit, and the like? Has he 
 partaken of beer or other alcoholic liquors to an extent which 
 is prejudicial to him ? — for example, taking a little beer daily 
 to lunch over a lengthened period, when leading a com- 
 paratively sedentary life. And lastly, has there been in 
 operation any contributory factor, such as constipation or 
 septic condition of the teeth, the existence of which would be 
 important contributing factors? In some patients it is a 
 useful plan to give for two or three days at the outset of 
 treatment nothing but skimmed- milk and buttermilk. 
 
 Most stages of rheumatism can, in their early stages, be 
 cured by correction of these faults. In conclusion, one may 
 formulate the following rules : — 
 
 1. The diet should be simplified, taken at regular intervals, 
 
 and eaten slowly. All extras such as sweets, sauces, 
 wines, and malt liquors should be withheld. When 
 the digestion is good and the appetite strong a large 
 amount of food may be taken, provided it be of a 
 simple nature. Special care must be taken to prevent 
 constipation. 
 
 2, Any article of food or drink indigestible to the patients 
 
 should be withheld or taken in sparing amount. In 
 this connection it is important to note the periodic 
 
326 THE BOOK OF DIET. 
 
 nature of the symptoms — for example, recurrence of 
 "rheumatism " at the fruit season. 
 3. More fluid should be taken. Most rheumatic subjects 
 drink too little. Plain water, hot water night and 
 morning, or Lithia water, to the extent of about 1 5 to 
 20 ounces (two tumblerfuls), should be taken daily on 
 an empty stomach. 
 Two illustrative dietaries are given. The first of these (a) 
 is suitable for many patients whose rheumatism is the result 
 of abnormal fermentation from long continued excess of 
 starchy foods ; the second (/5) is appropriate to other patients 
 whose rheumatism arises from abnormal putrefaction from 
 excess of meat foods. 
 
 Diet for Rheumatism associated with 
 Intestinal Fennentation. 
 
 {A.) 
 
 Tumblerful of hot water on waking (no early tea). 
 Breakfast. — Cup of tea or coffee with milk, no sugar and no cream. 
 
 Slice of freshly made thin toast or crisp roll and very little butter. 
 
 One course from the following — take a good helping of cold ham 
 
 or cold tongue or potted meat, fried or toasted bacon, or grilled 
 
 kidney. Fish — white, or of the smoked varieties, plainly cooked. 
 
 Eggs — plain boiled, poached, or scrambled, or as an omelet (not 
 
 fried). 
 Eleven a.m. — "Soured" milk, 8 oz., with a small piece of sweet 
 
 spongecake or biscuit. 
 Lunch. — One course : choice from fish, chicken, game, chop, steak, 
 
 roast beef, or mutton, plainly cooked ; \ slice of toast ; no vegetable ; 
 
 biscuits or dry roll with cheese and butter ; cup of coffee. 
 Four-thirty p.m. — Cup of " soured " milk, with spongecake or biscuit, 
 
 may be followed by a cup of freshly made tea with milk, not cream or 
 
 sugar, and no more bread-stuff. 
 
DIET FOR RHEUMATISM. 327 
 
 Dinner. — Clear soup (from meat stock, not thickened). Meat course : 
 choice as at lunch ; no vegetables or rich sauce. Pudding selected 
 from custard, baked or boiled, curds, jelly, fruit souffli, cream ; 
 stewed fruit, very little sugar ; and no coffee. 
 
 Ten p.m. — Drink of hot water. 
 
 Diet for Rheumatism associated with 
 Intestinal Putrefaction. 
 
 {B.) 
 
 Seven-thirty a.m. — Tumblerful of hot water. 
 
 Eight-thirty a.m. — Breakfast (vegetarian), I cup of tea or coffee. 
 
 Toast or roll with butter, a little marmalade or jelly. Cereal 
 
 porridge, oatmeal, barley meal, hominy, flaked rice, to be taken with 
 
 cream. Some fresh fruit. 
 Eleven a.m. — Glass of "soured" milk and sweet biscuit. 
 One-thirty Lunch. — An egg in some form, or vegetarian dish. 
 
 Omelet, soufH^, savoury or cheese custard, cauliflower au gratin, 
 
 tomato savoury, macaroni cutlets or cheese. Plain milk pudding 
 
 with cream. 
 Four-thirty p.m. — Cup of "soured" milk and spongecake, with i cup 
 
 of tea. 
 Seven p.m. Dinner. — Sonp from vegetable stock, or milk, tomato, 
 
 artichoke, potato, lentil, onion. Fish occasionally ; egg in some 
 
 form, or vegetable savoury. Pudding : simple pudding or stewed 
 
 fruit ; no savouries and no coffee. 
 Ten p.m. — Tumblerful of hot water. 
 
XVIII. 
 DIABETES, 
 
 FOODS ALLOWED TO THE 
 
 DIABETIC. 
 Milk. 
 Fat. 
 Breads. 
 Starch-fiee Breads. 
 
 Porridge or Gruel. 
 
 Puddings, etc. 
 
 Home-made Diabetic Bread Foods, 
 
 Fruit. 
 
 Vegetables. 
 
 Beverages. 
 
 11a 
 
Chapter XVIII. 
 DIABETES. 
 
 In diabetes there is a defect in the digestion and absorption 
 of carbohydrate foods, with the result that sugar appears in 
 the urine. It may be of a mild or a severe type ; in the 
 former, the sugar may be very small in amount, and its pres- 
 ence in the urine may give rise to few or no symptoms, and 
 the sugar in the urine can be made to disappear by restrict- 
 ing the sugars and starches of the food ; in severe cases the 
 sugar is large in amount, and its presence is associated with 
 the characteristic symptoms of thirst, tiredness, loss of weight, 
 and the passage of a large amount of urine. In these cases 
 sugar may continue to be excreted in the urine even although 
 the diet is almost free of sugar and starchy food. The main 
 essential in treatment is to restrict as far as possible the 
 amount of carbohydrates — sugar and starches — in the diet. 
 This involves the use of foods rich in proteins and fats. The 
 deprivation of starchy foods in the form of bread and bread- 
 foods is a great trial to the patient. Unfortunately, most of 
 the substances prescribed as diabetic foods are not very 
 palatable; they are, further, expensive, and to many the 
 strict diabetic diet becomes so irksome that the restrictions of 
 the dietary have to be relaxed. The type of the disease has 
 also to be considered. Thus the dietetic treatment of diabetes 
 
332 
 
 THE BOOK OF DIET. 
 
 in a stout elderly subject is a simpler matter than the treat- 
 ment of the severe form of the disease met with in young 
 subjects in whom there is much wasting and general weak- 
 ness. The list below gives the permissible foods, and upon 
 this the menus have to be framed. It is unfortunately 
 almost impossible to give a satisfactory diabetic diet that is not 
 expensive. 
 
 FOODS FOR THE DIABETIC. 
 
 Foods. 
 
 May Eat. 
 
 Butcher meat of all kinds except 
 liver. 
 
 Tongue, ham, bacon, or other 
 smolced, salted, dried, or cured 
 meats. 
 
 Poultry, game. 
 
 Fish of all kinds, salted, &esh, or 
 cured ; shellfish, except the bodies 
 of lobsters and crabs ; mussels. 
 
 Animal soups, not thickened with 
 any starchy materials ; beef-teas 
 and broths. 
 
 Eggs dressed in any way. 
 
 Cheese, cream cheeses, butter, 
 cream. 
 
 Greens, spinach, turnip-tops, French 
 beans,* brussels sprouts,* cauli- 
 flower. * 
 
 Broccoli,* cabbage,* asparagus,* 
 seakale,* vegetable marrow, let- 
 tuce, cucumber, tomatoes, mush- 
 rooms, mustard and cress, water- 
 cress, endive, spring onions, 
 leeks, celery, rhubarb, pickles. 
 * These should be boiled 
 
 May not Eat. 
 
 Sngar in any form (saccharin or 
 saxin may be used as sweetening 
 agents to replace the sugar). 
 
 Wheaten bread, and ordinary bis- 
 cuits of all kinds. 
 
 Toast, rice, arrowroot, cornflour, 
 oatmeal, sago, tapioca, macaroni, 
 vermicelli. 
 
 Potatoes, carrots, parsnips, beet- 
 root, peas, Spanish onions. 
 
 Pastry and puddings of all kinds, 
 and honey. 
 
 All fruit, fresh and preserved, ex- 
 cept lemons and unripe fruit. 
 
 Liver. 
 
 Oysters. 
 
 Cockles, mussels, and crabs. 
 
 in a large amount of water. 
 
May Eat. 
 
 Oil, vinegar. 
 
 Savoury jelly ; jellies and custards, 
 sweetened with saccharin ; blanc- 
 manges, made with isinglass or 
 gelatine. 
 
 All nuts, except chestnuts ; olives. 
 
 DIABETIC FOODS. 
 
 May not Eat. 
 
 333 
 
 Beverages. 
 
 May Take. 
 Tea, coffee, cocoa from nibs, dry 
 sherry, claret, dry Sauteme, 
 Burgundy, Chablis, hock, brandy, 
 whisky, and other unsweetened 
 spirits ; unsweetened aerated 
 waters ; milk (limited to i or ij 
 pints daily) ; kephir, sugar-free 
 milk. 
 
 May not Take. 
 Milk, except in limited quantities ; 
 sweet ales, porter, stout, cider, 
 all sweet wines, port, Tokay, 
 champagne ; liqueurs ; fruit juices 
 and syrups ; cocoa and ordinary 
 chocolate. 
 
 Milk is allowed only in small amount. The carbohydrate 
 present in milk — lactose — is more easily digested than other 
 forms of carbohydrates, and in severe forms of diabetes it is 
 sometimes the best food, on account of its protein, its rich- 
 ness in fat, and the solubility of its sugar. If milk is con- 
 sidered inadvisable, an artificial milk can be procured free 
 from sugar (from Messrs. Clay, Callard and Co., Regent Street, 
 London) ; this can be diluted with mineral water. Cream has 
 mainly to replace milk in the special cookery, being almost 
 free from lactose, and it has the great advantage in containing 
 the most easily digested form of fat (see p. 40). 
 
 The following recipe of home-made artificial milk prepared 
 from cream can be taken in unlimited quantity by diabetics, 
 and is a useful article of food : — 
 
 SOGAR-FREB MiLK. 
 
 Place 4 tablespoonfuls of cream in I pint of water. Mix well. 
 Allow to stand for 12 hours. Then skim off the fat and place in a 
 
334 THE BOOK OF DIET. 
 
 second vessel ; to this add water (cautiously), a pinch of salt, a trace of 
 saccharin, and a little white of egg, until the fluid has the consistence 
 and colour of ordinary milk, 
 
 A second form of milk, containing only a little sugar, may be made by 
 dissolving cream, and especially Devonshire clotted cream, in water. 
 
 A third artificial milk, practically free from sugar, can be made from 
 biogene powder and milk albumin (Bonthron, 50 Glasshouse Street, 
 London), as follows, — 
 
 To a glass of water a teaspoonful of cream and one or two table- 
 spoonfuls of biogene powder is added, and well mixed. 
 
 Fat. 
 
 The supply of abundance of fat is often a difficulty, but 
 fish and vegetables should be cooked and served with a 
 liberal amount of butter. Many patients can readily take 
 the fat of cold roasted beef, and ham, or bath chaps (pig's 
 cheek) ; and large quantities of fatty food can be taken in 
 this way. Bone-marrow, which consists almost entirely of 
 fatty material, may be used in the form of potted meat or 
 grilled marrow bones (ch. xxii.). 
 
 Salmon, herrings, mackerel, sardines in oil, p3.te de foie 
 gras, cream cheeses, rich sauces made with eggs, oil, and 
 cream (for example, mayonnaise), are all useful. If the 
 excess of fat in the food gives rise to dyspepsia, a small 
 quantity of brandy and water after meals aids digestion. 
 
 Breads. 
 Diabetic Breads are made from bran, gluten, casein ; and 
 in recent years the oily nuts — such as almond, cocoa-nut, 
 hazel nut, and the soya bean — have been largely used. The 
 made-up breads, cakes, and biscuits can be procured direct 
 from the makers (Blatchley, London, and Callard and Co., 
 London) ; or the ground nuts, etc., in the form of flour, can 
 be purchased and made up in the patient's own house. 
 
DIABETIC FOODS. 335 
 
 Almond flour or desiccated cocoa-nut powder made into 
 biscuits is very satisfactory, and they contain a considerable 
 quantity of fat. These both contain a little sugar, which is 
 destroyed by the action of yeast in the preparation of the 
 foods. Cocoa-nut, hazel-nut, and pine seeds can also be 
 procured in powder form, and made into biscuits and 
 flavoured in various ways. Bran flour is another product 
 which, if carefully prepared, is entirely free from starch ; this 
 can be bought by the pound, and made at home into bran 
 cakes of bread. 
 
 Diabetic foods are either made up by the manufacturers 
 or made at home from the specially prepared flours, as 
 follows. 
 
 The following albumins may be used for the preparation 
 of bread substitutes, puddings, etc., or in the cooking of 
 food in place of bread-crumbs : — 
 
 Vegetable Albumins. — (i) Gluten flour, best specimens 
 only contain 2 to 3 per cent, starch (as supplied by Messrs. 
 Bischof and Brooke, 35 Brooke Street, Holborn, London, 
 E.G.); (2) Glidine contains only 2.7 per cent, starch, or 
 less (Messrs. Menley and James, Farringdon Road, London, 
 E-C); (3) Aleurent contains only 7 per cent, of carbo- 
 hydrates (Messrs. Callard, Regent Street, London). 
 
 Milk Albumins (all starch free). — Protene (the Protene 
 Co., 36 Walbeck Street, London, W.); plasmon (Plasmon 
 Co., 56 Duke Street, Grosvenor Square, London); biogene 
 (Mr. Bonthron, 50 Glasshouse Street, London). 
 
 Meat Albumins. — Sanatogen (the Sanatogen Co., 12 
 Chenie's Street, London, W.C.). 
 
 There are few specimens of gluten flour (such as prepara- 
 tions supplied by Messrs. R. O. Bischof and Brooke, 35 Brooke 
 Street, Holborn, London, E.G. ; and by J. Bonthron and Co., 
 and Callard and Co., London, W.) which contain only 2 to 6 
 
336 THE BOOK OF DIET. 
 
 per cent, of starch. When the medical man has ascertained, 
 by his own testing with iodine, that the gluten flour contains 
 only a very small percentage of starch, it may be used freely 
 for the preparation of bread, puddings, pancakes, according 
 to directions supplied by the various firms (provided these 
 directions do not recommend the addition of ordinary flour). 
 
 Bread Substitutes which are free from Starch and 
 satisfactory chemically. 
 
 1. From Bonthron, 50 Glasshouse Street, London — 
 
 Casein biscuits (these are very palatable). 
 Casein bread. 
 
 Shortbread biscuits and Biobran drops. 
 Biogene wafers. 
 
 2. From Callard and Co., Regent Street, London — 
 
 Prolacto bread. 
 Cellulon bread. 
 Casoid bread. 
 
 Bran and almond bread. 
 Kalari biscuits. 
 Rislacto biscuits. 
 
 Casoid meal bread. 
 
 3. From Protene Co., 36 Welbeck Street, London — 
 
 Protene bread. | Protene bran bread. 
 
 Protene biscuits. 
 
 4. From Plasmon Co., 56 Duke Street, Grosvenor Square, London — 
 
 Plasmon diabetic biscuits. 
 
 5. From Huntley and Palmer, Reading — 
 
 AkoU biscuits. 
 
 6. From Messrs. R. Summer and Co., of Liverpool — 
 
 Titrumen bread. It is claimed that each roll contains as 
 much assimilable albumin as 3 oz. of meat or 4 eggs. 
 
 7. Brusson Jeune Co., Bedford Chambers, Covent Garden, London — 
 
 A crisp roll, not entirely free from starch, which is an 
 excellent diabetic food. 
 
DIABETIC FOODS. 337 
 
 A few directions for making porridge and puddings are 
 here given. 
 
 Porridge or Gruel made from almonds or cocoa-nut can 
 be prepared in the following manner : — 
 
 A small piece of German yeast (the size of two peas) is dissolved in 
 a little lukewarm water, and added to and well mixed with two tea- 
 spoonfuls of ground almonds. The mixture is allowed to stand in a 
 warm place (by the fire) for half an hour or longer. The small quantity 
 of sugar in the almonds is mostly or entirely destroyed by the action of 
 the yeast, and the mixture becomes spongy. It may be sweetened with 
 a trace of saccharin if desired. The consistence will vary according to 
 the quantity of water which has been added. If the consistence is that 
 of custard or rice pudding, the almonds may be eaten with stewed cran- 
 berries or other fruit as a pudding. Or a little more warm water, or 
 warm water and cream, may be added and the mixture will have the 
 consistence of porridge and milk, and may be taken in place of oatmeal 
 porridge. By adding still a larger quantity of water, a mixture like 
 gruel may be made. Desiccated cocoa-nut powder may be used in place 
 of ground almonds, and cocoa-nut pudding, porridge, or gruel may be 
 thus prepared. The almond and cocoa-nut porridge and gruel are of 
 great nutritive value on account of the large amount of fat they contain. 
 
 Puddings, etc. 
 
 The following are some of the simpler puddings, which 
 
 are very suitable : — 
 
 Cocoa-nut Pudding. 
 
 Half ounce of German yeast is mixed in a little lukewarm water with 
 J lb. of desiccated cocoa-nut powder. The mixture is kept in a warm 
 place for fifteen minutes. Then ^ oz. butter, a pinch of salt, and a little 
 milk are added. All must be well mixed. The mixture is placed in a 
 pudding-dish, and baked in a moderate oven for twenty or thirty minutes 
 until the surface is brown. This pudding can be eaten warm or cold. 
 It may be taken with custard, and sweetened, if desired, with saxin. 
 
 Almond Pudding. 
 
 Take 4 oz. of ground almonds. Mix a J oz. of German yeast with 
 a little lukewarm water. Add the ground almonds to the yeast and 
 
338 THE BOOK OF DIET. 
 
 water, and mix well. Allow the mixture to stand in a warm place for 
 fifteen minutes until spongy. Beat up one egg in a little milk, and add 
 a little solution of saccharin. Then mix the egg with the ground 
 almonds, place in a pudding dish, and bake for about fifteen minutes. 
 
 Suet puddings or suet and almond pudding, and especially custard 
 (made in the old-fashioned way from eggs and milk, and not from 
 custard powder), are very suitable. To sweeten the custard or puddings, 
 saccharin may be used. 
 
 Suet pudding may be prepared from a milk albumin (pastry flour) 
 obtained from Messrs. Callard and Co. Directions are supplied along 
 with the powder. 
 
 Sweets for dinner — ^jellies, ices, creams, etc.^almost free from carbo- 
 hydrates, may be prepared by an intelligent cook from cream, eggs, 
 butter, almonds, nuts, lemon, gelatine, vanilla, wine, and brandy, and 
 sweetened with saccharin or saxin. 
 
 Home-made Diabetic Bread Foods. 
 Cocoa-nut or Almond Cakes. 
 German yeast. 
 
 4 oz. desiccated cocoa-nut 
 
 or almond flour. 
 Pinch of saccharin. 
 
 2 teaspoonfuls cream. 
 
 Method. — The almond flour is mixed into a paste with a little water 
 and the German yeast. Allow the mixture to stand in a warm place 
 for twenty minutes. Then add the egg, two teaspoonfuls of cream, and 
 water sufficient to work the mixture. Divide into cakes and bake in 
 a quick oven. 
 
 Bkan Bread, 
 \ lb. bran (prepared). 
 
 2 OZ. almond flour. 
 
 3 oz. of butter, 
 6 eggs. 
 
 \ pint milk. 
 
 2 teaspoonfuls bicarbonate 
 
 of soda. 
 I teaspoonfiil of tartaric acid. 
 
 Method. — Place the butter in a basin and beat it to a cream, then add 
 the almonds and beat well ; add the eggs one at a time. Partly mix the 
 bran before adding the milk. Well mix the whole together, and place 
 it in a well-buttered tin, and bake for an hour in moderate oven. 
 
DIABETIC FOODS. 339 
 
 Gluten Bread. 
 
 I lb. gluten flour. 
 
 J lb. of prepared bran. 
 
 I oz. yeast. 
 
 1 oz. ground almonds. 
 
 2 eggs. 
 Pinch of salt. 
 
 Method. — Make a sponge as for ordinary bread, and set it to rise. 
 This will take about three-quarters of an hour. Then bake. 
 
 The addition of a little ground almonds and two eggs is an 
 improvement. 
 
 Gluten bread in slices, cut into small pieces, soaked in butter and 
 toasted or fried, is very palatable, and will be found a useful article in 
 the preparation of many dishes. 
 
 Protene Bread. 
 
 4 oz. of No. 2 Protene,* 2 oz. of butter, 2 eggs. Beat all together 
 thoroughly. Divide so as to form eight small cobs. Bake in oven. 
 
 Protene and Cocoa-nut Bread. 
 
 Mix together i tablespoonful of lukewarm water, J oz. of German 
 yeast, 3 tablespoonfuls of desiccated cocoa-nut powder. Cover and 
 leave in a warm place for about twenty minutes until it is spongy ; then 
 add three tablespoonfuls of bran protene, a pinch of salt, l egg well 
 beaten up with a little milk. Mix all well together, place into tins, 
 bake twenty minutes or longer. 
 
 Cocoa-nut and Flasmon Cakes. 
 
 Mix together 2 tablespoonfuls of cocoa-nut powder with a little luke- 
 warm water, and J oz. of German yeast, so as to form a stiff paste. 
 Allow to stand (covered) in a warm place for about ten minutes, until 
 it becomes spongy, then add 3 tablespoonfuls of plasmon, a pinch of 
 salt, I tablespoonful of glycerine, and i egg well beaten up with a little 
 milk. Mix all together. Divide into four to eight tins. Bake for twenty 
 minutes or more. 
 
 Protene and Almond Bread. 
 
 Mix J oz. of German yeast with 2 tablespoonfuls of lukewarm water, 
 and I oz. of almond flour (ground almonds). Allow the mixture to 
 
 * No. 2 Protene can be obtained from the Protene Co., 36 Welbeck Street, 
 London, W. 
 
340 THE BOOK OF DIET. 
 
 stand in a warm place for ten minutes, then add 4 oz. of No. 2 Frotene, 
 I egg (beaten np), a little salt, i^ oz. of butter, and a little milk. Mix 
 all well together with a fork, divide into cobs, or place into small tins, 
 and bake. 
 
 Plasmon Biscuits. 
 
 Flasmon 8 oz., I egg beaten up in milk. Mix well together into a 
 light paste. Divide into cakes and bake for ten minutes. 
 
 Most gluten bread contains so much starch that it is of little service. 
 It should always be tested with iodine, and should be regarded as 
 ordinary white bread, unless it is known to be one of the few specimens 
 containing only a very small percentile of starch. When it is considered 
 advisable to allow a diabetic patient a small quantity of white bread — 
 3 or 4 oz. daily — this may be replaced by an amount of gluten bread 
 containing the same quantity of starch as the 3 oz. of ordinary bread. 
 The bulk of this quantity of gluten bread will be much greater than that 
 of the equivalent white bread. Many patients much prefer the small 
 quantity of ordinary bread to its more bulky equivalent of gluten bread, 
 but to some patients the more bulky gluten bread is more satisfying. 
 
 Diabetic spongecakes, made from almond flour and sweetened with 
 glycerine, may be commended. 
 
 Gluten macaroni and gluten vermicelli are quite appetizing articles. 
 
 As a matter of practical experience in the treatment of 
 diabetes, the complete deprivation of starch in the bread- 
 stuffs is found to be so great a trial, and becomes so irksome, 
 that it is usually necessary and often desirable to allow a 
 small amount of ordinary bread. 
 
 Fruit. 
 
 Fruit when ripe, as a rule, should be avoided because 
 of the large amount of sugar present ; but in a few fruits — 
 strawberries, gooseberries, apricots, melons, and oranges — 
 the sugar is in the form of levulose, and this, as has been 
 mentioned before, is more easily utilized by the tissues. 
 Unripe fruits, gooseberries and raspberries, cranberries and 
 rhubarb, sweetened with saccharin or neutralized with an 
 
DIABETIC FOODS. 341 
 
 alkali, have to take largely the place of ripe fruit. The 
 " Forbidden Fruit," resembling a pale orange, contains very 
 little sugar, and is suitable for diabetic patients. Diabetic 
 niaimalade, made with gelatine, glycerine, and orange juice 
 and rind, is an attractive-looking compound, and a great 
 boon to the diabetic's breakfast table. Callard and Co. 
 also make a diabetic jam which is almost sugarless. 
 
 Vegetables. 
 
 Potatoes should not be taken by most diabetic patients ; 
 if taken, they are best in the form of well-fried potato chips. 
 A small amount of potato in this form makes a large dish, 
 as the potato expands with cooking. 
 
 In cooking green vegetables, butter and fat should be 
 freely used ; and oil, eggs, and cream may be used with the 
 salad dressings. 
 
 Beverages. 
 
 Beverages containing carbohydrates to any degree should 
 be excluded from the dietary. These include beer, porter, 
 ale and stout, rum, sweetened gin, liqueurs, sweet lemonade, 
 cocoa and chocolate, fruit wines and syrups, port, champagne, 
 sweet wines, and Tokay. The beverages allowable are water, 
 soda-water, and mineral water, tea, coffee, brandy, whisky, 
 dry sherry, claret. Burgundy, hock, Moselle, most Rhine 
 wines, and Hungarian wines. Citric acid lemonade, lo grains 
 to the pint, sweetened with 4 drams of glycerine or a little 
 saccharin, is an admirable thirst-quencher, and the following 
 are also suitable : — 
 
 Home-made lemonade, lemon juice and water, sweetened 
 with saccharin or saxin. 
 
 Soda and Lemon. — Squeeze a lemon, and add a glass of 
 soda or Seltzer water. 
 
 A specially prepared diabetic cocoa; and also chocolate 
 
342 
 
 THE BOOK OF DIET. 
 
 is prepared, flavoured with vanilla and sweetened with 
 saccharin. 
 
 A series of menus for six days are here given. The 
 beverages must be selected from those given on p. 333. 
 The bread foods must be selected from the different pre- 
 parations given in the preceding pages ; sauces must be made 
 without flour; those on pp. 422, 423 can be recommended. 
 
 Breakfast. 
 Fried fillet fish served 
 
 with lemon juice. 
 Savoury omelet. 
 Diabetic bread or 
 
 toast. 
 
 E^ boiled. 
 Toasted sardines 
 
 rolled in bacon, or 
 
 fried. 
 Gluten bread, batter. 
 
 Broiled kippered sal- 
 mon. 
 
 Scrambled eggs on 
 toasted bran bread. 
 
 Gluten flour bread. 
 
 Lunch, 
 
 Lemon drink sweet- 
 ened with saxin. 
 
 Vegetable marrow 
 stuffed (p. 431). 
 
 Cold ham. 
 
 Cream cheese. 
 
 Almond and bran bis- 
 cuits; gluten rolls. 
 
 11. 
 
 Fried bacon on pur6e 
 
 of spinach. 
 Cauliflower au gratin. 
 Gorgonzola cheese. 
 Gluten dinner rolls. 
 
 III. 
 
 Chicken panada. 
 Potted veal. 
 Imperial cheese. 
 Gluten cracknels and 
 
 Dinner, 
 Soup with vegetables. 
 Halibut with lemon. 
 Fillet of beef and 
 
 cauliflower. 
 Green apples stewed. 
 Pancakes made from 
 
 gluten, flour, milk, 
 
 ^ggs> sweetened 
 
 with saxin. 
 Cheese, eggs. 
 
 Tomato purie. 
 Steamed sole with 
 
 sauce hollandaise. 
 Boiled fowl. 
 Carrageen jelly (pp. 
 
 421, 430). 
 Stufied tomatoes. 
 
 Chicken broth 
 
 (strained, thickened 
 
 with cream). 
 Fish souffI4 curry and 
 
 French beans (no 
 
 rice). 
 Gluten and almond 
 
 pudding. 
 Anchovy toast. 
 
DIABETIC FOODS. 
 
 343 
 
 Breakfast. 
 Grilled kidney and 
 
 bacon. 
 Crab omelet. 
 Bran bread. 
 Cocoa-nut biscuits. 
 Butter. 
 
 IV. 
 Lunch. 
 Potted herrings. 
 Cold meat and to- 
 mato salad (p. 424). 
 P^t^ de foie gras 
 with bran biscuits. 
 
 Dinner. 
 
 Consomm^ with cus- 
 tard. 
 
 Salmon mayonnaise 
 and cucumber. 
 
 Sweetbreads and to- 
 mato. 
 
 Curds and cream. 
 
 Mushrooms augratin. 
 
 Findon haddock 
 stewed in butter. 
 
 Poached egg on 
 spinach. 
 
 Almond loaf. 
 
 Gluten cracknels. 
 
 Butter. 
 
 Cutlets of egg, ham, 
 
 or crab. 
 Camp pie. 
 Gluten and bran 
 
 bread. 
 
 Roast chicken and 
 
 watercress. 
 Stewed cucumber and 
 
 cheese sauce. 
 Stilton cheese. 
 Pine kernel biscuits. 
 Toasted gluten flour 
 
 bread. 
 
 VI. 
 
 Roe souffle (p. 433). 
 Smoked tongue and 
 
 salad. 
 Egg in aspic. 
 
 Pur^e spinach or 
 lettuce. 
 
 Turbot. 
 
 Game — pheasant with 
 stewed celery. 
 
 Blancmange (p. 421 ; 
 use saccharin in- 
 stead of sugar). 
 
 Tarragon creams 
 (P- 433)- 
 
 Tomato soup. 
 Whitebait with sliced 
 
 lemon. 
 Roast lamb, mint 
 
 sauce. 
 Asparagus. 
 Gooseberry fool. 
 Hot caviare on gluten 
 
 toast. 
 
XIX. 
 OBESITY. 
 
 Cause, 
 
 Principles of Dibtbtic Treat- 
 ment. 
 
 Remedies to be avoided. 
 How TO GET Fatter. 
 
Chapter XIX. 
 OBESITY. 
 
 CAUSE. 
 
 Obesity results from the excessive consumption of certain 
 foods which are fat forming. Fat is a carbon mixture. All 
 the food-stuffs — namely, proteins, fats, and carbohydrates — 
 contain carbon, but fat is chiefly formed from the fats and 
 carbohydrates in the diet, and of these the most important 
 clinically are the carbohydrates. The chief function of carbo- 
 hydrates and fats is that of energy producers, and all the 
 excess of these foods above the bodily requirements is stored 
 up in the tissues of obese subjects as fat. Contributory 
 factors are lack of exercise, and excessive indulgence in wines 
 and malt liquors. A vicious circle is often set up : lack of 
 exercise tends to promote obesity; obesity still further re- 
 stricts the active bodily movements which are so essential 
 for good health. 
 
 The following table is a useful one, indicating what should 
 be the relative weight and height of a person at adult age 
 in good health. On the higher scale a certain percentage 
 is allowed for differences in build, size of bones, etc. A 
 weight beyond the extreme means diminished respiration 
 and impeded action of the heart, conditions incompatible 
 with robust health and condition : — 
 
348 
 
 THE BOOK OF DIET. 
 
 Normal Weight. 
 
 
 Extreme Limit. 
 
 Stathrb. 
 
 Male. 
 
 Female. 
 
 Male. 
 
 Female. 
 
 ft ins. 
 
 St. 
 
 lb. 
 
 St. 
 
 lb. 
 
 St. 
 
 lb. 
 
 St 
 
 lb. 
 
 S 
 
 8 
 
 4 
 
 7 
 
 9 
 
 8 
 
 II 
 
 8 
 
 I 
 
 S I 
 
 8 
 
 9 
 
 7 
 
 12 
 
 9 
 
 2 
 
 8 
 
 4 
 
 S 2 
 
 9 
 
 o 
 
 8 
 
 2 
 
 9 
 
 6 
 
 8 
 
 7 
 
 S 3 
 
 9 
 
 7 
 
 8 
 
 8 
 
 10 
 
 o 
 
 9 
 
 o 
 
 S 4 
 
 9 
 
 13 
 
 9 
 
 2 
 
 ID 
 
 6 
 
 9 
 
 7 
 
 5 5 
 
 lO 
 
 2 
 
 9 
 
 8 
 
 10 
 
 lO 
 
 lO 
 
 o 
 
 S 6 
 
 lO 
 
 s 
 
 9 
 
 13 
 
 II 
 
 o 
 
 10 
 
 7 
 
 S 7 
 
 lO 
 
 8 
 
 10 
 
 S 
 
 II 
 
 5 
 
 10 
 
 13 
 
 5 8 
 
 II 
 
 I 
 
 II 
 
 o 
 
 II 
 
 10 
 
 II 
 
 4 
 
 5 9 
 
 II 
 
 8 
 
 II 
 
 6 
 
 12 
 
 2 
 
 12 
 
 
 
 S 10 
 
 12 
 
 
 
 II 
 
 lO 
 
 12 
 
 9 
 
 12 
 
 6 
 
 S " 
 
 12 
 
 6 
 
 12 
 
 2 
 
 '3 
 
 3 
 
 12 
 
 12 
 
 6 o 
 
 12 
 
 lO 
 
 12 
 
 8 
 
 13 
 
 12 
 
 13 
 
 4 
 
 PRINCIPLES OF DIETETIC TREATMENT. 
 The first essential in treatment is to greatly reduce the 
 amount of fat-forming foods. These are not required. When 
 these are cut off, nature draws on the reserve fat in the 
 tissues, until that which is superfluous is gone. By this 
 means we reduce the total amount of energy taken in the 
 form of food. At the same time combustion in the tissues 
 must be promoted by increased physical exercises carried 
 out at home daily under directions. A third important 
 factor in treatment is to promote the activity of the skin 
 by a carefully planned course of baths, which must be 
 taken with special precautions in the case of very obese 
 subjects. All the dietetic systems of treatment of obesity 
 are founded on the above principle, the best known system 
 being that of Banting, who in the year 1863 reduced his weight 
 by 44 lbs., and without any recurrence of corpulence when 
 ordinary diet was resumed. His diet — consisting of animal 
 food 13 to 16 oz., bread 2 oz., fruit and vegetables 6 to 12 
 oz.; total fluid restricted to 35 oz. — was made up as follows: — 
 
DIETETIC TREATMENT OF OBESITY. 349 
 
 Breakfast. — 5 to 6 oz. of animal food ; meat except veal and pork ; 
 boiled fish 01 kidneys ; I oz. of toast or biscuits ; 9 oz. of tea without 
 milk or sugar. 
 
 Dinntr. — 5 to 6 oz. of lean meat, poultry, game, or fish ; eels, 
 salmon, and herring are excluded ; every vegetable except potato, par- 
 snips, beetroot, turnip or carrot ; cooked fruit unsweetened ; i oz. dry 
 toast ; TO oz. of good claret, sherry, or madeira. 
 
 Tea. — 9 oz, of plain tea without sugar or milk ; 2 or 3 oz. of cooked 
 firuit ; a rusk or two. 
 
 Supper. — Meat or fish, as at dinner, 3 to 4 oz. ; claret or sherry and 
 water 7 oz. 
 
 An interesting and useful account of the regime in vogue 
 at Carlsbad is given by Mrs. Ernest Hart. Mrs. Hart gives 
 her personal experience as follows : " It may be of interest 
 to my readers, who suffer from too great an abundance of 
 fat, to learn how I put theory into practice and reduced my 
 weight 15 lbs. in three weeks. This result was obtained at 
 Carlsbad, and the regime was a follows : — Rose at six, took 
 three tumblers of hot Sprudel water, walking for about 
 twenty minutes between each glass. Breakfast at eight, con- 
 sisting of one or two small crescents of bread and a boiled 
 egg. On alternate mornings a vapour bath with cold douche, 
 or general massage of the body. Dinner at one o'clock, con- 
 sisting of a small amount of fish and meat or poultry, with 
 green vegetables ; no potatoes or sweets. In the afternoon 
 a walk of from six to eight miles up the hills in a flannel 
 dress. Supper at seven, consisting of a poached egg or a 
 small cut of cold meat. There is no doubt that I suffered 
 from constant hunger on this diet, but under it my weight 
 steadily diminished, and a feeling of lightness and well-being 
 took the place of previous heaviness. Continuing the diet 
 after I left Carlsbad, I lost another six pounds, and it was 
 some years before the tendency to increase in weight showed 
 itself again. I am quite certain that no one need fear be- 
 
330 THE BOOK OF DIET. 
 
 coming a ponderous size, a source of discomfort to them 
 selves and of disagreeable impression to others, if they 
 checked the beginning of obesity by suffering the small 
 inconvenience of submitting to a restricted diet for a 
 time." 
 
 Other systems of dietetic treatment, such as a modification 
 of the Salisbury diet (p. 297), and a milk diet cure with rest 
 and massage, should only be carried out under strict medical 
 supervision. 
 
 With regard to the taking of fluids in obesity, there 
 is no doubt that the amount of fluid taken with meals 
 should always be restricted, and to this end soups are, 
 as a rule, contra-indicated. Where there is any special 
 weakness of the heart and circulation, a dry diet is ad- 
 visable for sake of the heart, apart altogether from the 
 obesity. When a highly nitrogenous dietary is in use, 
 at least three pints of fluid in the form of hot or cold 
 water, or occasionally weak clear soup, should be taken 
 daily, this being taken on an empty stomach, between 
 meals. 
 
 To sum up. Every case of obesity must be treated on 
 its merits, remembering always that there are certain 
 broad principles to be followed. The total amount oj 
 food must be reduced, farinaceous foods in particular being 
 very greatly restricted. The entire quantity of liquid taken 
 •with meals should be very moderate. Suitable exercises, 
 either in the form of open-air exercises, Swedish move- 
 ments, or massage, according to the condition of the 
 patient, constitute an important part of the treatment 
 We have here tabulated the different articles of food 
 which may be taken. The cooking of all the meat foods 
 must be of the simplest, all sauces and condiments being 
 avoided. 
 
FOODS ALLOWED AND FORBIDDEN. 351 
 
 Allowed. 
 Clear soups in small amount 
 only ; broths not thickened 
 or containing ingredients like 
 rice or barley. 
 
 Seufs. Forbidden. 
 
 Thick soups — for example, 
 broth, potato, lentil, mulli- 
 gatawny, oxtail. 
 
 Fish. 
 
 All white fishes. 
 
 Salmon, herrings, mackerel, 
 sardines. 
 
 Poultry. 
 
 Fowls, turkeys, partridges, I Duck, goose, 
 pheasants, grouse. I 
 
 Meats. 
 
 All lean meats. | Pork, fat, bacon. 
 
 Bread-stuffs. 
 
 New bread, pastry, cakes, 
 scones. 
 
 Stale bread, toast, rusks, un- 
 sweetened biscuits, gluten 
 or almond bread (p. 339). 
 
 Fruits. 
 
 Fresh fruits, raw or cooked | Dried fruits, all sweets, jams 
 
 with saccharin. I and marmalade, and honey. 
 
 Vegetables. 
 
 All green vegetables, tomatoes, 1 Potatoes, peas, beans, parsnips, 
 celery. | carrots, turnips, beetroot. 
 
 Puddings. 
 
 Curds, custards, jellies, stewed 
 fruits made with saxin. 
 
 Suet puddings, milk puddings, 
 tapioca, sago, macaroni,com- 
 flour, oatmeal. 
 
 Milk and Milk Products. 
 
 Skimmed milk (best diluted), 
 cheese, especially cheddar, 
 American, and Dutch 
 skimmed milk cheese. 
 
 Butter in strict moderation. 
 
 Cream, fall milk, cream cheeses, 
 also Gorgonzola, Roquefort, 
 
 etc. 
 
352 
 
 THE BOOK OF DIET. 
 
 Allowed. 
 
 Fluids. 
 
 Forbidden. 
 
 Tea or coffee, sweetened with 
 
 saxin. 
 Hot or cold water. 
 Natural mineral waters — Vals, 
 
 Vichy, St. Salvier, Apolli- 
 
 naris. 
 Whisky, in very small amount, 
 
 or dry natural wines (p. Ii8). 
 
 Cocoa, malt liquor, such as 
 beer, porter, stout. 
 
 Sweet wine, such as cham- 
 pagne, port, and liqueurs. 
 
 Sweet temperance drinks. 
 
 EEllIEDIBS TO BE AVOIDED. 
 
 A word of caution may be given regarding proprietary 
 remedies extensively administered for the cure of obesity. 
 Most of them are useless, and some of them are dangerous. 
 They are also ridiculously expensive. The composition of 
 many of them has been determined by the British Medical 
 Association. Allan's anti-fat contains potassium iodide, 
 salicylic acid, and bladder-wrack or common seaweed. The 
 price is 6s. 6d. per bottle, the value of the ingredients being 
 3d. Antipon consists of citric acid, price 2s. 6d. per bottle 
 of 6 J oz., the value of ingredients being i Jd. Russel's anti- 
 corpulent preparation also contains citric acid as its main 
 ingredient, price 6s. for a 12J oz. bottle, the value of the 
 ingredients being 2d. Thyroid extract should never be 
 taken for the cure of obesity unless under close medical 
 supervision. 
 
 HOW TO GET FATTER. 
 
 A medical man is sometimes asked by thin, spare subjects, 
 How can I get fatter? In such cases the diet must be 
 liberal, and consist largely of fat-forming foods. On referring 
 to the column on the right-hand side of p. 351, the reader 
 will see the best examples of fat-forming foods. A menu 
 framed on these lines is, as a rule, admirably adapted to put 
 
HOW TO GET FATTER. 353 
 
 on flesh and fat. We must recognize, however, that some 
 spare subjects, notably those of a nervous temperament, will 
 not fatten on any diet ; and on the whole this is, from 
 their point of view, a matter for congratulation rather 
 than regret. 
 
 12 
 
XX. 
 TUBERCULOSIS. 
 
 AMONGST THE WELL-TO- 
 DO CLASS. 
 
 Fluid Dietary — Mainly Milk. 
 
 A Largely Meat Dietary. 
 
 AMONGST THE WORKING 
 CLASSES. 
 
 Directions for Economical Home- 
 feeding. 
 
 What Food to buy, and how to 
 cook it. 
 
 Meat. 
 
 Butter. 
 
 Milk. 
 
 Cheese. 
 
 Eggs. 
 
 Oatmeal. 
 
 Dried Peas, Beans, and Lentils. 
 
 Potatoes. 
 
 Fish. 
 
 Porridge. 
 
 Lentil, Pea, or Bean Soup. 
 
 Suet Puddings. 
 
 Milk Pudding. 
 
 DIET IN TUBERCULOSIS 
 IN CHILDREN. 
 Preventive Treatment. 
 
Chapter XX. 
 TUBERCULOSIS. 
 
 General Principles — Well-to-do Classes — 
 Working Classes — Children. 
 
 Tuberculosis manifests itself in many forms, the most 
 common being enlargement of glands, pulmonary tuber- 
 culosis, and tuberculous affections of the bones and joints, 
 especially in children. Tuberculosis is essentially a wasting 
 disease, prominent symptoms being loss of appetite, disturbed 
 digestion, interference with nutrition, and a resultant loss of 
 flesh. Cough and spit, associated in many cases with the 
 spitting of blood, are common symptoms in tuberculosis of 
 the lungs. The essential in treatment is to improve the 
 resistant and recuperative powers of the body by getting 
 the patient to eat properly, and to eat a sufficient amount. 
 The aim in the dietetic treatment is to get the patient 
 to increase the amount of food so that his weight shall 
 increase and remain stationary at a little in excess of the 
 patient's highest known weight before being affected with 
 tuberculosis. 
 
 There is no hard and fast rule for the dieting in tuber- 
 culosis. The disease may show itself at all ages and in 
 many varied forms. The stage and severity of the disease, 
 
358 THE BOOK OF DIET. 
 
 and the presence or absence of special complications, have 
 to be considered. 
 
 A continual supply of fresh air, with as much sunlight as 
 possible, is the first essential in the treatment of tuberculosis. 
 The patient should, as far as possible, therefore live in the 
 fresh air day and night, irrespective of the weather. This 
 promotes a good appetite, increases the digestive powers, 
 and so enables the full effect of a judicious dietary to be 
 obtained. A further important point is, that breathing 
 should be carried out properly. It is of comparatively little 
 value to put a child or young person who is a mouth- 
 breather on to a proper dietary if the oxygenating power of 
 the blood and tissues is greatly below the normal, from a 
 cause which can be readily removed. Breathing exercises, 
 carried out in a systematic and thorough manner, are of the 
 greatest value in those cases. 
 
 The food as a whole has to be increased, special impor- 
 tance attaching to the increase of the/w/««j and fats. As 
 a rough estimate of the extent to which the nutritive material 
 should exceed the normal diet of a non-tuberculous subject, 
 it may be said that the diet in a case of tuberculosis should 
 contain about one-third more. Of this third, the greater 
 part should be given in the form of animal protein, and 
 more especially meat, eggs, and milk. Animal proteins are 
 selected because they have a very special value in the treat- 
 ment of tuberculosis. The fats are increased by the addition 
 of milk, butter, cream, and yolk of eggs. There is no special 
 virtue in increasing the bread-stuffs and farinaceous foods; 
 on the contrary, special care has to be taken in regard to the 
 quantity of these foods supplied, because of their liability to 
 induce flatulence, which interferes with the digestion and 
 absorption of the protein foods. 
 
 The general principles to be followed in the dietetic treat- 
 
GENERAL PRINCIPLES. 359 
 
 ment of tuberculosis are admirably summed up as follows 
 (Bardswell) :— 
 
 1. The amount of protein in the ordinary diet should be 
 increased by 30 per cent., and this increase should be main- 
 tained until the disease is obsolete. 
 
 2. If the patient is under weight, the physiological diet 
 should also be increased 30 per cent, in the purely energy- 
 giving foods — namely, either in fats or carbohydrates, or 
 partly in each. 
 
 3. Patients with constitutional disturbance associated with 
 loss of appetite or dyspepsia usually require a somewhat 
 concentrated diet, so as to give the comparatively large 
 amount of nourishment in a but slightly increased bulk of 
 food-stuflfs. 
 
 4. The meals should be well cooked, varied, and given, as 
 far as possible, at considerable intervals, and reliance should 
 be placed upon plain food-stuffs whenever possible. Pro- 
 prietary invalid foods should only be used when ordinary 
 foods cannot be taken. 
 
 The diet should be restricted to three good meals a day, 
 with two snacks at suitably separated intervals. Thus, if 
 breakfast be at 9 a.m., lunch at i p.m., dinner at 7 p.m., a 
 light snack may be allowed at 7 a.m. and at 4 p.m. It is 
 unwise in such cases to allow further extras of any kind 
 between meals. In many cases, if the patient takes three 
 really good nourishing meals, the snacks are better withheld. 
 If the patient sleeps well, it is better not to give anything by 
 night If wakeful, a cup of beef-tea or diluted warm milk 
 may be allowed through the night. The food must be nicely 
 prepared, daintily served, and varied as much as possible. 
 It is not, as a rule, advisable to give much fluid at meal times. 
 Where the extra nourishment required is given in the form 
 of milk, not more than one tumblerful should be given with 
 
36o THE BOOK OF DIET. 
 
 meals. The quantity of food should be increased as appetite 
 advances. It is noteworthy that a patient in the most 
 favourable conditions of fresh air and sunlight may be able 
 to digest and assimilate an extra diet of from six to eight 
 raw eggs daily, whereas under less favourable conditions not 
 more than one or two eggs daily can be assimilated without 
 deranging the digestion. 
 
 AMONGST THE WELL-TO-DO CLASS. 
 
 The extra nourishment required can be given either in the 
 form of 3 pints of milk extra daily, or 2 to 3 eggs and 2 
 pints of milk ; or as underdone red meat, 6 to 8 oz. More 
 commonly it is supplied by a judicious combination of these 
 foods. The eggs may be taken raw, or added to milk or 
 soup, or ^ lb. raw meat or meat-juice may be added to the 
 daily dietary. 
 
 Suggestions are here given for a diet of an ordinary case 
 of tuberculosis where the digestion is fairly good. Notice 
 that the meat courses should be plentiful, and plainly cooked 
 without sauces, that cream and butter should be given 
 liberally, and that the amount of bread, bread-stuffs, suet 
 puddings, and potatoes, that predispose to flatulence, must 
 be restricted. 
 
 Brea/^ast (8 a.m.). — Two breakfast cnps of milk, to be taken with 
 tea, coffee, or cocoa ; a little cream ; two dishes from the following, 
 a good-sized helping of each : bacon, ham, tongue, potted meat, meat 
 rissoles, fish fried, herrings or sardines, eggs served in any form; a 
 plentifiil supply of batter, toast (2 half-slices), I roll, scone, or piece of 
 oatcake. 
 
 Forenoon. — Milk, \ pint, and 2 raw eggs. 
 
 Midday Meal (1.30). — Fish or entree; roast meat, hot or coldj 
 grilled steak or chop; roast fowl or game. The meat should be 
 
DIETARY FOR TUBERCULOSIS PATIENTS. 361 
 
 slightly underdone, and a large helping taken. Vegetable selected' 
 from tomatoes, celery, onions, spinach, seakale, French beans, peas, 
 salad vegetables; pudding selected from custards, curds, creams, 
 stewed fruit with cream souffles, omelets, all eaten with cream ; milk, 
 i pint (with this meal two half-slices of toast or a dinner roll may be 
 taken). 
 
 Four p.m. — Tea, with cream, thin bread or crisp toast thickly spread 
 with butter ; one slice of simple cake or biscuits. 
 
 Evening Meal (y p.m.) — 
 
 Dinner. 
 
 1. Soup, 8 oz. (clear consomm^). 
 
 2. Fish, entree, or poultry. 
 
 3. Meat and vegetable. 
 
 4. Pudding as at midday. 
 
 5. Savoury, or biscuit and cheese. 
 
 6. Milk, J pint, two half slices 
 
 dinner toast or a crisp roll. 
 
 Supper. 
 
 1. Fish, egg, or chicken. 
 
 2. Meat, ham, sausage, or brawn. 
 
 3. Cold sweet as at lunch, with 
 
 fruit. 
 
 4. Milk, J pint, made with cocoa or 
 
 coffee. 
 
 5. Biscuits, butter, and cheese. 
 
 With any tendency to sleeplessness, a cup of beef-tea or 
 a glass of hot milk, Horlick's malted milk, ovaltine, or a 
 teaspoonful of bovril, is a great help. 
 
 There are not a few cases of tuberculosis where, owing to 
 weakness of digestive power, the patients cannot take the 
 above dietary. Here we have recourse either to a fluid 
 dietary mainly composed of milk, the food being given often 
 and in small quantities, or to a dietary composed largely of 
 meat, which is often of service in cases where dyspeptic 
 symptoms follow the large mixed meals. Two illustrative 
 dietaries are here given : — 
 
 Fluid Dietary — Mainly Milk. 
 
 Seven a.m. — Milk, 8 oz. ; better given warmed. 
 
 Breakfast (8.30 a.m.). — Milk, 8oz., with a teaspoonful of prepared 
 plasraon, and flavoured with coffee or cocoa ; a milk gruel made from 
 oatmeal, Scott's oat flour, or barley meal, eaten with cream. 
 
 12a 
 
362 THE BOOK OF DIET. 
 
 Eleven p.m. — Milk, 8 oz,, with one or two raw eggs, or raw meat soup 
 containing lo oz. soup and J lb. raw beef (for preparation, p. 383, No. 4) ; 
 soup from good stock thickened with egg or cream and a tablespoonful 
 of prepared plasmon. 
 
 Dinner ^1.30 p.m.). — Chicken essence or restorative jelly soup (p. 413), 
 to which one tablespoonful of plasmon is added, or raw steak, J lb. 
 made into mince with 8 oz. milk, or raw steak, J lb. made into 
 rissoles (p. 298), with 8 oz. milk, or raw meat sandwiches (p. 416), with 
 8 oz. milk. 
 
 Three-thirty p.m. — Egg 6ip (p. 54), made with 8 oz. milk ; thin 
 boiled custard with flavouring ; two raw eggs (p. 53). 
 
 Five-thirty p.m. — Milk tea, 8 oz., with cream ; one sponge rusk. 
 
 Dinner (J.IS p.m.). — One of the following : A meat-juice home-made 
 (p. 384), or Wyeth's or Leube Rosenthal's meat solution mixed with 
 port or Burgundy ; soup with raw meat, as at lunch ; savoury custard 
 (p. 403) from beef extract, egg, and milk ; milk bovril (ch. xxii.) or other 
 meat extract with plasmon or casein, one tablespoonful ; an invalid food 
 made with milk, 8 to 10 oz., fortified with plasmon and eaten with 
 cream. 
 
 Nine p.m. — Milky arrowroot or milk gruel with plasmon, or pancre- 
 atized cocoa made with milk and plasmon up to 10 oz. 
 
 Eleven p.m. — Milk with raw egg, or chicken or meat tea with egg. 
 
 If there is difficulty in digesting milk, the fermented forms known as 
 koumiss and kephir are sometimes more easily tolerated. In some 
 cases the milk may require to be peptonized. 
 
 Whey also is more easily absorbed, and may be flavoured in varions 
 ways and fortified with plasmon or casein, and cream added. 
 
 A Largely Meat Dietary. 
 
 Six a.m. — Milk, J pint. 
 
 Breakfast. — Milk, at least J pint to i pint, fortified with i table- 
 spoonful plasmon, and flavoured with coffee or cocoa ; two good helpings 
 of meat course — for example, bacon, ham, eggs, fish, meat rissoles, or 
 kidney. 
 
 Eleven a.m. — Raw meat soup (which see, p. 383, No. 4), 8 oz. ; three 
 raw eggs ; glass of hot milk or thin custard (ro oz.). 
 
 Lunch {1.30 p.m.). — Good helping of fish; good helping of plain 
 slightly cooked meat selected from the following : mince (three minutes' 
 
DIETARY FOR TUBERCULOSIS PATIENTS. 363 
 
 cooking, which see, p. 417), grilled steak, or fillet of beef, grilled mutton 
 chop ; slice of underdone roast meat, sirloin, or rib roast, roast leg of 
 mutton. Avoid vegetables. Custard — Souffle omelet or cream shape, 
 fortified with plasmon and some stewed fruit and cream ; two slices of 
 dry toast ; glass of milk, 8 oz. 
 
 Feur p.m. — Cup of hot milk flavoured writh tea, toast and butter, or 
 biscuit and butter. 
 
 Dinner (f p.m.). — As at lunch. 
 
 Ten p.m. — Cup of raw meat soup. 
 
 AMONGST THE WOBEING CLASSES. 
 
 Here the extra protein required may be got from the 
 cheaper meats and fish, from skimmed milk, and from the 
 pulses. The extra fat may be obtained in the form of butter. 
 The cost of the following dietary works out at about is. per 
 day: — 
 
 Breakfast. — Bowl of well-boiled porridge, made with half milk and 
 half water ; milk, \ pint ; bacon, egg, or fish ; bread and butter ; 
 cocoa or coCfee, made with milk (breakfast cup). 
 
 Dinner. — Meat, potatoes, and green vegetable; suet pudding, with 
 jam, treacle, or stewed fruit ; milk, \ pint (skimmed). 
 
 Tea. — Tea made with skimmed milk ; bread and butter. 
 
 Supper. — Soup made from pulses (lentil, pea, bean), or porridge and 
 milk ; bread and butter ; milk, \ pint. 
 
 A still cheaper dietary may be necessary, and may be 
 framed by using skimmed milk in place of sweet milk, mar- 
 garine instead of butter, also by using the cheaper meats at 
 5d. to 8d. per pound, and making more use of lentils and 
 the cheaper varieties of cheese. 
 
 The following directions will be found useful for the 
 dietetic treatment of tuberculous patients of the poorer 
 classes living under home conditions. These are taken 
 from Bardswell's admirable work on this subject. 
 
 Directions for Economical Home-feeding — for patients 
 
364 THE BOOK OF DIET. 
 
 living at home, for instance, those attending out-patient 
 departments of hospitals, etc. It is by no means easy to 
 direct efficiently the dietetic treatment of tuberculous people 
 belonging to the working classes unless they are immediately 
 under supervision — for example, in an institution. In our 
 experience the prescription of a definite diet to consumptive 
 patients among the poorer classes is not satisfactory, as, for 
 the most part, they have not the means at home of carrying 
 out the instructions at all accurately. 
 
 We have obtained more satisfactory results in such cases 
 after giving general directions as under : — 
 
 You require to take much more food than you did before 
 you became consumptive. Do not hurry over your meals. 
 You will feel satisfied frequently before you have eaten 
 enough, and you must continue to eat even when you do 
 not want more foodt Your appetite is no guide as to the 
 amount you need. The best way to find out whether you 
 are eating enough is to weigh yourself every week, always at 
 the same time of day, and in the same clothes. If you have 
 not gained at least one pound during the week, you will 
 know you have not been eating enough. 
 
 What Food to Buy, and how to Cook it. — The following 
 is intended to give you a rough idea as to how you can 
 arrange your meals most satisfactorily, and the amount of 
 the various foods you require ; — 
 
 Breakfast, — Half-pint of porridge, with milk and sugar ; a rasher of 
 bacon or a herring, etc. ; a round of bread, tea or coffee. 
 
 Dinner. — Two large chops, or a large plateful of meat, with plenty of 
 potatoes ; a teacupfiil of milk pudding, or a large slice of suet pudding ; 
 half a round of bread, and a glass of milk. 
 
 Tea. — At least three rounds of bread and butter with jam, or, if you 
 can afford it, other relish. 
 
 Supper, — Half pint of pea, bean, or lentil soup, or J pint of porridge, two 
 rounds of bread, with sufficient cheese for both pieces, and a glass of milk. 
 
WHAT FOOD TO BUY. 365 
 
 If you take this diet, you ought to gain at least a pound a 
 week in weight ; but if you do not, your best course is to 
 take more milk until your weight increases. 
 
 The above diet should cost you about 6s. 6d. per week, 
 but you will require to be careful as to what you buy, 
 and the following notes will probably be of service to you 
 in showing you how to spend your money to the greatest 
 advantage : — 
 
 Meat. — If you cannot afford to buy EngUsh meat, buy the 
 best foreign, which contains just as much nourishment, and 
 will not cost you more than 6^d. per pound for the best 
 joints. If you cannot afford to buy joints, you must be 
 content to buy "pieces." Make full use of tripe, sausage, 
 bullock's liver, and kidney, which are cheap and nutritious, 
 but do not waste your money on veal or Iamb. 
 
 Butter. — Buy butter at is. per pound, if you can afford it; 
 but if money is scarce, buy good margarine, instead, at 6d. 
 or 8d. 
 
 Milk. — You can always get new milk at ijd. or 2d. per 
 pint, but if you cannot afford to buy much new milk, buy 
 what you can afford, and make up with separated milk, 
 which will cost you id. or ijd. per quart. 
 
 Cheese. — Dutch cheese will cost you 4jd. to 6Jd., and 
 American 6d. to 7d. Do not buy more expensive cheese, 
 as you will get no more nourishment for the extra cost. 
 
 Eggs. — Except during the early summer, eggs are always 
 an expensive form of food, therefore, do not spend more on 
 them than you can help. 
 
 Oatmeal. — Oatmeal is one of the very best and cheapest 
 foods you can have. Buy coarse Scotch oatmeal, Provost or 
 Quaker oats, and have a plateful of porridge every morning, 
 and, if you like it, occasionally at supper instead of the soup. 
 
 Dried Peas, Beans, and Lentils. — These, like oatmeal, are 
 
366 THE BOOK OF DIET. 
 
 most valuable foods for you, and should be used every day, 
 either boiled as a vegetable for dinner, or as a soup for 
 supper. You can buy them at the grocers, the peas and 
 haricot beans will cost you 2jd. per pound or pint, and the 
 lentils 2d. 
 
 Potatoes. — These are required every day, and you will 
 save money if you buy at least a stone at a time. 
 
 Fish. — Buy fish instead of meat occasionally, for the sake 
 of a change — either cod, plaice, herrings, bloaters, findon or 
 fresh haddocks, or whatever fish is in season and cheap. 
 Tinned salmon at sd. per tin is a cheap and nutritious food, 
 and makes a good change for supper. The following rough 
 directions for cooking may be of use : — 
 
 Porridge. — Stir oatmeal gradually into boiling water, add 
 a pinch of salt, and cook gently, stirring occasionally, for an 
 hour (Quaker and Provost oats take only twenty minutes to 
 cook). Allow two teacupfuls of water and two level table- 
 spoonfuls of oatmeal for each man. 
 
 Lentil, Pea, or Bean Soup. — Soak the seeds in cold water 
 overnight. Boil gently in plenty of water until soft, the 
 cooked seeds may be either eaten as a vegetable, or they 
 may be beaten to a fine paste, or, better still, rubbed through 
 a sieve, add a little of the liquid in which they were boiled, 
 and a flavour if required. To form a highly nutritious soup, 
 allow 3 tablespoonfuls of raw seeds for each man. 
 
 Suet Pudding. — i. Allow i level tablespoonful of 
 dripping, 3 level tablespoonfuls of flour, and a large pinch 
 of baking powder for each man. Mix the dripping thoroughly 
 with the flour and baking powder. Mix the whole into a 
 paste with a little water, form into a roll, flour the surface, 
 tie up tightly in a pudding cloth, and boil for two or three 
 hours. Serve with syrup, gravy, or jam. 
 
 3. Or the above paste may be rolled out flat, and jam or 
 
TUBERCULOSIS IN CHILDREN. 367 
 
 syrup spread upon it. Roll, fold in the ends, flour the 
 surface, tie tightly in a pudding cloth, and boil for two or 
 three hours. 
 
 3. Allow I level tablespoonful of dripping, 3 level table- 
 spoonfuls of flour, a large pinch of baking powder, and a 
 little sugar and fruit for each man. The fruit may be either 
 currants, figs, or dates, chopped up finely. Mix the flour, 
 dripping, and sugar, add the fruit, and make into a paste 
 with a little water, flour the surface, and tie tightly in a 
 cloth, boil two or three hours. Instead of the fruit, a little 
 syrup and a pinch of ground ginger may be used in the 
 above mixture. 
 
 Milk Pudding. — Allow for each person 2 level teaspoonfuls 
 of rice, sago, tapioca, etc., and § pint of milk and a small 
 teaspoonful of sugar. Put the rice, sugar, and milk, with a 
 pinch of salt, into a pie-dish, and bake slowly in the oven 
 for two or three hours. 
 
 DIET IN TUBERCULOSIS IN CHILDREN. 
 
 The most common forms of tuberculosis in children are 
 tuberculous peritonitis, enlargement of abdominal glands {tabes 
 mesenterica), tuberculous enteritis, glandular tuberculosis, 
 tuberculosis of bone, and pulmonary tuberculosis. The 
 most common source of infection is milk ; it also arises from 
 inhalation from contaminated air. The majority of cases 
 occur after two years of age. In the earlier stages the 
 symptoms are often slight, consisting in a general lack of 
 vigour, some degree of wasting, and anaemia. If the tem- 
 perature is closely observed at this stage, it is found that 
 there is some irregular fever. 
 
 Preventive Treatment is especially important in the case 
 of children with a family tendency to tuberculosis. Here 
 
368 THE BOOK OF DIET. 
 
 the general circumstances of the child, and also the dietary, 
 must be arranged so as to maintain the healthiest possible 
 condition of the digestive tract. Strict precautions are 
 necessary in regard to the milk supply. If the milk supply 
 is above suspicion, it is no doubt best for the child to take 
 untreated milk — that is, milk which has not been boiled or 
 sterilized. There is no question that the artificial treatment 
 of milk by heat and other methods interferes to some extent 
 with its properties as a food. It does so in all probability 
 by altering some vital ingredient present in fresh milk. 
 Since, however, the danger to the child from the use of 
 artificially treated milk is considerably less than that from 
 the use of fresh milk infected with tubercule, it is, as a rule, 
 advisable to recommend the former. It should, however, 
 be noted that the milk should not be sterilized in the manner 
 sometimes done, by exposing it to a very high temperature 
 for half an hour or more, it should be simply scalded (p. 190). 
 An abundance of fresh food is an essential in treatment 
 Milk, eggs, fresh meat, meat juice, fresh vegetables, and fruit 
 should enter largely into the dietary, and an extra amount 
 daily should be insisted upon. Care must be exercised to 
 prevent the immoderate use of farinaceous foods and sweets, 
 which are prone to induce indigestion, and so lower the 
 resistance of the bowels. Lastly, reference may again be 
 made to the importance of fresh air, by night as well as by 
 day, regular meals, and thorough mastication of the food, as 
 being factors of importance in the preventive treatment (see 
 also "Feeding of Delicate Children," p. 218). 
 
XXI. 
 
 COOKERY AND THE PREPARATION 
 OF FOODS. 
 
 COOKING OF FLESH AND 
 FISH. 
 
 When the Meat Juices are to be 
 retained. 
 
 When the Juices are to be ex- 
 tracted from the Meat. 
 
 SOUPS. 
 Nutritional Value. 
 Soup-making. 
 Varieties of Soup. 
 
 Stock-making. 
 Second Stock for Purees, 
 Gravies, and General Use. 
 
 HOME-MADE BEEF-TEAS, 
 EXTRACTS, AND ESSENCES. 
 Meat Infusions or Teas- 
 Preparation of Meat Infusion or 
 
 Tea. 
 
 Beef-tea. 
 Varieties of Teas. 
 
 Beef Essence. 
 Meat Juices. 
 Home-made Meat Juice. 
 
 COOKING OF VEGETABLES. 
 
 COOKERY OF FLOUR. 
 Bread-making. 
 
 Varieties of Bread. 
 
 PASTRY AND PUDDINGS 
 AND CAKES. 
 Cakes. 
 Pastry. 
 Cooking of Pastry. 
 
 PAPER-BAG COOKERY. 
 Paper-bag Cookery. 
 Improvement in the Food cooked. 
 Ease in the House. 
 An Economy in Food, Material, 
 
 and in Fuel. 
 As an Economy. 
 
Chapter XXL 
 
 COOKERY AND THE PREPARATION 
 OF FOODS. 
 
 Cooking of Flesh and Fish — Soups — Beef-teas, etc. — 
 Cooking of Vegetables — Bread-making — Pastry, 
 ETC. — Paper-bag Cookery. 
 
 Cooking may be defined as the process of rendering food 
 attractive and nutritious by the application of heat through 
 different means, and at greatly differing degrees of tempera- 
 ture. Some people contend that the art of cooking results 
 in the persistent overtaxing, instead of lightening, the labours 
 of the digestive organs ; but if some people are fools and 
 "live to eat," that is no reason why the sensible members 
 of the community should not avail themselves of the 
 improvements that the teaching and practice of cookery 
 have introduced. 
 
 The reasons for cooking food are as follows : — 
 
 1. To render mastication easier by softening tough 
 
 animal and vegetable fibres. 
 
 2. To encourage digestion; this is done by softening 
 
 the tissues, by bursting the starch envelopes, and 
 by making the food palatable to the taste and 
 pleasant to the eye. 
 
372 THE BOOK OF DIET. 
 
 3. To combine the right foods in proper proportion to 
 
 the needs of the body. Use and wont has 
 established certain well-known combinations of 
 foods which are found to be quite correct chemic- 
 ally — for example, rice is taken with butter and 
 cream, peas are taken with fat bacon, salt fish 
 is eaten with egg sauce. 
 
 4. To destroy dangerous bacteria and the eggs of para- 
 
 sites in the food — for example, germs of disease in 
 milk, the eggs of the tapeworm and trichinae in 
 meat, mutton, and pork. 
 It will be convenient to consider this subject in the follow- 
 ing order : — 
 
 1. Cooking of flesh and fish. 
 
 2. Soups and home-made beef-teas, etc. 
 
 3. Cooking of vegetables. 
 
 4. Cooking of flour, bread-making, pastry, puddings. 
 
 5. Paper-bag cookery. 
 
 COOEINa OF FLESH AND FISH. 
 
 The chemical composition of meat is modified by cooking, 
 the results varying according to the method of cooking 
 employed. Cooking abstracts a large amount of water, 
 about 20 per cent., also part of the extractives, salts, and fat. 
 A large amount of the extractives are removed by boiling ; 
 hence boiled beef is deficient in flavour. The cooking of 
 animal food develops in it new flavours and a greatly im- 
 proved appearance, two factors of importance in promoting 
 the digestibility of meat. The functions of digestion and 
 assimilation are best carried on at a blood-heat, therefore 
 another object of cooking is to raise the food to a suitable 
 temperature. 
 
COOKING OF FLESH AND FISH. 373 
 
 The effect of different degrees of heat on albumin is the 
 key-note of all the various culinary methods, which are varia- 
 tions of one another, depending on whether the meat juices are 
 to be retained or extracted. 
 
 (a) When the Meat Juices are to be retained there is first 
 a preliminary case-hardening of the albumin by intense heat ; 
 after which, cooking proceeds at a lower temperature, rising 
 in the interior of the meat just to the coagulating point 
 of albumin. This object may be carried out by any of the 
 following methods : — 
 
 (1) Roasting, Grilling, Baking. — The heat used is radiant 
 heat and hot gas. 
 
 (2) Steaming and Boiling. — In this the heat is hot water. 
 
 (3) Frying, Wet or Dry. — This process is carried on by hot 
 oil or hot oil and conduction. 
 
 By following these methods we retain all the nutritive 
 sapid qualities within the portion, leaving none of them, or 
 very little, in the medium used. 
 
 (b) When the Juices are to be extracted from the Meat, 
 the result is a stew or a soup. Stewing first extracts the juice 
 and then cooks the meat in it, and is thus conducted slowly 
 and over a long time. Soup-making aims at extracting as 
 much as possible, and therefore begins in the cold, never 
 rising above 160 F. 
 
 I. Roasting. — In this method of cookeiy the meat is cooked by the 
 radiant heat of a fire from a large glowing surface free from smoke. The 
 meat is exposed to this heat, a few inches from the fire, from five to ten 
 minutes, and is basted with melted dripping, the surface albumin being 
 coagulated to the thickness of a sixpence. After this has taken place the 
 meat is removed one-half to one foot ^rther from the fire, and the cook- 
 ing process is continued slowly at a greatly reduced temperature, the 
 meat being slowly cooked in its own juices. 
 
 If the heat is too great the hardened case is apt to, crack, allowing the 
 juices to escape. To prevent this the meat is basted with hot dripping, 
 
374 THE BOOK OF DIET. 
 
 which prevents charring and cracking of the surface. If properly done, 
 this fat does not soak into the meat. Although the surface heat is very 
 great, the heat in the interior of the joint should not be much above the 
 coagulating point of albumin, and any rise above this renders the meat 
 less digestible, the albuminous matters becoming hard and horny. The 
 inside parts of a properly roasted joint are the best for a weak 
 d^estion. 
 
 This process requires a quarter of an hour per pound for beef and 
 mutton, but longer for veal and poultry. The meat loses weight from 
 expulsion of water — from about 20 to 25 per cent 
 
 2. Baking. — Joints of meat can be well cooked in the oven of an 
 ordinary kitchen range or in a gas-cooker, and the results are very 
 similar to roasting. If the heat of the oven is not properly regulated the 
 results are different, the meat being richer, more flavoured, but more 
 indigestible. This is owing to the process being conducted at too high 
 a temperature after the preliminary case-hardening. 
 
 3. Broiling, Grilling, or Brandtring. — This is a similar process to 
 roasting, and is admirably adapted for quickly cooking a chop, steak, 
 kidney, fish, fowl, or mushroom. The object is the same as in roasting 
 — the formation of a surface skin of coagulated albumin, and the reten- 
 tion within this of all the juices of the meat. The effect of the heat on 
 a thin piece of meat seals the surface, but also coagulates the protein 
 throughout, so that the meat is practically cooked at once. This happens 
 when a chop is cooked on a grill ; the completeness of the sealing is 
 shown by the &ct that the water-vapour produced firom the fluids is 
 unable to escape, and causes the chop to assume the puffy form character- 
 istic of good cooking. 
 
 The sauce par excellence for broiled meat is mushroom ketchup, and the 
 garnish should be a raw vegetable — ^for example, tomato, lettuce, water- 
 cress, or endive. 
 
 4. Boiling and steaming consists in cooking meat or fish, either with 
 hot water or steam, with a view to retain in the meat all the flavours. 
 Here, again, the first step is to copulate a surface layer of albumin by 
 plunging the joint into a large pot of boiling water to which has been 
 added a handful of salt. Salt is added on account of the boiling-point of 
 salt water being higher than that of fresh water. The formation of this 
 hardened case takes about seven minutes ; the pot should then be with- 
 drawn and kept at the side of the fire, the temperature not higher than 
 180° F. I This method is not only much more economical, but the meat is 
 very much more tender if the cooking is slowly conducted over a period 
 
COOKING OF FLESH AND FISH. 375 
 
 of five or six hours. The best method of slow cooking is by steaming 
 the article of food in its own juice ; this can be done most satisfactorily 
 in a Warren cooking-pot or bain-marie. If the boiling is carried to 
 excess and the water really boils, the meat is boiled to shreds. In these 
 circumstances the connective tissue has become gelatinized, and the 
 muscle fibre has become tough like leather, and may often be recognized 
 in the faeces. 
 
 Boiling Fish. — In the case of fish, if the water is boiling the skin will 
 crack and spoil the appearance, and if fish is put into cold water it has 
 much of its goodness and flavour extracted. The best method, therefore, 
 is to put it into water just below the bubbling point and to put vinegar 
 or lemon juice into the water, as the albumin sooner coagulates if acid is 
 added to it. 
 
 Steaming is an excellent way of cooking fish. It retains the flavour 
 and also preserves the shape. 
 
 5. Frying is boiling in oil, but, as practised in this country, is a dirty 
 and wasteful method, being usually a combination of broiling and scorch- 
 ing. There are two forms. 
 
 Dry frying— yi\iu^ is our national form of fiying. A shallow frying-pan 
 is used, and the food is either cooked in its own fat or with the aid of 
 sufficient fat to prevent burning. It is only suitable for fatty food like 
 herrings and sausages, but the products of this form of frying are often 
 greasy, and for many persons exceedingly indigestible. 
 
 Wet frying or saut^ing is, essentially, boiling in oil. For this there 
 is required a deep pan of clarified dripping or of olive oil. If the pro- 
 cess is properly carried out, the food is deliciously cooked and absolutely 
 free from grease. The temperature of the fat is important. When fat 
 islplaced on the fire and reaches 212° F. (the boiling-point of water), it 
 bubbles and makes a hissing sound, due to a small portion of the water 
 in the fat becoming steam and being got rid of. Fat, however, does not 
 boil until it has reached a much higher temperature. At a temperature 
 of 340° F. a slight bluish vapour is given off, and this is the time when, 
 if a piece of bread be dropped in, it becomes brown in a second or two ; 
 on being taken out of the fat, it almost instantly loses its greasy appear- 
 ance. If the fat gets hotter and begins to boil — a state of affairs to be 
 avoided — it begins to smoke and decompose. 
 
 If the object to be fried is coated with egg and bread-crumbs, the 
 crumbs should be very fine, and firmly pressed down, to prevent the 
 grease adhering to the surface and being absorbed by it. 
 
 The best substance to use is second quality of olive oil, or roast-beef 
 
376 THE BOOK OF DIET. 
 
 dripping ; clarified lard should never be used — it is more expensive, 
 and leaves an unpleasant flavour — as the other media for frying are as 
 easily obtained, and are much better. Many specially prepared fats are 
 now on the market. Some are merely beef fat, freed from skin and blood, 
 and melted into cakes ; these are used like suet. Others are solidified 
 cotton-seed oil, or purified nut oil. They are excellent for frying pur- 
 poses, and are economical. 
 
 When the Juices are extracted. — Stewing and braising are 
 processes by which meat and poultry can be prepared and served in the 
 most tender condition possible. 
 
 1. Siewing- aivas at making an extract of nutritive juices of the food, 
 which are then used for cooking. A low, steady heat is wanted ; and 
 since nothing is lost in this process, it is one of the most economical ways 
 of preparing food. The meat is chopped into convenient-sized portions, 
 seasoned (if there are bones, they are also broken up and put into the 
 pot) ; the whole is covered with cold water and a tight-fitting lid put on 
 to the pot, which is placed near the fire, but never allowed to boil. The 
 old saying, "A stew boiled is a stew spoiled," is a true one. If 
 vegetables are to be added, they are best put into the pot after the meat 
 is half done, as the flavours of the vegetables are lost with too continuous 
 cooking. The more slowly the stew is cooked the better it is done. 
 Tough meats are rendered more digestible by the addition of a little 
 vin^ar to loosen their fibres and to convert them into acid albumoses. 
 
 2. Braising is very much the same as stewing. The meat is again 
 slowly cooked in a closed vessel, the meat being just covered with an 
 extract of animal and vegetable juices (stock) instead of water, and by 
 this means the flavour of the meat is improved, the meat becoming 
 impregnated with the flavours. This method is best adapted for foods 
 somewhat insipid in themselves, like veal, poultry, and sweetbreads. At 
 the end of the process the meat should be browned ; this is carried out 
 by having a concave lid in which hot cinders can be placed, or it may be 
 done by radiation before the fire. 
 
 3. Boiling. — This brings us to the consideration of Soups and Soup- 
 making. 
 
 SOUPS, 
 
 Nutritional Value. — The amount of nutriment to be got 
 from a simple soup is very small. Soup-making proceeds 
 upon the principle of taking as much as possible from the 
 
SOUPS. 377 
 
 food materials, the extraction being effected by the use of a 
 considerable quantity of water at a very moderate heat, 
 extending over a long time. A clear soup contains the 
 flavouring constituents and some of the salts of the meat 
 from which it is prepared, also a very small proportion of 
 soluble protein, all the coagulated protein having floated to 
 the top and been removed as a brownish scum during the 
 making ; there is also present a small quantity of fat. Most 
 clear soups contain [only from i to 2 per cent, of solids ; 
 thick soups contain a little more, usually up to 4 per cent. 
 
 If soup is to be made even moderately nutritious, the soup 
 must sir'ply be used as a vehicle by means of which other 
 food materials can be made use of. The following in- 
 gredients are frequently used to thicken soup : — 
 
 1. Starchy materials, such as cornflour, barley, rice, and 
 potatoes J also macaroni and vermicelli, which contain a 
 good deal of gluten. 
 
 2. The pulses — for example, lentils, peas, beans— which 
 make the most nutritious soups. 
 
 3. Eggs, grated cheese, and cream. 
 
 4. Purees of meat, chicken, game, and fish. 
 Soup-making. — In the making of soup the solvent power of 
 
 the water is increased by the addition of a little vinegar to 
 the water. The temperature is kept at a little below 160° F. 
 for several hours. As vegetables require a much greater heat 
 than this to soften them, they should either be first boiled, 
 and then the meat should be added, or the vegetables can be 
 cooked separately, and only added to the soup when it is 
 almost ready; this preserves the colour best. Flavouring 
 herbs should be put in at the last moment. In all soups 
 made from meat, great care should be exercised in the 
 removal of the fat. This is done by the soup being made 
 the day before it is required, put aside in a basin to 
 
378 THE BOOK OF DIET. 
 
 cool, and, when quite cold, the fat carefully skimmed from 
 the top. 
 
 Varieties of Soup. — The term " stock " is usually given to 
 the liquid part, to which the nutritious thickening and other 
 ingredients are added. 
 
 Stock is the foundation of soups, and, to be successful 
 in soup-making, the manufacture of stock is necessary. 
 There are varieties of stock — that is, white, brown, and 
 fish stock. Of white and brown a first and second stock 
 is made. 
 
 White stock is made usually fi-om veal, bone, and remains 
 of poultry and calves' feet. The liquid in which calves' head 
 or fowls have been boiled makes excellent white soup. 
 
 Brown stock is best made from beef, but it lacks the 
 gelatinous substance, therefore stock for good table soup 
 (or consomm^) should have some bones added — shin of 
 beef or knuckle of veal, vegetables being added to colour it. 
 
 Fish stock is made from fish and fish trimmings. 
 
 In the making of stock the meat should be lean and as fresh as 
 possible. It should be wiped with a dry cloth and cut into small pieces, 
 the allowance of water being one quart to every pound of meat ; but, of 
 course, if the water has been evaporated in cooking, more may be 
 necessary. The meat after cutting up should be allowed to lie in the 
 water to dissolve out any soluble constituent, and then the whole should 
 be slowly heated until boiling point is reached. When the scum thrown 
 up by boiling has been removed, the stock should be drawn to the side 
 of the fire and allowed to simmer. The vegetables should be in large 
 pieces, and be added after the stockf has boiled and the scum has been 
 removed — to four quarts of water allow one carrot, one onion, half a 
 turnip, one strip of celery, and about twelve peppercorns. The stock 
 should simmer very gently from five to six hours closely covered, and 
 never be allowed to get cold. Then strain through a hair sieve into 
 a large basin, and stand till cold. When cold the fat must be carefully 
 skimmed off. The meat and vegetables left should be returned ailer 
 straining into the stock-pot and boiled again for second stock. 
 
STOCK. 
 
 379 
 
 " Meat boilings " is the name given to the water in which 
 a joint of meat, fowl, or rabbit has been boiled. 
 
 Stock may be made in a proper stock-pot or in a large 
 goblet. The stock-pot should receive all scraps of meat and 
 vegetables that are over from the preparation of other dishes, 
 also any meat boilings. A sufficient quantity of fresh cold 
 water must always be added, and a little salt to throw up the 
 scum. 
 
 A stock-pot should be kept slowly boiling, gradually con- 
 centrating its contents, and should not stand by the side of 
 the fire in a lukewarm condition. Skim the stock thoroughly 
 once or twice. A few washed egg-shells put into the stock 
 will help to clear it. One whole day is sufficient to boil 
 stock; then strain thoroughly, wash the pan, and set it 
 outside to air. These precautions are necessary to prevent 
 the stock becoming sour from fermentation. 
 
 The bones and any pieces of the meat may be put on next 
 day with any fresh scraps. The vegetables are useless once 
 the flavour has all been extracted. 
 
 Stock and soup should never be allowed to cool in the 
 sauce-pan, but should be poured into basins and left un- 
 covered. The grease that rises to the top should not be 
 removed before the soup is used, as the covering of fat helps 
 to preserve it. If the stock has to be kept some time, it is 
 best preserved by putting into a sauce-pan and bringing it to 
 the boil each day. 
 
 Stock-making. 
 
 Brown Stock. — Three lbs. shin of beef, or 2 lbs. shin of beef and 
 I lb. knuckle of veal, 3 quarts cold water. Ve^eiailes.— One carrot, 
 half a turnip, 2 small onions, I stick celery or half a teaspoonful celery 
 seed, a few parsley stalks. Flavouring. — One teaspoonful mixed herbs 
 (small), 2 dozen peppercorns and cloves, i blade of mace, 2 teaspoonfuls 
 of salt. 
 
38o THE BOOK OF DIET. 
 
 Prepare as described above. A darker-colonred stock may be obtained 
 by frying the meat in a little dripping before ponring on the water. 
 
 White Stock. — Three lbs. knuckle of veal, or 2 lbs. knuckle of veal 
 and I lb. neck of mutton, 3 quarts cold water. Rabbit or chicken may 
 be used instead of the mutton, and a small ham bone improves the 
 flavour. Use fewer vegetables and flavourings than given for brown 
 stock, and make in the same way. 
 
 Fish Stock. — One lb. of white fish (whiting, haddock, or cod), i 
 quart of water. Vegetables. — Slices of carrot, half a small onion, 3 
 sprigs of parsley. Flavouring. — Six peppercorns and a very little salt. 
 Cut up the fish and its bones in small pieces, cook with the water, cook 
 with the vegetables and flavourings for twenty minutes, and then strain. 
 
 Consommi is a clear soup made from first stock, and 
 served with different garnishes. 
 
 Purie is a thick soup made from first or second stock. 
 The thickening may be either meat, game, or vegetables, the 
 substance with which it has been thickened being first rubbed 
 through a sieve. 
 
 The next variety of soup is that which is made on the 
 lines of a good Scotch broth, of meat and vegetables, either 
 boiled in stock or in water. This is known in France aspot- 
 au-feu, and here the boiled meat is intended to be eaten with 
 or immediately after the soup. 
 
 Grand bouillon is a stronger extract than pot-au-feu. It is 
 made from meat and vegetables, to which are added bones 
 and connective tissue for the sake of the gelatine. This, 
 when cold and strained, forms a slightly firm jelly, which 
 can be cleared and flavoured in many ways. (This 
 variety is usually "clear soup.") If an extract sufficiently 
 strong to be termed grand bouillon be taken, and to this 
 is added extract or pur^e of roast meat, fowl, or vege- 
 table, the result is known as a consomme. This form 
 of soup is the most nutritious, because it contains most 
 albumin. 
 
HOME-MADE BEEF-TEAS, ETC. 381 
 
 Second Stock for Purees, Gravies, and General Use. 
 
 After the first stock is made, the meat and vegetables 
 should be put on again with the same quantity of water, and 
 boiled as before. This has not the fresh flavour of first 
 stock, but is useful for making sauces, gravies, and many 
 soups for which a good stock is not required. Sometimes 
 the meat and vegetables are first fried in a little dripping. 
 This gives the stock a darker colour and a richer flavour. 
 
 HOME-MADE BEEF-TEAS, EXTRACTS, AND 
 ESSENCES.* 
 
 Meat Infusions or Teas. — Home-made infusions of beef, 
 mutton, veal, and chicken are always in demand for the 
 sick-room. They are to be regarded more in the nature of 
 pleasant, palatable, and stimulating beverages than as foods. 
 Their nutritive value depends entirely on how they are made, 
 but is always low. 
 
 Preparation of Meat Infusion or Tea. — This is best pre- 
 pared by using meat from the buttock, rump, or thick flank 
 in preference to the " shin of beef." In the same way fillet 
 of veal is preferable to the knuckle or neck. For chicken-tea 
 a full-grown fowl should be selected ; the legs and dark part 
 of the fowl can be used for soup, while the white portion can 
 be served in some other way. In mutton and veal-tea equal 
 parts of the meats are used ; this gives a very delicate flavour. 
 In the process of cooking, the tea must not be allowed to 
 boil, otherwise the juices are not extracted, owing to the 
 insoluble albuminous coating formed on the surface of the 
 meat In every case care must be taken to insure that all 
 the fat is removed from the surface before serving. 
 
 * The patent and proprietary meat extracts are described on p. 141. 
 
382 THE BOOK OF DIET. 
 
 Beef-tea. 
 
 Method i. — The following recipe gives method of extracting the 
 greatest possible quantity of nutriment : i lb. lean juicy beef; i pint 
 cold water ; I small teaspoonfiil salt After removing all skin and 
 fat, shred the meat down as finely as possible. Place the shredded 
 meat in a basin with salt and water, cover the basin with a plate, 
 allow to stand twenty minutes. By the end of the twenty minutes 
 the solution is practically a raw-beef juice. Turn it into a clean, 
 lined sauce-pan, heat slowly, and whisk it well until it almost 
 reaches boiling-point ; on no account let it boil. Draw the pan to 
 the side of the fire, put on the lid, and allow the beef-tea to simmer as 
 slowly as possible for about fifteen minutes. By this time the liquid will 
 be a rich red brown, and the meat will be white. Strain through a 
 coarse strainer, pressing the meat as dry as possible with a wooden 
 spoon. Skim all the fat off carefully before serving. After cooling, 
 the tea will be found to have settled into two layers, a lower layer 
 composed of flocculent particles and an upper layer of brown fluid. 
 The lower flocculent layer consists of the protein, which has been 
 slightly coagulated by the heat. If the tea had passed through a muslin 
 or fine strainer these particles would have been kept back, and the value 
 of the infusion lessened. The upper or fluid layer consists of a solution 
 of the extractives and salts of the meat only. 
 
 Method 2. — The same proportion of meat and water is used. The 
 meat is prepared in the same way, but is placed, after standing in water 
 for half an hour, in a beef-tea jar, and cooked in a very cool oven for two 
 hours. The jars are strong stone jars, with a strong screw lid, and can 
 be obtained from Dale & Co., Edinburgh. This method of making 
 beef-tea gives the best flavour. It may be too savoury for a delicate 
 palate. 
 
 (Caution. — After making beef-tea in this way, the jar must not be 
 opened until the contents are cold. If opened too soon the steam rushes 
 up, and it is very apt to scald the cook's &ce and arms.) 
 
 Varieties of Teas. — There are various ways in which beef- 
 tea may be thickened — for example, with tapioca, bread- 
 crumbs, or baked flour — thus adding considerably to the 
 nutritive value. When permissible, the flavouring can be 
 improved by the addition of vegetables and celery seed ; or 
 
HOME-MADE BEEF-TEAS, ETC. 383 
 
 a muslin bag containing a variety of vegetables can be cooked 
 with the beef-tea and afterwards removed. 
 
 I. Thick Beef-tea. 
 
 Half-pint of made beef-tea. One yolk of egg. 
 
 Salt to taste. 
 
 Beef-tea, veal-tea, mutton-tea, or beef essence may be used in this 
 
 preparation. Warm the beef-tea ; this will probably take about fifteen 
 
 minutes. Beat up the yolk of an egg in a cup, pour the warm beef-tea 
 
 gradually over it, stirring all the time, and it is ready for serving. 
 
 Serve with thin strips of toast. 
 
 2. Half-pint of made beef-tea. One teaspoonful of arrowroot. 
 One teaspoonful cold water. 
 Mix the arrowroot and the water in a small basin until quite smooth. 
 Then add it to beef-tea that is being warmed in a pan ; stir well for 
 a few minutes to prevent its becoming lumpy. Then simmer slowly for 
 fifteen minutes. The beef-tea may also be thickened by sprinkling in 
 one teaspoonful of tapioca groiit, and simmer by the fire for about 
 fifteen minutes. 
 
 3. Beef-tea Gruel. 
 
 One tablespoonful fine oatmeal. One gill beef-tea. 
 
 One gill cold water or milk. Salt. 
 
 Make the gruel (see p. 426). When coolced, add it to the beef-tea ; 
 
 stir them together until quite hot, but do not boil. It is then ready for 
 
 use. 
 
 4. Beef Pcr6e. 
 
 Half-pint good beef-tea. Quarter-pound lean juicy meat. 
 
 Warm in a pan the beef-tea. Wipe and shred very finely a quarter 
 
 pound of meat, pound it well, and rub it through a fine wire sieve. 
 
 Take a cup, make it thoroughly hot, put in the pounded meat, and pour 
 
 on the hot beef-tea. Stir it up well, and serve at once. 
 
 Beef Essence. — One pound of meat will make one gill of 
 essence. Chicken can be prepared in a similar manner. 
 
 Prepare meat as in last recipe, shredding it down very finely. The 
 chicken is jointed and meat chopped down finely. Place in a jar with- 
 
384 THE BOOK OF DIET, 
 
 out any water, with a pinch of salt ; cover with two or three folds of 
 strong greased kitchen paper. Place the jar in a sauce-pan of boiling 
 water, and let it steam slowly from four to five hours. Strain through a 
 coarse strainer, and press the meat well to extract all the juice. This 
 liquid is thus pure extract. When cold, this is in the form of a jelly, 
 and should be served in small quantities. 
 
 Meat Juices. — This variety of food differs greatly in 
 nutritive value from the beef-teas and essences previously 
 mentioned. The meat juice is extracted without any heat 
 and under strong pressure, and thus a large portion of the 
 albumin is present. The preparation and value of the pro- 
 prietary meat juices, such as Brand's and Wyeth's meat 
 juices, are referred to on p. 147. 
 
 Home-made Meat Juice is cheaper than the proprietary 
 preparations, and is more valuable on account of its fresh- 
 ness and the absence of preservatives. It contains a rela- 
 tively small quantity of extractives, and can be given in 
 considerable amounts without causing diarrhoea or thirst. 
 The great drawback to the home-made product is its red 
 colour, which is decidedly objectionable. This can be 
 partially overcome by servii^ in a red glass or a cup. 
 
 I. Raw Bbef Juice. 
 
 Two ounces best rump steak. One ounce cold water. 
 Pinch of salt or sugar to taste. 
 
 Wipe and shred very finely two ounces of meat, pound it well, and 
 rub it through a fine wire sieve. Pour on the water, cover, let it stand, 
 stirring occasionally, for a couple of hours. The liquid will then be a 
 bright red colour, and should be served in a coloured glass. Strain 
 through a fine strainer, pressing the meat with the back of a spoon. The 
 fluid obtained will contain four to five per cent, of protein. 
 
 Meat juice should be made in very small quantities, as it very soon 
 becomes rancid. Another method, such as squeezing the meat in a 
 lemon squeezer, may be tried, but this is wasteful, as the pressure is not 
 su£Sciently powerful to extract all the juice. 
 
COOKING OF VEGETABLES. 385 
 
 ■2.. Bebf-juice Cooked. 
 Half-pound rump steak. Salt and pepper. 
 
 GrUI the lean meat rapidly over a clear fire till cooked. Cut into 
 strips, press out the juice with a lemon squeezer into a hot cup ; season 
 to taste and serve. 
 
 COOKING OF VEGETABLES. 
 
 The methods of cooking vegetables are less varied than 
 those employed in the cooking of meat. In almost all cases 
 the object is to retain in the vegetable as much flavour as 
 possible. Hence boiling is, par excellence, the method. 
 The mechanical action of the heat is of great importance in 
 the cooking of vegetables. The time required to boil them 
 depends upon their age — young vegetables, as a rule, take 
 about twenty minutes, while older vegetables will require 
 about three-quarters of an hour. ' 
 
 All vegetables should be placed in boiling water, to which 
 salt has been added in the proportion of one tablespoonful 
 to every two quarts of water. This improves the flavour, 
 raises the boiling-point of the water, and thus is more 
 softening for tough cellulose, and helps also to retain the 
 colour. As soon as vegetables are sufficiently cooked they 
 should be drained from the water, otherwise they lose their 
 flavour and become discoloured. 
 
 Baking and frying are occasionally the methods, and are 
 fully described under the cooking of meats. 
 
 When the flavour is to be extracted from the vegetables, 
 stewing and boiling are the methods employed. A few may be 
 stewed, and almost all may be boiled to make stock for soup. 
 
 Celery, celeriae, onion, and salsify are the most suitable 
 for stewing. Very little stock or water should be used, and 
 the vessel in which they are cooked must be kept closely 
 covered to prevent steam escaping. 
 
 13 
 
386 THE BOOK OF DIET. 
 
 Where it is desirable to extract the flavour and salts out of 
 vegetables, as in the making of soup, the vegetables are put 
 on to the fire with cold water and subjected to a long process 
 of cooking. 
 
 The following is a good method of preparing a vegetable 
 stock. A few " Vegetable Soups " are referred to in ch. xxii. 
 
 Vegbtablb Stock for Soups. 
 
 2 oz. haricot beans, 
 2 oz. split peas. 
 I piece of turnip. 
 
 I onion. 
 I carrot. 
 J stick of celery. 
 
 Parsley, pepper, salt, 2 cloves. 
 Boil all the ingredients in 2 quarts of water for three or four hours. 
 Skim well. Strain, and, after standing, pour oflf the sediment. 
 
 This should serve as the basis of vegetarian soups and 
 sauces, and be used in the same way as stock made from 
 meat and bones. 
 
 The vegetables and pulses that have been kept back 
 during the straining can again be boiled, and rubbed through 
 the sieve. These make a nice bean or pea soup. 
 
 COOKERY OF FLOUR. 
 
 Bread-making. — The making of bread is possibly the most 
 important of all cooking processes. 
 
 Bread is a mixed food containing fat, protein, salts, sugar, 
 and starch. It does not contain enough fat to be a perfect 
 food, and hence the almost universal custom of using butter 
 with it. 
 
 The chemical composition of bread is thus given by 
 Atwater :— 
 
 Water. Protein. Salts. 
 
 White Bread 35.4 9.5 i.l 
 
 Brown Bread 40.0 5.0 1.9 
 
COOKERY OF FLOUR. 387 
 
 The whole process of bread-making aims at converting the 
 dough (flour and water) into a porous mass. Dough is pre- 
 pared by kneading together by hand or machinery the 
 necessary proportions of flour and warm water. A pound of 
 bread is made from | lb. of flour by the addition of 25 per 
 cent, of water. The porosity of bread, which distinguishes 
 it from biscuit, is obtained by the disengagement within the 
 mass of carbonic acid gas. 
 
 Rice flour boiled is sometimes added in bread-making, 
 causing the bread to become more adhesive and to hold 
 more water. Hence bakers sometimes resort to this means 
 to make their bread heavier when it is sold by weight. 
 
 Fresh baked bread is less digestible than stale bread, the 
 moist new bread forming a tenacious mass in the mouth 
 which is not readily penetrated by the saliva and other 
 digestive juices. Stale bread crumbles into small particles 
 and is easily attacked. Similarly, the crust is more digestible 
 than the interior part of the loaf. 
 
 Spoiled Bread. — Bread may be unfit for use from being 
 made with adulterated or old flour, sour from bad flour, 
 bitter from yeast, and may be sodden from insufficient 
 fermentation; and it may grow mouldy from exposure to 
 warm, damp air when it is moist. 
 
 Varieties of Bread. 
 
 Bakers produce various types of loaves, known by different names. 
 The chief difference is the type of crust and the porosity of the bread. 
 The pan loaf is generally the most porous, and consequently makes the 
 best toast. 
 
 Toast is bread browned by heat in front of an open fire, the starch 
 being partly converted into dextrin in the process. The additional 
 caramel of flavour and dryness acquired lessen the time of digestion of 
 toasted as compared with fresh bread by about one-third. A slice of 
 bread if cut sufficiently thin toasts dry and crisp throughout, but if thick. 
 
388 THE BOOK OF DIET. 
 
 the outer layers are scorched while the mass within may become softei 
 than before toasting. 
 
 Dinner Toast. — Another method of presenting bread to people with 
 weak digestion is by giving very thin slices of bread dipped in milk and 
 slowly browned in the oven. 
 
 Baked Bread. — Slices of bread put into a cool oven and slowly dried, 
 and very slightly browned. The slow baking transforms the starch into 
 dextrin. The bread is hard and needs a great deal of mastication, and 
 with a plentiful supply of butter makes an excellent food for children. 
 Many rusk biscuits are prepared in this way. 
 
 Buttered toast is still another way of serving bread. The crisp toast 
 is buttered when hot, and the fat droplets penetrate it. This is a good 
 method of giving an extra supply of butter, bat is indigestible. 
 
 Brown Breads. — This is an elastic term, meaning that a certain pro- 
 portion of bran or germ, or of both, have been added to the flour. It is 
 also applied to bread made from whole-wheat meal. Any bread made 
 with the addition of bran is richer in mineral constituents. Another 
 difference is the amount of water present. The protein of bran converts 
 some of the starch into dextrin, and this keeps the brown bread moist. 
 There is a smaller proportion of carbohydrates in brown as compared 
 with white bread, and a larger amount of cellulose. For this reason 
 brown bread is recommended in constipation. 
 
 Of the patent breads, the most are of the brown variety. They are 
 made from flours prepared by various patent processes. Some are whole- 
 meal breads, with the bran reduced to varying d^rees of fineness. Others 
 contain the germ in various proportions, such as hovis and Frame food 
 meal. 
 
 Others are matted — for example, bermaline, Carr's, veda, etc. The 
 malting consists in adding malt extract. When the malt extract is 
 mixed with the dough, the latter is ultimately converted into malt sugar 
 and dextrin. This makes the bread keep moist, but its activity is 
 stopped as soon as the bread is placed in the oven, the ferment being 
 destroyed by the heat. Thus malted bread does not aid digestion of 
 other starchy food. 
 
 Vienna bread is made from the whitest flour (the patents), fermented 
 with compressed yeast, and milk often added to the dough. The crust 
 is glazed by being subjected to the action of overheated steam before 
 leaving the oven. 
 
 Pumpernickel is German black bread made with soui dough ; it is 
 somewhat laxative. 
 
VARIETIES OF BREAD. 389 
 
 Zwieback is a thoroughly dry form of aerated bread which is very 
 wholesome for invalids. 
 
 Gluten Bread. — Sread made from gluten flour is useful where there is 
 diabetes, and in some cases of obesity. It is very unappetizing. The 
 best breads contain 40 to 50 per cent, of gluten, but some only contain 
 16 per cent, of gluten, and the rest starch. It can be toasted like 
 ordinary bread. 
 
 Standard Bread. — In 191 1 public attention was directed in the 
 columns of the Daily Mail to the use of " standard bread " in dis- 
 tinction to the white bread generally in use. It was contended that 
 the milling and sifting should be so conducted that not less than 80 
 per cent, of the grain should go into the flour instead of the usual 
 70 to 73 per cent., and that this 80 per cent, should include the germ 
 of the grain at present rejected and also the "semolina" (the com- 
 mercial name of certain grades of the partly ground flour which are 
 rich in protein). It is such 80 per cent, flour to which the name stan- 
 dard flour is applied, and the bread made from it is called "standard 
 bread." In the course of the saltation there was much loose thinking, 
 and many inaccurate statements were made by lay and medical writers 
 on the subject, the majority of whom overrated the importance of the 
 alterations induced in flour by the ordinary milling method. The Sta- 
 tion has, however, been of distinct value in fixing attention on the 
 modem methods of treatment of wheat, and in showing that this may 
 be detrimental to the interests of the public. Of much greater impor- 
 tance, however, than the question of "standard flour" is the question of 
 the present day methods of bleaching flour, and the addition of so-called 
 " improvers," both of which improve the commercial value of the flour 
 to the miller and baker, and, there is good reason to believe, lessen its 
 value to the consumer. Legislative measures directed to these evils are 
 urgently called for. 
 
 Rusks may be regarded as a kind of toast. They are made in much 
 the same way as bread, with the addition of butter and milk, and some- 
 times sugar. They are twice passed through the oven, which thoroughly 
 dries them. 
 
 Biscuits are made from flour, but no yeast is used in the manufacture. 
 They are made from fine starchy flour, and worked into dough, either 
 with water, as ordinary ship biscuits, or with butter, milk, and sugar 
 in the case of table biscuits. All their starch is converted into 
 dextrin, and many good infants' foods are made up largely of biscuit 
 powder. Biscuits contain less water than bread, } lb. biscuit being 
 
390 THE BOOK OF DIET. 
 
 equivalent to I lb. bread. Biscuits are deficient in fat and salts, and are 
 thus not a suitable diet for constant use. Biscuits, claiming to be starch 
 and sugar free, are made for use in obesity and diabetes. 
 
 The bread supplied to sailors at sea has to be of the unleavened sort, 
 and takes the form of "ship biscuits" or "hard tack." These biscuits 
 are exceedingly hard and tough, and require soaking before they can be 
 eaten. 
 
 Most biscuits if kept long exposed to the air become exceedingly 
 tasteless and soft, though they do not mould. 
 
 PASTRY AND PUDDINGS AND CAKES. 
 
 These are prepared in innumerable variety from flour, in 
 various proportions, with milk, cream, butter, sugar, eggs, 
 flavouring agents, nuts, and fruits (such as hazel nuts, walnuts, 
 currants, raisins, pineapple, cherries, ginger). The dough 
 is usually raised by baking powders or whipped white of egg ; 
 sometimes alcohol or yeast are used. 
 
 For puddings a hot fire is used, and the principles of boil- 
 ing, steaming, baking, and frying are employed, so that the 
 flour is altered by the heat much in the same manner as in 
 the manufacture of bread. 
 
 Success in preparing dishes of this class depends more 
 on suitable proportions, manipulation, and proper application 
 of heat than on the materials themselves. 
 
 Puddings made with flour may be divided into the follow- 
 ing groups : — 
 
 I. Boiled and steamed puddings, in which flour, suet, 
 baking-powder, and other ingredients are mixed 
 together, and are then cooked by being immersed 
 in rapidly boiling water, or placed in a basin 
 surrounded by boiling water. 
 
 Steamed puddings are lighter than boiled ones, 
 but take longer to cook. 
 
PASTRY. PUDDINGS, AND CAKES. 391 
 
 2. Milk puddings usually have milk and egg — for 
 
 example, custard, or milk and a farinaceous grain 
 or powder — for example, rice pudding — or consist 
 of milk, eggs, and grain — for example, semolina 
 pudding. 
 
 3. Fritters, where fruit or dough of some sort is dipped 
 
 in a batter of flour and egg, and then cooked in 
 boiling fat. To successfully fry anything coated 
 with batter, the fat must be hot enough to im- 
 mediately harden the surface of the fritters and 
 thus prevent its soaking in. 
 
 4. Souffles and omelets are also types of puddings, but as 
 
 they do not contain flour, they are referred to in 
 another section (pp. 404-406). 
 
 The digestibility of puddings cannot be easily classified. 
 They are rich, and, on the whole, not easily digested, 
 except the "Milk Puddings.'' Sago, semolina, etc., when 
 well made, are useful in the dietary of invalids. 
 
 Cakes, like puddings, are made of many rich things — 
 flour of the best quality, the best fresh butter, eggs, sugar, 
 preserved fruits of different kinds, and almonds. They are 
 mixed in various ways; the simpler ones, when eaten in 
 moderation, are quite wholesome, but rich buttery cakes are 
 not to be recommended for the young, or for the old, or for 
 any one suffering from a weak digestion. 
 
 Pastry is a dough composed of flour and butter or fat. 
 " Lightness " is the quality most desired in pastry, and this 
 depends almost entirely upon the amount of cold air in the 
 pastry when expansion takes place in the oven. 
 
 The best pastry is, therefore, that which contains the 
 greatest quantity of the coldest air prior to baking. The 
 repeated foldings and rollings increase the air in puff paste, 
 while in short paste the lightness is aided by baking powder. 
 
392 THE BOOK OF DIET. 
 
 Cooking of Pastry. — The oven in which it is baked should 
 be hot, for a high temperature is necessary to expand the air 
 or gas, and thus make the pastry light. But pastry, even 
 when well made and light, is a buttery compound, and the 
 high temperature at which it is cooked prevents the whole of 
 the flour being properly cooked, and the uncooked buttery 
 starch is almost always indigestible. 
 
 PAFER-BAa COOKEBT. 
 
 Paper-bag Cookery is the term applied to the cooking of 
 food by means of grease proof paper bags. The method of 
 cooking a cutlet, fillet of beef, etc., wrapped in paper, has 
 long been known as a good way of making the food very 
 tender, but a drawback to its employment has been the 
 liability of the food to acquire a taste from the paper. It is 
 only during the year 191 1, after the introduction of grease 
 proof bags that do not taste the food cooked in them, that 
 the method has become popular. 
 
 This method of cookery claims to have the following 
 advantages : — 
 
 I. Improvement in the Food cooked. — The flavour is 
 better, shrinkage is prevented, the nutritive juices 
 are retained. The special advantages of the 
 method are well seen in the case of tough meats — 
 for example, old poultry or game ; a " tough bird " 
 will seldom be seen if this method of cooking is 
 employed. 
 
 a. Ease in the House. — The method saves the necessity of 
 using pots and pans, and of cleaning the oven and 
 cooking utensils. It also prevents the smell of 
 cooking invading a house. 
 
PAPER-BAG COOKERY. 393 
 
 3. An Economy in Food, Material, and in Fuel, whether 
 gas or coal. 
 
 This type of cooking is very valuable for people who live 
 in flats, and for women or girls living in a single room. All 
 that is required is a small gas oven. The bags take up much 
 less room than an assortment of pots and pans, and the 
 absence of smell of cooking is advantageous. For those 
 living alone a good hot meal can be provided in half-an-hour, 
 and no pots be required, no utensils beyond a plate, knife 
 and fork, and the paper bags. 
 
 Again, in the cooking of tough meat, poultry, or game, the 
 paper bag will be found to improve the flavour, lessen the 
 time necessary for cooking, and reduce the shrinkage. In 
 the cooking of somewhat tasteless foods — for example, fish, 
 sweetbreads — the impnrovement in the flavour is marked. 
 Further, the burning of foods in this process of cooking 
 becomes almost impossible. 
 
 As an Economy. — There is no loss of actual food materials, 
 everything being conserved in this method of cooking. If 
 four pounds of meat are put into the bag, four pounds come 
 out ; in ordinary cooking from one-sixth to one-fourth of the 
 total weight of the meat is lost. There is also economy in 
 regard to fuel consumed, in cases where cooking is done by 
 gas. When gas cooking is employed the shorter time the 
 foods take to cook, and the fact that several foods can be 
 cooked in the same oven at once, materially reduce the 
 amount of gas consumed. 
 
 IZa 
 
XXII. 
 
 RECIPES. 
 
 Milk, 
 
 Milk Diluents. 
 
 Thirst Quenchers. 
 
 Cheese. 
 
 Eggs. 
 
 Peptonized Foods. 
 
 Invalid Foods. 
 
 Meat Extracts. 
 
 Soups. 
 
 Raw Meat Cookery. 
 
 Tripe. 
 
 Sweetbreads. 
 
 Fatty Foods. 
 
 Jellies. 
 
 Sauces. 
 
 Salads. 
 
 Oysters. 
 
 Vegetarian Dishes. 
 
 Diabetic Dishes. 
 
 List of Starch-free Puddings. 
 
Chapter XXH. 
 
 RECIPES. 
 
 MILK. 
 
 The monotonous flavour of milk can be altered in the manner 
 suggested below, which is often found very useful for invalids who 
 must take milk and strongly object to its flavour. 
 
 MUE AND BAKED FLOUR. 
 
 i pint milk. | i teaspoonful castor sugar. 
 
 I tablespoonful lightly-baked flour. 
 
 Lightly colour the flour in a baking tin in the oven ; then, with a 
 
 little milk, rub the flour into a smooth paste. Bring the remainder of 
 
 the milk to the boil and add to the paste ; boil it together for ten 
 minutes, stirring constantly. 
 
 CINNAMON mix. DBINE. 
 
 Boil a sufficient quantity of cinnamon stick with a pint of new milk, 
 to give a pleasant flavour, and slightly sweeten with sugar. 
 
 This may be taken hot or cold. If a little brandy is added it will 
 be found very useful in cases of diarrhoea. 
 
398 THE BOOK OF DIET. 
 
 MALTED MILE. 
 
 I tablespoonful Horlick's malted I i cup hot water, 
 milk I Sugar to taste, 
 
 i cup hot milk. 
 
 Mix the malted milk powder to a smooth paste by adding the hot 
 water gradually and stirring all the time ; then add the J cup of hot 
 milk and sweeten to taste. 
 
 A teaspoonful of port or sherry wine may also be added. 
 
 MILE BOTSIL. 
 
 Make a meat extract preparation as directed on the packages of bovril, 
 lemco, Armour, etc., but prepare with boiling milk instead of water. 
 
 KILK TEA. 
 Warm thoroughly in small china teapot, put in two teaspoonfuls of 
 tea, and just cover with boiling water. Allow to stand for three minutes, 
 then fill up the teapot with boiling milk. Allow this to stand for one 
 minute, then pour off and serve. 
 
 MILK COFFEE. 
 Hot milk may be pleasantly flavoured with a tablespoonful of strong 
 coffee. 
 
 MILK FOSSET. 
 
 I pint milk. i dessertspoonful castor sugar. 
 
 I tablespoonfitl brandy or 2 thin slices of bread, 
 sherry. Pinch of salt and nutmeg. 
 
 Cut the bread into squares, place in a bowl, and sprinkle over it the 
 sugar and the pinch of salt and nutmeg. Pour the boiling milk over 
 the bread and allow it to stand in a warm place, covered, for ten 
 minutes. Stir in the brandy and serve. 
 
 MILK CEREAL (pancreatited). 
 
 Milk, I pint. 
 
 Arrowroot, farina, or baked flour, 
 
 I teaspoonful sugar. 
 
 Benger's liquor pancreaticus, i 
 teaspoonful (or other peptoniz- 
 ing mixture). 
 
 Mix the flour into a paste with a little milk, then stir in the cold 
 milk until it is smooth ; boil until it thickens, stirring all the time ; boil 
 for five minutes longer. 
 
RECIPES. 399 
 
 Then add the peptonizing fluid, and stir constantly until the prepara- 
 tion is the consistence of cream ; bring sharply to the boil, and continue 
 boiling for five minutes. 
 
 WHEY. 
 
 To the pint of fresh milk warmed to blood heat (98 to 100° F.) add 
 2 teaspooniiils of rennet ; set it aside in a warm place for a quarter of an 
 hour, when clotting will have occurred. The clot is then very thoroughly 
 broken up by stirring, and the whole strained through muslin. The 
 whey has percentage composition of water 93, lactose 5i albumin .8, 
 ash .6, fat 3. It is practically an aqueous solution of milk sugar. It is 
 apt to turn sour. 
 
 Whey makes a palatable drink, with slightly diuretic and laxative 
 properties. Whey cures, where up to 5 pints of the whey are taken in 
 twenty-four hours, have been established for the treatment of renal and 
 dropsical affections. 
 
 Lemon Whey. — Whey can also be prepared from milk by boiling with 
 lemon juice — for example, boil a pint of milk with 2 teaspoonfuls of 
 lemon juice. Strain in muslin ; squeeze out all fluid from the curd. 
 The whey can be added to beef-tea, or yolk of egg beaten up in hot 
 water. 
 
 Wine Whey. — Whey may be similarly prepared by boiling \ pint of 
 milk with \ glass of white wine — for example, sherry — and adding 
 sugar to taste. 
 
 MILK DILUENTS. 
 
 BABLEY WATER. 
 
 (A diluent for milk. ) 
 I oz. pearl barley (Robinson's). | i pint cold water. 
 
 Blanch the barley by putting in a pan on to the fire with enough 
 cold water to cover it ; bring it to the boil and then pour the water 
 away. After this put on the barley and \ pint of water ; simmer slowly 
 down to f of a pint, and then strain. 
 
 When used as a diluent for infant feeding a fresh supply must be 
 made twice daily. 
 
400 THE BOOK OF DIET. 
 
 BABLET LEMON WATEB. 
 {A thirst quencher ; a sedative for an irritable bladder.) 
 2 oz. pearl barley. I Lemon rind. 
 
 I pint boiling water. I Sugar to taste. 
 
 Blanch the barley as above. Pour boiling water over the barley, 
 lemon rind (from i lemon), and sugar, and stand beside fire for half an 
 hour, covered over. Strain before using. 
 
 SICE WATEB. 
 
 ( Useful in dysentery and diarrhcea ; a milk diluent — infants or 
 
 adults ; a thirst-quenching drink. ) 
 I tablespoonful rice. | i quart water. 
 
 Soak I tablespoonful of well-washed rice in a quart of water by stand- 
 ing beside fire for three hours ; then boil slowly for three hours, and 
 strain. 
 
 OATMEAL WATEB. 
 
 I tablespoonful oatmeal. | I pint boiling water. 
 
 Mix I tablespoonful of oatmeal with a pint of boiling water, and boil 
 slowly for one hour. Add water to make up the quantity after boiling 
 to one pint, then strain. 
 
 TOAST WATEB. 
 I slice crust bread. | i pint cold water. 
 
 Toast the bread very brown and hard, but do not bum it. Break the 
 pieces of toast into a jug of cold water. Let it soak for one hour, then 
 strain and use. The water by this time should be the colour of sherry. 
 
 GELATINE JELLY. 
 
 {For Infant Feeding, p. 194.) This is used in the proportion 
 
 of I tablespoonful to 4 ounces of milk and water. 
 I tablespoonful French leaf I \ cup cold water, 
 gelatine. I 
 
 Soak I teaspoonfiil of fully broken-np leaf gelatine in half a pint of 
 cold water for three hours. Then stand it in boiling water, which is 
 kept boiling until the gelatine is dissolved. 
 
RECIPES. 401 
 
 THIRST QUENCHERS. 
 
 APPLE WATER. 
 
 2 large apples. I Lemon to flavonr. 
 
 2 or 3 lumps sugar. | I quart boiling water. 
 
 Feel and slice apples and put them into a jug with lemon and sugar. 
 Pour over the boiling water, and put in a warm place until contents are 
 quite soft. Keve the apples, and bottle. 
 
 A piece of toast well browned and cut up and put into the apple 
 water for about half an hour and strained makes a pleasant drink. 
 
 Barley water or rice water mixed with apple water in equal parts and 
 strained also makes a nice drink. 
 
 Fruit drinks can also be made from rhubarb, black and red currants, 
 raspberries or gooseberries, in the same way. 
 
 BLACK CURRANT DRINK. 
 
 Juice of a lemon. 
 
 I teaspoonful rice flour. 
 
 I pint boiling water. 
 
 1 dessertspoonful black currant 
 jelly. 
 
 2 lamps sugar. 
 
 Put the jelly, sugar, and lemon into a saucepan, and pour over the 
 boiling water. Allow to simmer about twenty minutes and strain. Mix 
 the rice flour in a little cold water and pour into the mixture, and stir 
 over the fire until clear. Put into a cool place until cold. 
 
 IMPERIAL DRINK. 
 
 J oz. cream of tartar. I Lemon juice or essence to flavour. 
 
 8 lumps sugar. I I quart water. 
 
 Put all into the boiling water, stir well, and allow it to get quite cold. 
 
 LEMON SQUASH. 
 
 I lemon, | i small bottle soda water. 
 
 2 lumps sugar. 
 
 Squeeze and strain the lemon juice into a glass, add the sugar, and 
 lerve while effervescing. 
 
402 THE BOOK OF DIET. 
 
 LEMONADE (1). 
 Rind and juice of i lemon. I I pint water. 
 
 8 lumps sugar (or to taste). I i white of egg. 
 
 Melt sugar in the water, add the lemon, and pour over the egg, which 
 must be stiffly beaten. 
 
 IfUONADE (2). 
 
 Juice of 2 lemons and rind of I. | 6 lumps sugar. 
 
 2 pints boiling water. 
 Strain the juice of the lemons. Put the sugar, and lemon juice, and 
 rind into a basin and pour over the water ; strain, and allow it to get 
 cold. 
 
 ORANGEADE. 
 
 2 oranges. I 2 lamps sugar. 
 
 Juice of I lemon. I i pint boiling water. 
 
 Peel the orange finely and put the peel, sugar, and water in a sauce- 
 pan. Simmer for J hour and strain, and then strain the juice of the 
 orange and lemon into it. Stir and allow to cool. Ice can be served 
 with it. 
 
 CHEESE. 
 
 Methods of Use in Cooking. 
 CHEESE OMELET. 
 
 3 eggs. 
 
 I tablespoonful grated Par- 
 mesan or American cheese. 
 
 I tablespoonful cream. 
 Flavourings of pepper and salt. 
 
 Have the eggs thoroughly beaten ; add the flavourings, cheese, and 
 cream. Have ready a hot greased omelet pan, pour in the prepared 
 mixture, and stir over the fire until half set. Fold over the omelet and 
 cook until lightly browned. Serve immediately. 
 
 CHEESE FRITTERS. 
 
 2 whites of egg. I Flavourings — pepper, salt, 
 
 2 oz. grated cheese. I cayenne. 
 
 Season the grated cheese, and stir lightly into the well-whisked white 
 of egg. Have prepared a deep pan of boiling fet ; drop in small spoon- 
 fuls, and fry until nicely browned. Drain off the fat. Serve with 
 fried parsley and grated cheese. 
 
RECIPES. 403 
 
 CHEESE BALLS. 
 
 2 tablespoonfuls grated cheese. 1 i egg. 
 
 I tablespoonful flour. | Flavouring. 
 
 Make a paste by mixing the cheese, flour, and yoke of egg together, 
 and add flavouring to taste ; then stir in the well-beaten white of egg. 
 Have ready a pan of boiling fat, and fry small balls of this until 
 nicely browned. 
 
 EGGS. 
 
 Methods of serving raw eggs have been described on p. 53. When 
 cooked alone they can be sent to table plain boiled, poached, scrambled, 
 or baked. 
 
 They can be used as thickening for soup or added as custard, as 
 on p. 412 (under " Consomm^ "). 
 
 Eggs, mixed with milk and various flavourings, can be served as 
 custards, omelets, and souffles. 
 
 SOILED CUSTABD. 
 
 i pint milk. 
 
 2 yolks of eggs and i white. 
 
 I oz. sugar (loaf or castor). 
 
 A few drops of flavouring — 
 vanilla, etc., or lemon rind, 
 or bay leaf. 
 
 Rinse out a pan with cold water. Put in the milk and flavourings, 
 and simmer until flavoured, and add the sugar. Strain this on to the 
 eggs, stirring all the time, then return the mixture to pan and stir by side 
 of fire until it thickens. This method is very apt to curdle, and to an 
 inexperienced cook it is better to place the egg and milk, etc., in a jug 
 and stand in the pan of hot water and cook until it thickens. 
 
 Two tablespoonfuls of cream, stirred in about five minutes before 
 the custard is allowed to cool, is a great addition. 
 
 BASED CUSTASD. 
 
 2 yolks and i white of egg. I i oz. loaf or castor sugar. 
 J pint milk. I Flavouring. 
 
 Beat up the eggs, add the sugar and the flavouring, and add the milk. 
 Strain into a buttered pudding dish, and bake in a slow oven (thirty 
 minutes) until set. When the oven is hot, place the pudding dish in 
 a tin of water to prevent the custard baking too quickly. 
 
404 THE BOOK OF DIET. 
 
 A slice of sponge cake or some sponge cake crumbs sprinkled on the 
 top of the pudding when nearly finished cooking makes n. pleasant 
 variety. 
 
 CABAMEL CiraTABD. 
 
 For the caramel, 2 oz. loaf sugar, 2 tablespoonfuls of cold water. 
 
 For the custard, quantities as under custard pudding. 
 
 Boil the loaf sugar and cold water together until the fluid becomes 
 a good brown shade, then pour it into a plain mould, and coat all the 
 sides and bottom with the caramel. Prepare the custard as in custard 
 pudding. Strain the custard into the mould, cover with a greased 
 paper, steam very slowly for forty minutes, turn out carefully. A little 
 more caramel sauce may be poured round it. 
 
 This pudding can be served hot or cold. 
 
 OMELETS. 
 Eggs may also be advantageously used as omelets, as follows : — 
 
 How TO MAKE AN OmELET. 
 
 For an omelet of z eggs, break them into a bowl, add salt and pepper, 
 and beat them with a fork for about a minute — not longer, as a rule. 
 When the eggs are sufficiently beaten they "run" off the fork in a 
 homogeneous liquid, without any glutinous appearance. It is not 
 necessary to beat for several minutes, with the idea that the more the 
 eggs are beaten the lighter the omelet. This is a great mistake, as too 
 much beating causes eggs to lose their consistency. It is, however, 
 better to beat too much than too little. Place the pan on the fire to 
 warm it, put in a small piece of butter — about the size of a hazel-nut for 
 an omelet of 2 or 3 eggs. Add the contents of the bowl when the butter 
 steams. If this precaution is taken, the omelet will not catch, as the 
 high temperature of the butter isolates the eggs. It is therefore a 
 mistake to shake the eggs directly they are poured into the pan. But 
 a second or two later the fork must be passed round the sides of the 
 pan to loosen the eggs, and then they are worked in all directions with 
 the back of the fork as if they were scrambled. When they are sufficiently 
 cooked they look, in fact, almost like scrambled eggs ; but now the omelet 
 is shaken on to one side of the pan, and with the fork one half is folded 
 on the other and slid on to the dish. The shape of the omelet is thus 
 obtained without difficulty, and the heat of one half just finishes the 
 cooking of the other as it rests upon it. 
 
RECIPES. 405 
 
 Sweet Omelets. 
 Omeht Souffle {Sweet). 
 White sugar, I tablespoonful. 1 2 eggs. 
 
 Pinch of salt. | A little powdered vanilla. 
 
 Take two bowls. Put into one of them i teaspoonful of white sugar ; 
 into the other a pinch of salt. Break 2 eggs ; separate the yolks, and 
 drop one yolk at a time into the bowl containing the sugar ; whip them 
 well with a wooden spoon and they become creamy like a mayonnaise. 
 Add a little powdered vanilla to another J teaspoonful of sugar, and mix 
 with the yolks. Put the whites of the eggs into the bowl containing the 
 salt, and whip into a stiff froth. Mix with the yolks as lightly as possible, 
 and pour the contents into a buttered dish in the shape of a pyramid. 
 Cover it with sifted sugar, and leave it for three or four minutes on the 
 side of the stove. Then put it into the oven for ten to twelve minutes, 
 turning the dish occasionally to colour it on all sides. Make two or 
 three incisions with a knife, and serve immediately. This omelet must 
 be eaten as soon as it is cooked, or it loses both its shape and its 
 delicacy. 
 
 Snowball Eggs. 
 
 I pint milk. 
 
 Rind of lemon, or vanilla. 
 
 3 eggs- 
 
 I J tablespoonfuls powdered white 
 sugar. 
 
 Sugar to taste. 
 
 Place I pint of milk in a saucepan on the fire with the rind of a 
 lemon or a little vanilla, and sufficient white sugar to sweeten. 
 
 Break 3 eggs, separating the white from the yolk. Put ij teaspoonfuls 
 of powdered white sugar on a plate. Beat the whites of the eggs into 
 a stiif iroth, adding a small pinch of salt. When sufficiently stiff, add 
 the sugar and mix briskly. Take a teaspoonful of this mixture and 
 throw it into the boiling milk in the saucepan ; turn it three minutes 
 later ; remove it with a skimmer and place it on a dish. Take as many 
 spoonfuls of the white of egg as remain and cook them in a similar 
 manner, three or four at a time. (If the white has been beaten sufficiently 
 stiff, when cooked each spoonful will be a compact mass.) Dress the 
 snowballs in a pyramid on a dish. Pour the remainder of the milk from 
 the saucepan into the yolks of the eggs ; put this mixture into another 
 saucepan on the fire, turn it constantly with a spoon, and let it thicken 
 without boiling. Pass it through a strainer, and when cold pour it over 
 the snowballs in the dish. 
 
4o6 THE BOOK OF DIET. 
 
 Savoury Omelets. 
 Omelet with Tomatoes. 
 
 Break the eggs into a bowl, with salt and pepper ; beat them for a 
 few minutes with a fork, place the omelet pan on the fire to warm, add 
 a lump of butter. When the butter steams pour in the eggs. Make 
 little incisions with a fork to let the heat reach the eggs in all parts ; 
 pass a knife round the edge of the pan to prevent the eggs from 
 "sticking"; fold one half on the other as soon as they begin to get 
 firm, and shake the omelet on to a hot dish. Four over it a good 
 tomato sauce. 
 
 Bread Omelet. 
 
 Put I tablespoonful of crumbled bread into a saucepan with J gill of 
 cream, salt, pepper, and nutmeg. When the bread is swollen with the 
 cream, break 3 eggs, beat them, and make an omelet. 
 
 PEPTONIZED FOODS. 
 
 FEFTONIZED MILK. 
 I pint milk. I 2 teaspoonfiils liquor pan- 
 
 J pint water. I creations. 
 
 20 grs. (\ small teaspoon) bicarbonate of soda. 
 
 Method I. — Allow the milk to stand. Skim off the cream. Dilute the 
 skimmed milk with i pint of water, and heat to a temperature of 140° F. 
 Mix with the warm milk the liquor pancreaticus and 20 grs. of bicarbonate 
 of soda. The mixture is poured into a covered jar, with a tea-cosy over, 
 and left near the fire. Let it stand one hour and a half. Let the 
 mixture boil for two or three minutes to arrest any fiirther fermentative 
 action, which will make the milk unpalatable. Add the cream that was 
 removed, and it is ready for use. 
 
 When peptonized by the cold process, described below, the milk has 
 no taste or evidence of the presence of the peptonizing agent, and is 
 especially suitable for dyspeptics. 
 
 Method II. — Mix the peptonizing agent in cold water and cold milk as 
 above, and immediately place the bottle on ice without subjecting it to 
 any heat. When needed, pour out the required portion, and use in the 
 same manner as ordinary milk. 
 
 Note. — It is sometimes found that the cold process is sufficient, but 
 the warm process is the better of the two. 
 
RECIPES. 407 
 
 EFFERVESCENT PEPTONIZED MILE. 
 
 Put some finely crushed ice in a glass, and then half fill it with 
 ApoUinaris, Vichy, or carbonated water as preferred, and then pour it 
 quickly into the peptonized milk and drink during effervescence. It 
 is agreeable to many patients to put in a little grated nutmeg ; or the 
 peptonized milk may be sweetened, or flavoured with a little brandy. 
 
 PEPTONIZED MILE GRUEL. 
 
 This is an artificially digested milk, and forms a complete and highly 
 nutritious food for weak digestions. It was a favourite preparation of 
 Sir W. Roberts. A thick gruel is made from farinaceous material (see 
 p. 280). To the boiling gruel add an equal quantity of cold milk. It 
 will then have a temperature of about 140° F. To each pint of the 
 milk gruel add 3 teaspoonfuls of liquor pancreaticus and 20 grs. of 
 sodium bicarbonate (or other peptonizing agent). Let it stand covered 
 for two hours in a warm place ; boil for five minutes, and strain. 
 Most invalids will take this without the least objection, as the peculiar 
 flavour of predigested milk is quite masked by this process. 
 
 Note. — Peptonized gruels are acted upon by the ferment, the starch 
 being turned into sugar, and the albuminoid matters are peptonized. 
 The gruel should be very well boiled, and can be made from any 
 farinaceous article in use, such as oatmeal, Quaker oats, etc. 
 
 PEPTONIZED MILE LEMONADE. 
 
 Juice of I lemon. 1 i gill effervescing water. 
 
 I gill peptonized milk. I I tablespoonful sugar and rice. 
 
 Fill a small tumbler one-third full of crushed ice, add the water, 
 lemoi. juice, and the sugar to the ice, and fill up the glass with milk. 
 
 PEPTONIZED MILE PUNC?. 
 
 Fill a small tumbler about one-third full of crushed ice, and pour on 
 to it a tablespoonful of St. Croix rum, and half a tablespoonful of 
 brandy ; then fill the glass with peptonized milk, stir well, sweeten to 
 taste, and grate a little nutmeg over the top. 
 
 PEPTONIZED MEAT. 
 To 4 a pint of water add 4 ounces of minced meat, and bring 
 gradually to the boil. Reduce the temperature to about 140° F. by 
 adding \ a pint of cold water, and add 30 grs. of zymine or some other 
 
4o8 THE BOOK OF DIET. 
 
 peptonizing agent, and 20 grs. of bicarbonate of soda. Keep warm for 
 three hours, and the meat will be peptonized. 
 
 PEPTONIZED MEAT, BROTHS, AND TEAS. 
 i lb. lean beef finely minced. I i tablespoonful liquor pancrea- 
 20 grs. bicarbonate of soda. I ticus. 
 
 I pint water. 
 
 Mix all together, and simmer slowly for an hour and a half ; when it 
 has cooled down to 140° F. add liquor pancreaticus ; keep it covered 
 in a warm place for two hours, shake it occasionally, then strain off the 
 liquid and boil five minutes. 
 
 Note. — This has a nitrogenous value almost equal to milk. The tea 
 can be flavoured with celery seed, or vegetables, or thickened with sago, 
 breadcrumbs, etc. 
 
 INVALID FOODS. 
 
 INVALID FOOD. 
 
 I oz. invalid food. | J pint boiling milk. 
 
 4 tablespoonfuls cold milk. 
 
 Mix the food into a paste with 4 tablespoonfuls of cold milk. Add 
 i pint milk gradually, which should be almost boiling ; keep stirring all 
 the time. Put in a warm place for twenty minutes, then boil altogether 
 for a minute, stirring all the time, and strain if necessary. This can be 
 taken as an invalid food or used in making other dishes. 
 
 CUSTABD PUDDING. 
 
 ^ pint invalid food made with I 2 e^s. 
 milk. I 2 teaspooniiils sugar. 
 
 Prepare the food according to the direction on the tin ; after it has 
 cooled, add the sugar and the eggs (well beaten). Flavour with nutmeg, 
 cinnamon, or grated lemon rind as desired, and pour into a greased 
 dish, and bake in a moderate oven ten to fifteen minutes. It can be 
 served hot or cold. 
 
 BATTER PUDDING. 
 
 i pint invalid food made with I 2 eggs and a pinch of salt, 
 milk. I 
 
RECIPES. 409 
 
 Take the prepared food and let it boil up. When it is cool add the 
 salt and eggs (well beaten). Pour the mixture into a greased basin, cover 
 with greased paper, and steam slowly for half an hour. Do not fill the 
 basin too full, as the pudding will rise. When done, it is firm to the 
 touch. It can be served with sugar, preserves, or meat gravy. 
 
 INVALID FOOD JELLY. 
 
 i pint invalid food with milk. I 2 teaspoonfiils castor sugar and 
 
 J oz. French leaf gelatine. I flavouring. 
 
 Make the invalid food. While hot add the gelatine, and stir over 
 the fire until dissolved. Add the sugar and any suitable flavouring- 
 port, sherry, lemon, or vanilla. Pour into a wetted mould until set. 
 Turn out and serve cold. 
 
 TO PREPARE PEPTONIZED COCOA AND MILK WITH 
 INVALID FOOD. 
 
 Take i tablespoonful of the food (J ounce) and i or 2 teaspoonfuls 
 of cocoa (any good brand). Mix together in a basin and add gradually 
 8 tablespoonfuls of cold water. Then add slowly I pint of boiling milk 
 and water (half and half) ; set aside for ten or fifteen minutes, then pour 
 into a saucepan and bring to the boil. Sweeten to taste. It is ready 
 when cool. Take half the above quantities for a breakfastcup. The 
 natural digestive principles contained in the invalid food digest the 
 cocoa as well as the milk with which it is mixed. 
 
 INVALID FOOD WITH CHOCOLATE. 
 
 Prepare the food according to the directions on the tin, then add the 
 chocolate (grated). Those who are not fond of chocolate can have it 
 flavoured with cinnamon ; and for this i inch or so of cinnamon stick 
 will be enough for a breakfast cup of invalid food ; or, if lemon is pre- 
 ferred, a small piece of lemon rind pared off' thinly may be added. 
 
 mVALID FOOD AND RAW EGQ. 
 
 Beat up a fresh egg to a froth, add the prepared food gradually, 
 stirring the while. Brandy, sugar, or other flavouring may be added if 
 desired. 
 
 J^ote, — ^The food should not be hotter than can be sipped comfortably 
 when the egg is added. 
 
410 THE BOOK OF DIET. 
 
 ARROWROOT FUDDINO HADE WITH PREPARED 
 INVALID FOOD. 
 
 1 tablespoonfiil arrowroot. I A little grated nutmeg. 
 
 2 teaspoonfiils sugar. I I egg. 
 
 i pint invalid food. 
 Mix the arrowroot with a little cold water, add the prepared food to 
 the mixture while stirring, return the whole to a saucepan, and boil three 
 or four minutes ; add the sugar and nutmeg, beat up the egg, and add 
 to the mixture. Pour into a buttered dish and bake in a slow oven, 
 
 QUEEN PUDDINa MADE WITH PREPARED 
 INVALID FOOD. 
 
 i pint prepared food. 
 I oz. butter. 
 
 2 tablespoonfuls castor sugar, 
 i pint white breadcrumbs. 
 Flavour with vanilla or lemon 
 rind. 
 
 2 eggs. 
 
 I tablespoonful jam. 
 
 Mix the breadcrumbs, i tablespoonful of sugar, and the butter together 
 in a basin ; pour over these the prepared food, and stir in the yolks of the 
 eggs (well beaten) and the flavouring; pour the whole into a buttered dish, 
 and bake twenty to thirty minutes, or until set. Then spread the jam on 
 the top, beat up the whites of eggs to a stiff froth, add to them the re- 
 mainder of the sugar, pile this on the top of the pudding, and return 
 to the oven until set. Serve hot or cold. 
 
 SAQO PUDDINO MADE WITH PREPARED 
 INVALID FOOD. 
 
 I oz. sago. 
 
 Pinch of salt. 
 
 I oz. castor sugar. 
 
 A little grated lemon rind. 
 i oz. butter. 
 J pint water. 
 
 J pint prepared food. 
 Put sago into a saucepan with the water and salt, and slowly simmer 
 for from twenty minutes to half an hour. Then add the food, sugar, 
 lemon, and egg (well beaten). Pour into a buttered dish, and bake in 
 a slow oven for about half an hour. Semolina may be used instead of 
 sago if preferred. 
 
 MEAT EXTRACTS-BOVRIL, 
 LEMCO, ETC. 
 
 EXTRACT SOUP (1). 
 Make the soup according to directions, and add albumin water (p. 53) 
 made from the white of one or more eggs. 
 
RECIPES. 411 
 
 EXTEACT SOUP (2). 
 Place a. beaten-up egg in a bowl, and pour over it a pint of hot 
 extract soup. 
 
 MILE BOVBIL (see p. 398). 
 
 EXTRACT CUSTAED. 
 Take "Milk Bovril," and to this add one or two eggs as directed 
 under custards, and a delightfully flavoured dish is prepared. 
 
 HEAT JUICE WITH MILE. 
 J lb. lean beef. | i pint milk. 
 
 Beef extract for flavouring. 
 Pass the steak through mincer, and scrape very fine. This should 
 give about 7 oz, of meat pulp. Mix thoroughly with the milk and pass 
 through a fine strainer. This should give about a pint of fluid of the 
 consistency of cream. Add a teaspoonful of the extract for flavouring. 
 This preparation can be warmed by standing the vessel in hot water. 
 
 STEAMED EGQS. 
 
 I fresh egg. I i teaspoonful of extract. 
 
 I tablespoonful milk. | Salt to taste. 
 
 Mix the milk and extract together, gently drop the egg into it, and 
 sprinkle with salt. 
 
 Stand the cup in a saucepan, with sufficient water to come up half 
 way. 
 
 Boil slowly for five minutes, and turn on to a slice of buttered toast. 
 
 SAVOUBV SCRAMBLED EGGS. 
 
 I egg. I I tablespoonful milk. 
 
 Meat extract. 
 
 Beat up an egg. Add the milk and meat extract. Melt a little butter 
 
 in a saucepan, and when thoroughly hot pour in the egg and milk 
 
 mixture ; keep beating with a fork until the egg is set. Serve on slice 
 
 of hot buttered toast. 
 
 SAVOURY VEAL JELLY. 
 
 I pint jellied veal stock. | i egg. 
 
 I teaspoonful meat extract. 
 
 Melt the veal stock, and in it dissolve the meat extract, and beat up 
 
 the egg. Mix the three ingredients and add salt to taste. Place in a 
 
 basin, and when cold a nicely flavoured jelly can be turned out. 
 
412 THE BOOK OF DIET. 
 
 SOUPS. 
 
 CLEAR SOUP OR CONSOMH^. 
 
 I quart good jellied stock (see I 8 oz. lean meat (from neck of beef), 
 stock-making, p. 379). I The whites and shells of 2 eggs. 
 
 When stock is cold carefully remove all the fat. Put stock in a well- 
 lined saucepan, add the meat finely chopped or shredded down (as in 
 beef-tea making, p. 382), the shells of the eggs, washed and crushed, 
 and the whites. Whisk all together over the fire until just on boiling — 
 then stop whisking ; allow the stock to boil up, and then draw the pan 
 to the edge of the fire ; cover it with a plate, and allow it to stand for a 
 quarter of an hour, keeping hot, but not simmering. Strain through a 
 warm, clean cloth into a basin, and repeat the straining until the soup 
 is quite clear ; this may have to be done two or three times. 
 
 Serving. — Re-heat the soup, season to taste — a knot of sugar added at 
 the last makes the soup sparkle. The flavour may be altered by the . 
 addition of a glass of sherry or a dessertspoonful of white vinegar or 
 lemon. This consomm^ may be served with a variety of garnishes, such 
 as egg, vermicelli or Italian paste, sago or semolina — for example : 
 
 I. 
 Pour a pint of boiling consomm^ slowly into a basin containing a well- 
 beaten-up egg, stirring briskly all the time. The egg curdles and forms 
 golden threads. 
 
 II. 
 
 Make a small custard by placing the yolk of an egg, pepper and salt, 
 or a tablespoonful of white stock, in an egg cup ; cover over with greased 
 paper, and cook in oven until firm to the touch (about ten minutes). 
 Cut the custard into small dices and add to a soup-bowl of hot consomm6. 
 
 III. 
 
 I pint consomm^. | I teaspoonfiil Italian paste. 
 
 Into the soup sprinkle the Italian paste, and cook for a few moments 
 before serving. 
 
 I pint consomm6. | i tablespoonful fine sago. 
 
 Wash the s^o well, sprinkle into the boiling stock, and cook until 
 the sago becomes transparent (about twenty minutes). 
 If necessary, add more flavouring. 
 
RECIPES. 413 
 
 V. 
 I pint consomm^. | i tablespoonful semolina. 
 
 Stir into boiling soup, and cook for twenty minutes, stirring all the 
 time. If necessary, add flavourings. 
 
 MEAT JEUT. 
 
 Meat, veal, or chicken jelly can be obtained by preparing the meat and 
 chicken as in beef-tea No. 2 (p. 382) and serving it cold. A restorative 
 meat jelly may bemade in one or two ways, either from beef with an 
 ox-foot or from knuckles of veal. 
 
 EESTORATIVB MEAT JELLY. 
 
 I lb. shin of beef. i slice turnip. 
 
 I ox-foot. 2 slices carrot. 
 
 I quart cold water. Pinch of salt. 
 
 Get the ox-foot broken in several pieces, split it between the toes, and 
 remove all the fat and the marrow from the bones ; wash thoroughly,?and 
 blanch by placing in cold water and bringing to the boil ; place in basin 
 of cold water, and scrape thoroughly. 
 
 Cut up the beef into small pieces ; place it, with the prepared ox-foot, 
 water, vegetables, and salt, in a close-fitting jar (see p. 382). Place jar 
 in the oven, or in a saucepan of boiling water, to cook for seven to nine 
 hours. Slowly open the jar when cooled, strain and skim, and pour 
 into a small dish or bowl. This can be served as a jelly, but is excellent 
 when heated as a soup. 
 
 VEAL JELLT. 
 
 I lb. knuckle of veal. 2 thin slices turnip. 
 
 I lb. mutton. (i stick celery.) 
 
 I quart cold water. Pinch of salt. 
 
 Slice the veal and mutton thinly arid break up the bone, and place in 
 a jar with the vegetables, salt, and water. Cover the jar with a close- 
 fitting lid or several layers of strong paper. Cook in a, saucepan of 
 boiling water coming half-way up, slowly, for from four to six hours, or 
 cook in the oven. Open the jar when slightly cooled, strain, skim 
 off fat carefully, mould in small dishes, and serve cold in form of a jelly. 
 
 Sweet jelly may be made from calves' feet or from gelatine. The 
 former takes more time and is more troublesome to make than jelly 
 from gelatine. The more delicate flavour repays the labour when the 
 jelly is for an invalid. Both methods, however, are given. 
 
414 THE BOOK OF DIET. 
 
 CALF'S FOOT JELLT. 
 
 2 calves' feet. 
 
 6 oz. sugar. 
 
 Whites and shells of 3 eggs. 
 
 Lemon juice, ^ pint. 
 
 Rind of three lemons. 
 J inch of cinnamon. 
 4 cloves. 
 2 glasses sherry. 
 
 Water, 2j quarts. 
 
 Wash and blanch the feet and divide in several pieces. (See " ox- 
 foot" recipe, restorative meat jelly, p. 413.) 
 
 Simmer the calves' feet slowly in water for from six to eight hours, 
 skimming from time to time. Strain the stock into a basin and measure. 
 There should not be more than one quart of stock ; if there is, boil again 
 until stock is reduced to a quart. When quite cold, very carefully 
 remove all fat from the top. Turn the jelly into a well-lined saucepan, 
 and add finely-cut rind of lemon, the lemon juice strained, the sugar and 
 the flavourings, the whites stiffly beaten up, the shells of the eggs 
 washed and crushed. Whisk all together over the fire until just on boil- 
 ing, then stop whisking ; allow the stock to boil up well, and draw the 
 pan to the side of the stove, and there stand it for a quarter of an hour. 
 Add two glasses of sherry, and strain through a scalded jelly bag or a 
 scalded linen cloth tied to the legs of a chair reversed. Four the jelly 
 two or three times through the jelly bs^, taking care not to squeeze or 
 shake the contents. The jelly should be clear and sparkling. Mould 
 in glasses rinsed with cold water, and serve cold. 
 
 Calves' foot jelly can be served with various flavourings : — 
 
 1. Put in no wine, but add a little more cinnamon and cloves. 
 
 2. Orange jelly, made by substituting orange for lemon juice. 
 
 3. Wine jelly, made by using 3 gills port wine or claret, i tablespoon- 
 ful red currant jelly, and i gill of water instead of the sherry wine and 
 lemon juice. 
 
 4. Whipped jelly. — Dissolve a pint of any jelly by standing the basin 
 containing it in hot water ; whisk with wire whisk nntil it becomes a 
 firm, white froth. 
 
 In making jellies from gelatine, employ French leaf gelatine and use 
 in the proportion of 2 oz. of gelatine to i quart of fluid. All the above 
 described jellies can be made with gelatine, substituting the gelatine for 
 the calves' foot jelly, the method of clearing and serving being the 
 
 same as above. 
 
 VEOETABIAN SO0F. 
 
 A good vegetarian stock can be prepared as described on p. 386 ; to 
 
 this all varieties of vegetable purees can be added. 
 
RECIPES. 
 
 415 
 
 2 quarts water. 
 I oz. butter. 
 
 1 slice bread. 
 
 2 onions. 
 
 Brown Vegetable Soop. 
 
 1 cabbage. 
 
 2 potatoes. 
 2 carrots. 
 I turnip. 
 
 Parsley, salt, and pepper. 
 Fry a slice of onion in a large saucepan. When it is brown and not 
 burnt, add water, salt, and pepper, and bread toasted, and vegetables 
 cut into small pieces. Boil three or four hours, then rub the vegetables 
 through a colander and boil again for ten minutes, and the soup is 
 ready. If too thick, add a little more water. 
 
 Julienne Soup (Vegetarian). 
 
 I quart clarified vegetable stock. 
 Mushroom ketchup. 
 Salt and pepper. 
 
 Turnip, carrot, celery, onion. 
 Walnut ketchup. 
 Sherry, if liked. 
 
 Cut the vegetables into fine strips about the size and shape of a small 
 match, and boil them separately until tender, but not broken. Have 
 the stock ready boiling; add salt, pepper, a very little ketchup, and 
 sherry to taste ; put in the prepared vegetables, cook for fifteen 
 minutes, and serve. 
 
 White Soup. 
 
 2 small onions. 
 I head celery. 
 i pint milk. 
 I turnip. 
 
 2 artichokes. 
 
 I dessertspoonful flour. 
 I lb. potatoes. 
 
 3 pints water. 
 
 I oz. butter. 
 
 Cut about 2 lbs. weight of any white vegetables ; wash and peel and 
 cut in pieces, boil them until soft in the water, salt and butter. Rub 
 them through a sieve or colander, put them back in the stewpan with the 
 milk, and let boil. Put in the flour, mix smoothly with cold water, 
 let the soup boil for ten minutes, and serve with slices of fried bread. 
 
 Water Cress Soup. 
 Wash two bunches of water cress ; pluck the leaves and throw into 
 a saucepan of boiling water ; after a minute remove the cress, and chop 
 finely. Melt some butter in another saucepan and add the cress. Turn 
 it with a spoon in the butter over a slow fire for a few seconds, and then 
 add hot water sufficient to make the soop. 
 
4i6 THE BOOK OF DIET. 
 
 When the water boils sprinkle in 4 tablespoonfuls of tapioca, grout, 
 salt and pepper, and boil till clear. Beat the yolk of an egg in tureen ; 
 add a lump of butter and a gill of cream. Slowly pour the contents of 
 the saucepan into the tureen, stirring constantly in order to avoid 
 curdling the egg. 
 
 BEAN SO0F. 
 
 A quart of white beans soaked overnight in water and boiled in a 
 sufficient quantity of water, and a little carrot, turnip and onion, and 
 salt. Strain off the water when the beans are soft, and serve the beans as 
 a vegetable, or keep for a bean purie next day. Take the water and use 
 as stock, boiling it with rice, and add a squeeze of lemon, or boil a little 
 piece of sorrel, and salt to taste. 
 
 Put the yolk of an egg into the tureen and a little piece of butter. Stir 
 the contents of the saucepan gradually into the tureen, and an excellent 
 soup will be ready. 
 
 RAW MEAT COOKERY. 
 
 Raw steak can be made fairly palatable in the following methods : — 
 
 RAW MEAT. 
 
 A J lb. scraped beef can very easily be added to a small cup of beef 
 soup ; or J lb. scraped meat made into sandwiches, with tomatoes, is 
 an easy way for some patients to take extra nourishment. Cream and 
 the yolk of an egg are the best methods of getting on the necessary fat. 
 
 LEAN MEAT CASES. 
 The beef should be taken from well-grown animals, and steaks cut 
 from the centre of the round are the best for this purpose. The beef- 
 pulps can be prepared in the following way : All the fat, fascia, and 
 connective tissue and bone are removed, and the meat is placed on 
 a board and is shredded down with a blunt knife. The pulp is then 
 scraped together with a spoon. The result is that all the tough fibrinous 
 parts remain. The scraped pulp is lightly moulded by the hand into 
 cakes about 4 to i inch thick, and slowly broiled over a clear fire free 
 from smoke. When cooked, serve on a hot plate with a little butter, 
 and season to taste with pepper and salt. The flavouring may be varied 
 by using Worcestershire or Halford sauce, mustard and horseradish, or 
 lemon juice. A small quantity of dry celery is also permissible. From 
 
RECIPES. 417 
 
 4 to 6 oz. of meat is the maximum that can usually be taken at a meal at 
 the outset of the treatment ; later 8 to 10 oz. or more may be taken by 
 some patients. Four meals should be taken daily. 
 
 RAW BBEF JUICE. 
 2 oz. best rump steak. I Pinch of salt or sugar to 
 
 I oz. cold water. { taste. 
 
 Wipe and shred very finely 2 oz. of meat ; pound it well, and rub 
 it through a fine wire sieve. Pour on the water, cover, let it stand, 
 stirring occasionally, for two hours. The liquid will then be a bright 
 red colour, and should be served in a coloured glass. Strain through 
 a fine strainer, pressing the meat with the back of a spoon. The fluid 
 obtained will contain 4 to 5 per cent, of protein. 
 
 Meat juice should be made in small quantities, as it soon becomes 
 rancid. Another method, such as squeezing the meat in a lemon- 
 squeezer, may be tried ; but this is wasteful, as the pressure is not 
 sufficiently powerful to extract all the juice. 
 
 BBEF JUICE COOKED. 
 
 J lb. rump steak. | Salt and pepper. 
 
 Grill the meat rapidly over a clear fire till cooked. Cut into strips, 
 press out the juice with a lemon-squeezer into a hot dip, season to 
 taste, and serve. 
 
 TRIPE. 
 
 Methods of Preparing. — The varieties of tripe known as the 
 ' ' blanket " (because it has a folded appearance), and the dark 
 variety known as the " monk's hood," are best for invalids, on account 
 of their tenderness. 
 
 If tripe is properly prepared it is a most delicately flavoured and 
 easily digested article of food, and should be in more constant use than 
 it is at present. It requires, however, very careful cleaning and boiling. 
 In Scotland prepared tripe cannot be purchased at the butcher's, so it is 
 necessary to understand the whole process. Tripe sold in England has 
 generally had a preliminary boiling. 
 
 First wash and scrub in several waters and scrape it with a knife, 
 pulling away any pieces of fat firom it. Cut it into pieces and put it 
 into a clean saucepan with cold water to cover it, and bring it to the 
 
 14 
 
4i8 THE BOOK OF DIET. 
 
 boil. This is repeated until the water in which the tripe was boiled 
 loses all its heavy smell. This may require to be done four or five 
 times. Then rinse the saucepan well, put in the tripe with cold water 
 to cover it, bring to the boil, and cook slowly for ten to twelve hours. 
 If cooked too quickly the tripe will harden. When sufficiently cooked, 
 it ought to be so tender that it will pull easily to pieces. Four it out 
 into a basin, and cover it with the liquor in which it was cooked. 
 
 The water in which the tripe is boiled should never be thrown away, 
 as it contains a certain amount of nourishment. It is sometimes served 
 as an invalid jelly. 
 
 The prepared tripe can be stewed in various sauces for fifteen minutes, 
 and served in one of the following ways : — 
 
 1. Tripe stewed in white sauce and onions, and served with sippets 
 of toast. 
 
 2. Tripe stewed in a thick tomato sauce, and served with little rolls 
 of bacon and croquettes of fried bread. 
 
 3. Tripe heated in a. good curry sauce, and served with a. border 
 of rice. 
 
 4. Baked Tripe. — Grease a small pie-dish, and put the tripe, with 
 thin square pieces of bread and butter, into this, in alternate layers. 
 The last layer should be bread, with the buttered side up. Beat up 
 an egg in a basin until it is frothy ; add to it a gill of tripe liquor, and 
 season with pepper and salt. Strain this into the pie-dish, and then 
 wipe round the edge of the dish with a cloth. Let the mixture stand 
 for ten minutes, until it gets thoroughly soaked. Bake in a moderate 
 oven for about fifteen minutes until nicely browned. Serve hot. 
 
 2 lbs. tripe. 
 2 large onions. 
 J pint milk. 
 
 TEIFE ASO ONIONS. 
 
 J pint water. 
 
 I tablespoonful flour. 
 
 I teaspoonful salt and pepper. 
 
 Cut the tripe up, put into a stewpan, cover with cold water, bring 
 to the boil, and strain. Replace the tripe, add the milk, water, and 
 salt, boil up, add the onions thinly sliced, and simmer for three hours. 
 Mix the flour with a little milk, put into the stewpan, stir until boiling, 
 and simmer fifteen minutes. Season to taste, and serve. 
 
 FRIED TSIFE. 
 
 2 lbs. tripe. I i pint milk or water. 
 
 3 tablespoonfiils flout, | Salt and pepper. 
 
RECIPES. 419 
 
 Mix the flour with the milk into a batter ; add a little more milk if too 
 stiff. Add the salt and pepper. Cut the tripe up, dip into the batter, 
 and fry, until crisp and brown, in a little dripping. Onions can be served 
 with the tripe if preferred. 
 
 SWEETBREADS. 
 
 There are two varieties of sweetbread — the "throat" sweetbread 
 (thymus gland) and the "stomach" sweetbread (pancreas). The latter 
 is much more digestible. Lamb's sweetbreads are very tender. This 
 article of food must be nicely prepared, or it is very unappetizing. The 
 difficulty is to clear off all the connective tissue and fat from between 
 the lobules. 
 
 Soak the sweetbread in cold water for one or two hours. Then put 
 it into a saucepan with cold water to cover it. Bring to the boil, and 
 boil for five minutes. Then lift it out and place in a basin of cold 
 water to cool it. This preserves the colour of the sweetbread. Then, 
 with great care, remove from it all the fat and skin, pulling them off 
 with the fingers. It is now ready for cooking. 
 
 2 sweetbreads. 
 A little meat stock. 
 Stick of celery. 
 I small onion. 
 
 I small carrot. 
 I small turnip. 
 Herbs. 
 Seasoning. 
 
 Prepare the sweetbreads as above. Braise them for an hour and a 
 half by putting all the ingredients into a saucepan, and cover with 
 a well-fitting lid. Take them out and brown, and serve on a piece 
 of fried bread or mashed potatoes, and serve with sauce. 
 
 SAUCE ITALIENNE. 
 
 I oz. flour. 
 
 I oz. butter. 
 
 i pint second stock. 
 
 Parsley and onion to taste. 
 I bay leaf. 
 I gill sherry. 
 
 Melt the butter, and fry onion, flour, and herbs until brown. Add 
 the sherry, and allow to boil a few minutes; add the stock, and simmer 
 for one hour. Strain the sauce round. 
 
 STEWED SWEETBREADS. 
 
 I sweetbread. I Salt and pepper. 
 
 I gill white stock. | l teaspoonful rice flour. 
 
 I tablespoonful cream. 
 
420 THE BOOK OF DIET. 
 
 Cut the prepared sweetbread into pieces, pnt into a lined saucepan 
 with the stcck, and allow to simmer with the cover on until tender. 
 When done take out and put on to toast and keep warm. Mix the rice 
 flour with a little water, and add it to the stock in the saucepan. Stir 
 over the fire until boiling ; boil for five minutes. Add the cream, and 
 season. Pour the sauce over the sweetbreads, and serve. 
 
 FATTY FOODS. 
 
 SASHEBS OF BACON 
 are finely-cut slices from the back and streaky part of the pig, and can 
 generally be purchased cut in fine slices by a machine. The slices from 
 the back have most lean ; but for young children and old people, where the 
 administration of fat is of some importance, it is best to take slices from 
 the streaky portion. 
 
 The rashers may be fried, toasted, or baked. They should always 
 be served as hot as possible, preferably in a hot-water dish, and with 
 squares of bread that have been fried in the bacon fat. 
 
 FRIED BACON. 
 
 Lay the slices in a cold frying-pan, and cook over a slow fire until the 
 
 fat is clear and then crisp ; if the bacon is preferred moist, remove before 
 
 it is quite crisp, and place the bacon on toast, and pour round it the fat 
 
 that has run into the pan. 
 
 MABBOW BONES (1). 
 
 Have the bones sawn into 3-inch lengths, cover the ends with flour 
 and water paste, and fasten them into a floured cloth and boil in salted 
 water for i} hours. 
 
 Remove the cloth, crust, and send the bones to table in a dish with a 
 table-napkin. They should be served with dry toast. 
 
 MABBOW BONES (2). 
 Prepare the bones as above, scoop out the marrow, season to taste, 
 and place on a half-slice of crisp toast. Serve as hot as possible. 
 
 JELLIES. 
 
 LEHON PUDDING. 
 2 eggs. Juice of lemons or oranges (} 
 
 5 oz. loaf sugar. pint). 
 
 I oz. gelatine. Water to make up I pint. 
 
RECIPES. 421 
 
 Rub the loaf sugar on the lemon rind ; take lemon juice,, water, 
 gelatine, sugar, and lightly beaten yolk of egg ; stir by the side of the 
 fire until the gelatine and sugar are dissolved and the egg sufiSciently 
 cooked. Do not let it boilj or it will curdle. Whisk the whites to a stiff 
 froth, and mix lightly into the other ingredients when off the fire. Turn 
 into a wetted mould. Serve with whipped cream. 
 
 CREAM JELLY OR BLANCMANGE. 
 J pint milk. i J oz. isinglass, or I oz. gelatine, 
 
 i pint cream. I Rind of lemon. 
 
 I oz. sugar. 
 Into a wetted saucepan put the isinglass, milk, and lemon rind; 
 place at the side of the fire when the milk is well flavoured and the 
 isinglass dissolved ; add the sugar, and strain into a basin ; add the 
 cream, and stir until nearly cold; then pour into a wetted mould. 
 Turn out, and serve with a jelly or jam. 
 
 CARRAGEEN JELLY OR BLANCMANGE. 
 
 I teacupfiil carrageen mo: 
 
 (Irish sea moss). 
 I quart milk. 
 
 I saltspoonful salt. 
 Vanilla and sugar or saccharin for 
 flavouring. 
 
 Pick and wash the dried seaweed, soak in cold water for half an hour, 
 and tie it loosely in muslin ; cook with milk and salt in a double sauce- 
 pan until the milk vrill set, and sweeten and flavour. Strain and pour 
 into wetted moulds (small size). 
 
 SAUCES. 
 
 WHITE SAUCE FOR VEGETABLES, MEAT, POULTRY, OR FISH (1). 
 
 I pint milk. 
 
 1 tablespoonfiil cream (this may 
 be omitted). 
 
 2 oz. butter. 
 li oz. flour. 
 
 I small carrot, 
 t small onion. 
 A piece of celery. 
 Peppercorns. 
 Bay-leaf. 
 
 Cut the carrot and celery into rather large pieces ; put them, with the 
 milk, onion, and bay-leaf, into a saucepan, and simmer gently for about 
 half an hour ; make up the milk if it reduces while simmering ; melt the 
 butter, stir in the flour, and cook for seven or eight minutes without 
 
422 THE BOOK OF DIET. 
 
 browning, and when slightly cool, add the milk and vegetables, and 
 whisk briskly until it boils. Simmer for ten minutes, strain through a 
 fine sieve, re-heat, season to taste, and add the cream. 
 
 MAYONNAISE SAUCE. 
 
 Yolks of 3 eggs. I J pint salad oil. 
 
 i gill tarragon vinegar. | Salt and pepper. 
 
 Break the yolks into a basin, add the pepper and salt, and stir with a 
 wooden spoon until they are well mixed. Then add by drops the 
 vinegar and oil, stirring in the same direction all the time or the egg 
 curdles. The sauce will have a creamy appearance when finished. 
 
 TAKTAR SAUCE. 
 
 2 tablespoonfuls mayonnaise 
 
 sauce. 
 I teaspoonful mustard. 
 
 I teaspoonful chopped parsley. 
 A small piece of shallot finely 
 chopped. 
 
 Mix all well together and slowly heat. 
 
 SAUCE HOLLANDAISE. 
 
 Melt a quarter of a pound of butter, more or less, according to the 
 quantity of sauce required, throw in a handful of table salt, and whip 
 with a fork until it becomes frothy. Pour into a warm sauce tureen, 
 and serve with boiled fish. 
 
 UAItRE D'HdTEI. SAUCE. 
 
 Put a good lump of butter into a saucepan or earthenware pan on a 
 moderate fire ; chop a little parsley and chives, or parsley alone, and 
 add to the butter, with salt and pepper and a dash of lemon. This 
 sauce is poured over a steak or fish, or served in a sauce-boat, and is 
 ready as soon as the butter is sufiiciently warmed, 
 
 SAUCE AU BEURSE NOIS. 
 
 Place a frying-pan on the fire to warm ; throw into it a lump of 
 butter ; let it brown without burning. When hot, remove the pan from 
 the fire, and pour two tablespoonfiils of vinegar into the hot butter, salt 
 and pepper, and a handful of capers. 
 
 SAUCE BEMOULADE (COLD). 
 
 Mix a tablespoonful of mustard with a tablespoonful of vinegair in a 
 bowl ; add four or five gherkins finely chopped. Break the yolks of two 
 
RECIPES. 423 
 
 eggs into another bowl, chop a few leaves of tarragon and three shallots, 
 and mix with the eggs ; add four spoonfuls of salad oil drop by drop, 
 as if for a mayonnaise, turning briskly with a wooden spoon. Mix the 
 gherkins in the first bowl with the sauce, and serve with hot or cold 
 meats, or boiled fish, 
 
 SAUCE BAVI60TE (COLD). 
 
 Boil two eggs hard; mix the yolks to a paste with four anchovies 
 boned and scraped ; put them into a bowl with a spoonful of mustard, 
 salt, and pepper ; add four spoonfuls of salad or olive oil, turning 
 briskly with a wooden spoon ; chop a handful of sweet herbs as finely 
 as possible, and mix them with the other ingredients. The oil should be 
 added very slowly, a small quantity at a time. 
 
 HORSE-RADISH SAUCE (COLD). 
 
 J gill white vinegar. 
 
 2 hard-boiled eggs. 
 
 I oz. grated horse-radish. 
 
 i teaspoonful salt. 
 I teaspoonful castor sugar, or 
 flavour with saccharin. 
 
 I tablespoonful cream. 
 
 Boil the eggs hard and remove the whites from the yolks ; put them 
 into a basin, and work with a wooden spoon until quite smooth, then 
 add the vinegar gradually, and stir the mixture until it becomes creamy ; 
 add the grated horse-radish, salt, sugar or flavouring, then stir in the 
 cream, and serve. 
 
 VINAIGEETTE SAUCE. 
 
 J teaspoonful finely chopped gher- 
 
 kin, parsley, and shallot. 
 Salt and pepper. 
 
 4 tablespoonfuls salad oil. 
 
 2 tablespoonfuls tarragon 
 
 vinegar. 
 Mix all well together. 
 
 DUTCH SAUCE. 
 
 2 oz. fresh butter. I i gill cream. 
 
 Yolks of 4 eggs. I I teaspoonful tarragon vinegar. 
 
 Pinch of pepper, salt, and mustard. 
 
 Put all together into a basin ; stand it in a pan of boiling water on the 
 fire, then beat it over the fire until it thickens and looks creamy. Care 
 must be taken to prevent it curdling ; if it should curdle, add two more 
 yolks of eggs. 
 
424 THE BOOK OF DIET. 
 
 SALADS. 
 
 TOIVIATO SALAD. 
 
 Select firm, not over-ripe tomatoes ; wipe each tomato, but do not 
 wash them ; cut the fruit into chunks in a salad bowl ; add a small 
 onion chopped fine. 
 
 One tablespoonful of vinegar to two of oil ; plenty of salt and pepper. 
 
 CELERY SALAD. 
 Cut a head of celery into small pieces ; throw into cold water and 
 strain in a salad basket ; mix a tablespoonful of vinegar, two tablespoon- 
 fills of oil, a teaspoonful of mustard, salt, and pepper in a salad bowl ; 
 add the celery, and mix well. Beetroot can be added in thin slices. 
 
 FSENCH BEAN SALAD. 
 Boil the quantity of French beans required, cut them in halves, and 
 serve in a salad bowl [with the usual oil and vinegar dressing. The 
 beans must be allowed to be cold before they are served. 
 
 POTATO SALAD. 
 
 Cut the potatoes, when boiled and peeled, into a salad bowl with salt 
 and pepper, and mix with mayonnaise. Sprinkle with capers before 
 serving. 
 
 FRENCH BEA^S AND TOMATOES. 
 
 French beans, boiled and prepared as for French bean salad, can be 
 placed in a salad bowl with chopped parsley and fresh tomatoes cut into 
 chunks ; season with salt, pepper, and two tablespoonfuls of oil to one 
 of vinegar. 
 
 OYSTERS, 
 
 OYSTERS AU NATUREL 
 
 I doz. oysters. 
 Cayenne. 
 
 Salt. 
 
 Lemon. 
 Brown bread. 
 Butter. 
 
 Open the oysters carefully, so as to preserve as much of the liquid as 
 possible, and leave them in their shells ; sprinkle lightly with salt, 
 pepper, and a pinch of cayenne ; garnish with parsley, and serve with 
 sliced lemon and thin brown bread and butter. 
 
RECIPES. 425 
 
 OTBTBSS DEVILLED. 
 
 Ingredients as above. 
 
 Again sprinkle the opened oysters with a little salt and more cayenne, 
 and add to each a small piece of butter. 
 
 Place the oysters on a gridiron over a clear, slow fire until thoroughly 
 heated, then serve with sliced lemon and thin brown bread and butter. 
 
 OYSTER SOUP. 
 
 I dozen oysters. 
 
 I pint fish stock or white stock. 
 
 I oz. butter. 
 
 I oz. flour. 
 
 Pinch of cayenne. 
 
 I gill cream. 
 
 I egg- 
 
 A few drops of anchovy essence. 
 A squeeze of lemon juice. 
 White pepper and salt. 
 
 Place the oysters in a small saucepan with their own liquor, bring 
 them almost to the boil, then strain. Beard the oysters (that is, remove 
 the piece like a fringe that encircles them), cut them in two, and put 
 them aside for stewing in the soup. Put the beards into a saucepan 
 with the liquor and the stock, and let them simmer for half an hour, to 
 extract all the flavour firom them. If the stock is not previously well 
 flavoured, small pieces of the different flavouring vegetables should 
 also be cooked in it. Strain through a fine hair sieve or piece of 
 muslin, and rinse out the saucepan ready for use. First melt in it the 
 butter, being careful it does not brown, add to it the flour, and mix 
 together until quite smooth. Pour on the stock, and stir constantly over 
 the fire until boiling. Skim if necessary. Season to taste with » little 
 white pepper, salt, anchovy essence, and pinch of cayenne. Beat up the 
 yolk of an egg in a basin with the cream, and strain into the soup. When 
 off the boil, stir all the time. Place oysters in the soup tureen, pour 
 the soup over them, and serve. 
 
 OTSTEB FRITTERS. 
 
 I dozen oysters. 
 
 3 oz. flour. 
 
 J pint warm water. 
 
 I tablespoonfnl oiled butter. 
 The whites of 2 eggs. 
 Frying fat. 
 
 Make a batter by stirring the water and oiled butter gradually into the 
 flour ; when quite smooth, add the salt, and, lastly, the stiflly whipped 
 whites of eggs. Beard the oysters, dip them in the batter, and fry them 
 in hot fat until golden brown. 
 
 14a 
 
426 THE BOOK OF DIET. 
 
 SCALLOPED OYSTEBS. 
 6 oysters. I Breadcrumbs, 
 
 i oz. butter. I Pepper and salt. 
 
 Lemon juice. 
 Boil the oysters and their liquor, then remove the beards and strain oft 
 the liquor. 
 
 Grease china oyster shells well, coat with breadcrumbs, and put 
 2 or 3 divided oysters into each shell. Season with pepper and salt, 
 and pour over a little oyster liquor. Sprinkle in some more bread- 
 crumbs, and pour some melted butter over the top. Brown in the oven, 
 and serve very hot. 
 
 VEGETARIAN DISHES. 
 
 GRUEL. 
 Barley. 
 
 I oz. Robinson's barley. I Thinly-cut rind of lemon (a piece), 
 
 f pint water. I Sugar to taste. 
 
 Simmer the barley, water, and lemon rind for twenty minutes. 
 Strain, and add flavouring to taste. A glass of port wine is a. very 
 nice flavouring. ^^ 
 
 Oatmeal. 
 
 2 tablespoonfuls of oat- I i J pint water, or water and 
 meal. I milk mixed. 
 
 Salt and sugar to taste. 
 
 Allow the oatmeal to stand in water for an hour or longer, stirring 
 occasionally, then pour o6f the water, and boil this for thirty minutes. 
 Add a pinch of salt, or sugar if preferred. It is much improved if eaten 
 with cream. Nutmeg or ginger can be added if the gruel is taken as 
 a remedy for a chill. 
 
 OATMEAL FOBBIDGE. 
 
 Soak 4 ounces of medium oatmeal in i^ pints of cold water for some 
 hours. Strain the water into a stewpan, and when boiling add the 
 oatmeal, and salt to taste. Twenty to thirty minutes will sufficiently 
 cook it, but it requires frequent stirring. 
 
RECIPES. 427 
 
 HOUINT OS MAIZE MEAL FRITTERS. 
 
 Make a well-flavoured hominy porridge. Allow it to get cold ; cut 
 the cold porridge into neatly sized slices about one inch thick, sprinkle 
 well with flour, and fry in butter or oil. 
 
 HOMINT CHEESE PUDDING. 
 
 Cold maize meal porridge. | Grated cheese. 
 
 Salt, cayenne, and butter. 
 
 Cut the cold porridge into small squares, arrange on a flat dish, and 
 sprinkle well with cheese and flavouring. Put on a few bits of butter, 
 and brown in a hot oven. 
 
 BREAD FRITTERS. 
 Fingers of stale bread are soaked in a little milk flavoured with sugar 
 and nutmeg or cinnamon, dipped in batter and fried in fat. 
 
 2 eggs. 
 
 Brown breadcrumbs. 
 
 Pepper and salt. 
 
 POTATO AND CHEESE MOULD. 
 
 J lb. mashed potatoes (with 
 
 butter and milk). 
 3 tablespoonfuls grated cheese. 
 
 Mix well together the mashed potatoes, the yolks of eggs, seasoning, 
 and cheese ; if not moist enough, add a little more milk. Stir in lightly 
 the whites stifily beaten. Grease and line a basin with the breadcrumbs, 
 and add the potato mixture, not filling basin too fiiU. Bake for thirty 
 minutes, turn out, and serve hot. 
 
 CAULIFLOWER AU GRATIN. 
 I well-boiled cauliflower. 1 4 tablespoonfuls cheese (Par- 
 
 i pint white sauce. | mesan). 
 
 Breadcrumbs. 
 
 Divide up a cold boiled cauliflower, and arrange in a fireproof dish. 
 Add 3 tablespoonfuls of cheese to the white sauce, and pour over the 
 cauliflower. Coat the top with breadcrumbs and cheese, and bake in 
 a moderate oven until well browned. 
 
 Cauliflower d, ritidienne is prepared in a similar manner. Use much 
 less cheese and breadcrumbs, and add 1 dessertspoonful of curry powder 
 and I tablespoonful of cocoanut. 
 
428 
 
 THE BOOK OF DIET. 
 
 4 pint tomato pulp. 
 
 White and brown breadcrumbs. 
 
 i oz. butter. 
 
 TOMATOES SCAU.OPED. 
 
 i teaspoonful finely chopped onion. 
 Flavourings — salt, pepper, sugar, 
 nutmeg. 
 
 Heat the butter in a pan, and lightly fry the chopped onion, add the 
 preserved tomato pulp, sind stir in white breadcrumbs until the mixture 
 reaches the consistency of cream. Add the flavourings, and turn the 
 mixture into well-buttered scallop shells. Cover with brown bread- 
 crumbs and small pieces of butter. Bake for ten to fifteen minutes. 
 
 POACHED EG&S WITH CHEESE. 
 
 3 eggs. 
 
 i pint white sauce. 
 
 Butter. 
 
 Breadcrumbs. 
 Grated cheese. 
 Pepper and salt. 
 
 Line a buttered flat fireproof dish with layer of breadcrumbs. Place 
 on the breadcrumbs 3 lightly poached eggs. Pour over the sauce, 
 thoroughly hot, and sprinkle the cheese and remaining breadcrumbs on 
 the top. Put on a few bits of butter, and place in a hot oven until the 
 top is lightly browned. 
 
 CHEESE BAILS. 
 
 Whites of 2 eggs and 2 oz. I Flavouring of salt and cayenne, 
 grated cheese (Parmesan). I 
 
 Flavour the whites with salt and cayenne, and beat into a very stifl 
 froth. Stir the cheese in lightly at once. Form the mixture into little 
 balls the size of walnuts ; drop at once into boiling fat. Fry for five 
 minutes, and drain well. Serve on a dish paper sprinkled with grated 
 cheese. 
 
 CHEESE MOULD. 
 
 1 lb. mashed potatoes 
 milk and butter). 
 
 2 oz. grated cheese. 
 
 (with 
 
 2 eggs. 
 
 Browned crumbs, and flavour- 
 ing of pepper and salt. 
 
 Add to the mashed potatoes the yolks of eggs, the grated cheese and 
 seasoning. Mix well together. Stir into the potato mixture the whites 
 beaten to a stiff froth. Line a greased basin with breadcrumbs, fill g 
 with the mixture, and bake for about thirty minutes in a moderate oven. 
 Serve at once. 
 
RECIPES. 429 
 
 DIABETIC DISHES. 
 
 (In addition many of the Sauces given are suitable. ) 
 FORRIDOE AKD FUDDUrGS. 
 
 Porridge or Gruel, made from almonds or cocoanut, can be prepared 
 in the following manner : — 
 
 A small piece of German yeast (the size of two peas) is dissolved in a 
 little lukewarm water, and added to, and well mixed with 2 tablespoon- 
 fuls of ground almonds. The mixture is allowed to stand in a warm 
 place (by the fire) for half an hour or longer. The small quantity of 
 sugar in the almonds is mostly or entirely destroyed by the action of the 
 yeast, and the mixture becomes spongy. It may be sweetened with a 
 trace of saccharin if desired. The consistence will vary according to 
 the quantity of water which has been added. If the consistence is that 
 of custard or rice pudding, the almonds may be eaten with stewed cran- 
 berries or other fruit as a pudding. 
 
 COCOANUT PUDDING. 
 
 Half-ounce of German yeast is mixed in a little lukewarm water with 
 
 J lb. of desiccated cocoanut powder. The mixture is kept in a warm 
 
 place for fifteen minutes. Then \ ounce of butter, a pinch of salt, and 
 
 a little milk are added. All must be well mixed. The mixture is placed 
 
 in a pudding-dish, and baked in a moderate oven for twenty or thirty 
 
 minutes until the surface is brown. This pudding can be eaten warm or 
 
 cold. It may be taken with custard, and sweetened, if desired, with 
 
 saxin. 
 
 AIMOND PUDDING. 
 
 Take 4 ounces of ground almonds. Mix \ of an ounce of German 
 yeast with a little lukewarm water. Add the ground almonds to the 
 yeast and water, and mix well. Allow the mixture to stand in a warm 
 place for fifteen minutes until spongy. Beat up one egg in a little milk, 
 and add a little solution of saccharin. Then mix the egg with the ground 
 almonds, place in a pudding-dish, and bake for about fifteen minutes. 
 
 Suet puddings or suet and almond pudding, and especially custard 
 (made in the old-fashioned way from eggs and milk, and not from custard 
 powder), are very suitable. To sweeten the custard or puddings, 
 saccharin may be used. 
 
 Suet pudding may be prepared from a milk albumin (pastry flour) 
 obtained from Messrs. Callard and Co. Directions are supplied along 
 with the powder 
 
430 THE BOOK OF DIET. 
 
 Sweets for dinner, jelly, ices, creams, etc., almost free from carbo- 
 hydrates, may be prepared by an intelligent cook from cream, eggs, 
 butter, almonds, nuts, lemon, gelatine, vanilla, wine, and brandy, and 
 sweetened with kristallose, saccharin, or saxin. 
 
 6IBDLE SCONES, 
 \ lb. gluten flour, 
 i oz. butter. 
 ^ teaspoonfiil soda. 
 
 \ teaspoonful cream of tartar. 
 Salt or saccharin to taste. 
 \ teacupful buttermilk. 
 
 Rub butter into the flour and other dry ingredients ; make into a soft 
 dough with milk. Form into a scone, or little breakfast rolls, or twists, 
 and bake in oven for fifteen minutes. 
 
 SAVOURY EGOS. 
 
 3 hard-boiled eggs. 
 \ gill cream. 
 \ oz. butter. 
 
 I tablespoonfiil Parmesan 
 cheese. 
 
 I small piece of onion, chopped. 
 
 Pepper. 
 
 Salt to taste. 
 
 Mustard. 
 
 I tomato. 
 
 Divide the eggs in half ; take out the yolks. 
 
 Mix together the yolks, cream, cheese, butter, onion finely chopped ; 
 pepper, salt, and mustard to taste. Fill the white parts of eggs with the 
 mixture. 
 
 Cut six rounds of gluten bread ; butter them ; on each piece lay a slice 
 of tomato, and on this half of a filled egg. Garnish the dish with cress. 
 
 CARRAGEEN JELLY OR IRISH MOSS. 
 Irish moss is a seaweed, and is collected on the northern shores of 
 Ireland. Its nutritive value is slight ; it contains mainly mucilage, and 
 also some iodine and sulphur. It should be well washed and soaked for 
 some hours previous to cooking. The flavour is somewhat peculiar, but 
 delicate, and to some very palatable. 
 
 I oz. Irish moss. I Lemon juice. 
 
 I quart cold water. I Saccharin to taste. 
 
 Wash the Irish moss well, and soak it for several hours in cold water. 
 Then put into a saucepan with I quart of cold water, and simmer 
 slowly for from four to five hours. Strain, add the lemon juice, and 
 sweeten to taste. Pour into a wetted mould and set aside until cold. 
 
2 eggs. 
 
 i lb. almond flour. 
 
 Jilb. butter. 
 
 RECIPES. 431 
 
 ALMOND CAKE PUDDING. 
 
 : tabloids of saccharin dis- 
 solved in a tablespoonful of 
 brandy. 
 
 Warm the butter, beat in the almond flour and the yolks of the eggs, 
 adding the dissolved saccharin. Whisk the whites to a stiff froth ; beat 
 all together. Put into small cake moulds, bake in a quick oven, and 
 serve with a little hot sauce made with dry sherry and saccharin. 
 
 Cocoanut pudding can be made in the same way. 
 
 STUFFED VEGETABLE MARROW. 
 Small marrows make an excellent dish, boiled and stuffed with the 
 stuffing of mushroom forcemeat. The marrow should be first peeled 
 very thinly, then cut long-way into three slices ; remove the pips, and 
 fill the interior with the forcemeat. The forcemeat should be made hot 
 before it is placed in the marrow ; if not, the marrow will be cooked 
 before the stuffing is heated through. The marrow should be placed in 
 boiling water and boiled until tender ; this takes about twenty minutes 
 to half an hour. 
 
 MUSHROOM FORCEMEAT. 
 
 I lb. mushrooms. I 2 hard-boiled eggs. 
 
 J teaspoonfiil lemon juice. I i oz. butter. 
 The mushrooms after being cleaned should be chopped and fried in 
 the butter ; lemon juice should be added before they are chopped in 
 order to preserve the colour. Add two hard-boiled eggs to the mixture, 
 and rub the whole through a wire sieve while hot. 
 
 When hot this mixture is moist, but on standing gets hard. 
 
 SAVOURY OMELET. 
 
 1 teaspoonful chopped parsley. 
 3 eggs. 
 
 2 oz. butter. 
 
 Herbs, savoury 1 
 
 Pepper r for flavouring. 
 
 Salt I 
 
 Melt the butter in a frying-pan, beat up the eggs thoroughly, add a 
 little pepper and salt, parsley and herb, pour the beaten-up eggs into 
 the filing-pan as soon as the butter begins to frizzle, and with a table- 
 spoon keep scraping the bottom of the frying-pan in every part. Go on 
 scraping until two-thirds of the mixture have become lumpy. 
 
 Now lift the pan a little off the fire, and push the omelet into half the 
 frying-pan. When nearly set, hold the pan in a slanting direction in 
 
432 THE BOOK OF DIET. 
 
 front of the fire, and as soon as set, slide the omelet from the pan on to 
 a hot dish and serve at once. 
 
 This may be varied by addition of a little cooked 6sh, grated cheese, 
 tomato, ham, crab. 
 
 STUFFED TOMATOES. 
 
 3 ripe tomatoes. 
 
 i oz. butter. 
 
 I spring onion. 
 
 I teaspoonfiil chopped parsley. 
 
 1 pinch mixed herbs. 
 
 2 mushrooms, or a teaspoonfiil 
 Parmesan cheese. 
 
 Crumbs of i almond biscuit. 
 
 Pepper and salt. 
 
 Cut off the stalks, leaving a hole the size of a threepenny bit. Squeeze 
 out the juice and pips. To the juice and pips add the onion chopped, 
 the chopped parsley, mixed herbs, and the mushrooms or cheese. Melt 
 the butter and fry the mixture. Then add sufficient almond biscuit 
 crumbs to make the whole into a moist paste. 
 
 Fill the tomatoes vfith the mixture until they resemble their original 
 shape. 
 
 Put a few crumbs and a little piece of butter on the top of each. 
 
 Place the filled tomatoes in a baking dish and bake until tender, and 
 moisten with a. little oil or butter. Serve in a dish with fried parsley 
 round. 
 
 SWEETBREADS AND VEOETASLES. 
 
 For the preparation of sweetbreads, see p. 419. The prepared sweet- 
 breads are first stewed in milk, then rolled in slices of fat bacon, and 
 placed in the oven for a quarter of an hour. 
 
 The bacon is then removed ; the sweetbreads are cut in slices, and 
 grated Parmesan cheese is shaken over them. They are again placed 
 in the oven and braised in a rich brown gravy. 
 
 Served on crofitons of gluten bread, in the centre of which can be 
 placed stewed tomatoes, green peas, fresh French beans, stewed 
 mushrooms. 
 
 UUSHROOIIS AU 6SATIN. 
 
 10 mushrooms. Pepper 
 
 Piece of onion. Salt Vto taste. 
 
 I teaspoonfiil chopped parsley. Lemon juicej 
 
 I saltspoonful thyme, fresh. Almond biscuit crumbs. 
 
 I saltspoonful thyme, dried. i oz. butter. 
 
 Select 10 cup mushrooms about the same size. Peel the mushrooms 
 very carefully without breaking them ; cut out the stalks close down with 
 
 Hoi 
 
RECIPES. 433 
 
 a spoon, and scoop out the inside. Peel the stalks, and chop them up 
 with the scooped-out portion ; add the onion, parsley, and thyme. Fry 
 all this in the pan with a little butter. Add sufficient biscuit crumbs to 
 make the whole into a moist paste, and season to taste. Bake in the 
 oven until the mushrooms are quite tender. Serve with some nicely 
 fried parsley round it. 
 
 TASBA60N CBEAMS. 
 2 eggs. I J pint cream. 
 
 Pepper and salt. | 2 teaspoonfuls chopped tarragon. 
 
 Beat up thoroughly i white and yolks of 2 eggs, the cream, and a little 
 white pepper and salt. .Add a little chopped tarragon. 
 
 Pour the mixture into some prepared moulds with chopped 
 tarragon and truffles, and stand the moulds in a stewpan of boiling 
 water reaching to three-quarters height of the moulds. 
 
 Let the water boil, then poach for about twenty minutes at the 
 side of the fire till the creams are set. Turn out on a warm dish and 
 serve with sauce hollandaise ronnd them. 
 
 FISH EOE SOUFFLES. 
 
 Take six roes of fresh herrings, blanch and pound them ; then flavour 
 with salt, pepper, pounded mace, and nutmeg. Add J ounce butter and 
 yolks of 2 eggs well beaten. Stir the whites of 6 eggs beaten to a stiff 
 froth with the roes, and bake in ramekin cups for five minutes. Serve 
 at once. 
 
 LIST OF STARCH-FREE PUDDINGS. 
 
 Curds. 
 
 
 Jellies. 
 
 Custards. 
 
 
 Blancmange. 
 
 Soufflfe. 
 
 
 Honeycomb cream. 
 
 Omelets. 
 
 
 Stewed fruit. 
 
 Creams. 
 
 
 Fools. 
 
 Meringues. 
 
 
 Mac^doines of fruit. 
 
 
 Comp6te 
 
 of fruit. 
 
XXIII. 
 APPENDIX. 
 
 TABLES GIVING APPROXIMATE COMPOSITION OF 
 VARIOUS FOOD PREPARATIONS. 
 
 I. Milk combined with Cereals. 
 II. Peptone Preparations. 
 
 III. List of Malted Foods. 
 
 IV. Meat Extracts. 
 V. Meat Juices. 
 
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APPENDIX. 
 
 439 
 
 III. List of Malted Foods. 
 A. Starch Utile Altered. 
 
 T. and T. Food. 
 Nicholi's Food of Health. 
 
 Triticumina. 
 Worth's Perfect Food. 
 
 B. Starch partly Converted. 
 
 AUenbuiy's No. 3 Food. 
 Cheletine's Infant Food. 
 Coomb's Malted Food. 
 
 Moseley's Food. 
 
 Hovis Babies' Food No. 2. 
 John Bull No. 2. 
 Kufeke's Infant Food. 
 
 C. Starch completely Converted. 
 
 Cheltine Maltose Food. 
 Diastased Farina. 
 
 Horlick's Malted Food. 
 Hovis Babies' Food No. I. 
 
 Mellin's Food. 
 
 IV. Composition of Meat Extracts. 
 
 
 Water. 
 
 Pro- 
 teins. 
 
 Extrac- 
 tives. 
 
 Nitro- 
 gen 
 Free 
 Sub- 
 stances. 
 
 Salts. 
 
 Armour's Extract 
 
 Bovril 
 
 Bouillon Fleet 
 
 24-3 
 39-5 
 61.9 
 36.2 
 87.1 
 
 3S-0 
 17.8 
 20.0 
 77.0 
 62.9 
 38.1 
 90.6 
 
 16.0 
 
 9-1 
 II. 8 
 
 9-5 
 10.4 
 
 38.0 
 16.4 
 
 30 
 13.0 
 18.9 
 
 3-6 
 
 20.5 
 
 34-1 
 9.8 
 
 19-3 
 
 I.O 
 
 16.0 
 
 38.1 
 
 55- 7 
 
 7-4 
 
 4-S 
 
 20.3 
 
 1.8 
 
 20.0 
 1.2 
 
 3-8 
 
 19.7 
 
 1-5 
 6.0 
 0.9 
 2.9 
 
 5-3 
 2.4 
 
 19.0 
 
 I3-S 
 
 12. S 
 
 iS-o 
 
 1-3 
 
 8.4 
 21.S 
 24.0 
 
 H 
 19.6 
 
 17-3 
 1.4 
 
 Brand's Beef Bouillon... 
 
 Brand's Essence 
 
 Hipi (mutton prepara- 
 
 Lemco 
 
 Liebig's Extract 
 
 Mason's Essence 
 
 0x0 
 
 Villing Beef Essence.... 
 
440 
 
 THE BOOK OF DIET. 
 
 V. Composition of Meat Jdicbs. 
 
 
 Water. 
 
 Proteins. 
 
 Extrac- 
 tives. 
 
 Salts. 
 
 Armour's Beef Juice 
 
 Annour's Soluble Beef.... 
 
 74.1 
 23.0 
 81.0 
 52.0 
 59-1 
 49-5 
 S2-4 
 42.9 
 56.0 
 36.6 
 60.3 
 66.5 
 44.8 
 
 8.3 
 
 33-3 
 
 13-9 
 
 7.2 
 
 iS-4 
 13.0 
 
 7.6 
 22.1 
 
 6.9 
 30-3 
 
 0-5 
 21.0 
 38.0* 
 
 9-S 
 13-4 
 
 34 
 14.0 
 16.S 
 
 8.1 
 
 18.7 
 
 S-o 
 
 19.1 
 
 29.1 
 
 6.0 
 
 7-S 
 
 13-2 
 
 I.O 
 
 n 
 14.2 
 20.3 
 16.2 
 
 3-S 
 9-7 
 
 "•3 
 6.S 
 
 17.1 
 
 
 Brand's Meat Juice 
 
 Burgoyne's Meat Juice.... 
 Esco Beef Juice 
 
 Lipton's Fluid Beef. 
 
 Liquor Carnis 
 
 Puro 
 
 Valentine's Beef Juice 
 
 Vitalia's Meat Juice 
 
 Wyeth's Meat Juice 
 
 * iDcluding Extractiveik 
 
INDEX. 
 
 Absinthb, 1x7. 
 
 Absorption of food, 19. 
 
 Acetic acid in wine, 121. 
 
 "Acidity," value of milk 
 in, 38. 
 
 Acids in wine, 121. 
 
 Acorns, ^5. 
 
 Adult, diets for, 233; food 
 required, 23. 
 
 Adulteration of milk, 168. 
 
 Aerated waters, 109. 
 
 Agar-a^ar, 243. 
 
 AkoU biscuits, 336. 
 
 Albene, 241. 
 
 Albulactin, 49. 
 
 Albumin, 13. 
 
 Albumin water, 53, 188, 203. 
 
 Alcohol, 113, 124 ; allowable 
 quantity, 124 ; amount in 
 beverages, 115 ; effects of, 
 1x4 ; in disease, X26 ; 
 natiu-e of, 114 ; source 
 of, Z14 ; time to take, 
 125 ; treatment in dis- 
 ease, X25 ; use of, 123 ; 
 varieties of, 1x4. 
 
 Ale, ginger, xog. 
 
 Aleuron, X47. 
 
 Aleuronat, 147, 336. 
 
 Algae, 96. 
 
 Allan's auti-fat, 352, 
 
 Allenbury foods, 49, 160, 
 x6i ; for infant feeding, 
 zoi, 202, 
 
 Almond porridge, 429 ; pud- 
 ding, 337, 429, 431. 
 
 Almonds, 95. 
 
 American beef, cost, 59; 
 cheese, 44. 
 
 Anisette, 117. 
 
 " Antipon," 352. 
 
 ApoIIinaris, iia 
 
 Appetite, 28. 
 
 Apple, 91 ; time to digest, 
 22 ; water, 401. 
 
 Apricot, 91. 
 
 Arrowroot, 98 ; pudding, 
 410. 
 
 Artichokes, green, 100. 
 Artox flour, 242. 
 Asparagus, 100 ; time to 
 
 digest, 22. 
 Asses' milk, 188. 
 " Atwater," 23. 
 Australian wines, 122. " ' 
 Auto-intoxication, 29, 269. 
 Avenine, 85. 
 Avenola, 242. 
 
 Bacon, 65 ; cost of, 65 ; 
 
 rasher of, 420 ; fried, 
 
 420. 
 Baking, 374, 
 Banana, 91 ; coffee, 243 ; 
 
 oats, 243. 
 Barcelona nuts, 95. 
 Barley, 83 ; gruel, 426. 
 Barley water, X94, 399 ; 
 
 apple, 401 ; lemon, 400. 
 Bass's beer, xi8. 
 Batter pudding, 408. 
 Beans, 88 ; in tuberculosis, 
 
 365 ; time to digest, 22. 
 Bean soup, 4x6. 
 Beech nuts, 95. 
 Beef, 55, 58 ; rib, spare, 59 ; 
 
 roast, time to digest, 22 ; 
 
 steak, time to digest, 22. 
 Beef essence, 381, 383; ex- 
 tracts, to be made, 38X. 
 Beef juices, composition of, 
 
 table, 440 ; cooked, 385 ; 
 
 raw, 384. 
 Beef purde, 383. 
 Beef tea, 38X, 382, 383; 
 
 tabloids, X46 ; time to 
 
 digest, 22. 
 Beer, X17 ; purity of, 124. 
 Beetroot, 97. 
 Beet tops, X03. 
 Benger^s food, x6o, 202 ; 
 
 curdling fluid, 197 ; pan- 
 
 creatized lentil flour, z6o ; 
 
 peptonized jellies, X57. 
 Beverages, 107 ; in diabetes, 
 
 341 ; in fevers, 280 ; in 
 
 gout, 320; forvegetariansi 
 
 243. 
 
 Bile, 21. 
 
 Biobran drops, 336. 
 
 Biogene, 335, 336. 
 
 Biscuits, 389 ; diabetic, 
 335 j. for children, 215; 
 ship," 390 ; time to 
 digest, 22. 
 
 Blackberry, 91. 
 
 Black cock, 64. 
 
 Black currant drink, 401. 
 
 Black wheat, 84. 
 
 Blancmange, 421 ; carra- 
 geen, 42X ; peptonized, 
 155- 
 
 Blood, 64. 
 
 Boiling, 374, 376 ; flsh, 
 375 ; of vegetables, 385. 
 
 Bone, marrow, 63. 
 
 Bones, 63. 
 
 Borage, xo2. 
 
 Bovinine, 145. 
 
 Braising, 376. 
 
 Bran and bread, 336, 338. 
 
 Brandering, 374. 
 
 Brand's beef tea, 143 ; fever 
 food, X47 ; nutrient pow- 
 der, 146. 
 
 Brandy, xx6. 
 
 Brazil nuts, 95. 
 
 Bread advisable for chil- 
 dren, 2x5 ; adulteration 
 of, X70 ; baked, 388 ; 
 bermaline, 388 ; brown, 
 388 ; Carr's, 388 ; diabetic, 
 334. 336. 33S; fritters, 
 427 ; in old age, 22S ; 
 making, 386 ; omelet, 
 406 ; protene and al- 
 mond, 339 ; starch free, 
 specialists in preparing, 
 335 ; starch free substi- 
 tutes, 335 ; time to digest, 
 22 ; varieties of, 387 ; 
 veda, 388 ; Vienna, 81, 
 388. 
 
 Breakfast for children, 2x7 ; 
 
442 
 
 INDEX. 
 
 for working man, 136 ; 
 
 suitable, 134. 
 Breast feeding, 177 ; feed- 
 ing, rules for, 179; pump, 
 
 use of, 186. 
 Brill, 68. 
 
 Brisket of beef, 59. 
 British wines, 133. 
 Broccoli, 100. 
 Broiling, 374. 
 Brose, 86. 
 
 Brussels sprouts, loi. 
 Buckwheat, 8^. 
 Bulgarian bacillus^ 289. 
 Burgundy, ethers in, 122. 
 Butter, ^2 ; adulteration of, 
 
 169 ; in old age, 228 ; 
 
 beans, 89. 
 Butterine, 43. 
 Buttermilk cure,'288. 
 Butter nuts, 95. 
 Butters, nut cream, 241 ; 
 
 vegetable, 73. 
 Bynin, 159. 
 
 Cabbages, 100. 
 
 Cafiea arabica, in. 
 
 Caffeine, iia. 
 
 Cake, almond, diabetic, 
 338 ; cocoanut, diabetic, 
 
 ^338,339.,. 
 
 Cakes, making of, 390, 391 ; 
 plasmon, 339. 
 
 Calcium, x6; citrate in 
 milk, 36. 
 
 Califomian wines, ethers 
 in, X22. 
 
 CalFs foot jelly, 414. 
 
 Calf's head, 60. 
 
 Callard and Co.* diabetic 
 food specialists, 333. 
 
 Cane sugar, 76. 
 
 Canning food, 166. 
 
 Canterbury lamb, 6z. 
 
 Capon, 64. 
 
 Caramel, 76 ; cereal, 243 ; 
 custard, 404. 
 
 Carbohydrates, 149 ; advis- 
 able in children, 2x4 ; in 
 gout, 318 ; in vegetables, 
 
 74 ; of milk, 35. 
 Carlsbad regime, ^49. 
 Camrick's soluble food, 
 
 x6x. 
 Carrageen blancmange, 
 
 49X ; jelly, 421 ; moss, 96. 
 Carrots, 97 ; time to digest, 
 
 22. 
 Casein, 13-35 ; biscuits, 
 
 335 ; dried, 50 ; in kephir, 
 
 45 ; preparations, 50. 
 
 Casoid bread, 336. 
 
 Casumen, 51. 
 
 Caudle, 57. 
 
 Cauliflower, 22, zoo, 427. 
 
 Celery, loi ; salad, 424. 
 
 Cellulose, 74. 
 
 Cereal coffees, 243 ; foods 
 malted, x88. 
 
 Oerealine, 84. 
 
 Cereals, 78, 79, 214, 242, 
 
 Chablis, ethers in, X22. 
 
 Chalk, adulterant, as an, 
 X70. 
 
 Champagne, ethers in, 123 ; 
 sugar in, 121. 
 
 Chapman's whole flour, 303. 
 
 Chapman vegetable pro- 
 teins, 339. 
 
 Chartreuse, 1x7. 
 
 Cheap meals, 349. 
 
 Cheek, ox, 60. 
 
 Cheese, 43 ; adulteration 
 of, X69; in gout, 317; 
 methods of cooking, 402, 
 403, ^8 ; value in tuber- 
 culosis, 365 ; vegetarian, 
 243- 
 
 Chemical composition of 
 milk, 33. 
 
 Chemistry of nutrition, g. 
 
 Cherry, 91. 
 
 Cheshire cheese, 44. 
 
 Chestnuts, 95. 
 
 Chevril, Z02. 
 
 Chicken, roasted, time to 
 digest, 22. 
 
 Chicory, 171 ; influences, 
 
 171. 
 
 Child, delicate, diet for, 
 2x8, 219, 231 ; food re- 
 quired, 23. 
 
 Children, food require- 
 ments of, 213 ; tubercu- 
 losis, diet in, 367. 
 
 Chiltine maltose food, z6o. 
 
 Chips of beef, 59. 
 
 Chittenden, 24. 
 
 Chives, X02. 
 
 Chocolate, 113'; invalid 
 food, 409 ; of soured milk, 
 - 289. 
 
 Cider, ethers in, X23. 
 
 Cinnamon milk, 397. 
 
 Circulation, effect of diet 
 on, 270. 
 
 Citrated milk, x88, X98. 
 
 Citric acid in milk, 36. 
 
 Claret, ethers in, X22. ' 
 
 ClaKt, sugar in, X2i. 
 
 Climate, influence on food, 
 37. 
 
 Cockle, 69. 
 
 Cocoa, 112, 17X ; time 10 
 digest, 32. 
 
 Cocoanut, 95, 339, 499 ; 
 butter, 241 ; oil, adulter- 
 ant, as an, 169. 
 
 Cod, 66, 67. 
 
 Coffee, XXI, 398 ; adultera- 
 tion of, 17X. 
 
 Coffees, cereal, 243. 
 
 Colic in infants, X84. 
 
 Colostrum, 17S. 
 
 Condensed milk, 46, X69, 
 x88, 200. 
 
 Confectionery, 77. 
 
 Consomm^, 380, 4x2, 4x3; 
 vegetarian, 415. 
 
 Constipation, 308 ; in in- 
 fants, X85. 
 
 Cookery in paper bags, 
 392; of cakes, 390; of 
 eggs, 403 ; of fish, 66, 
 
 ?,73 ; of flour, 386 ; of 
 ruits, 93 ; pastry, 390 ; 
 
 of puddings, 390 ; of raw 
 
 meat, 4x6. 
 Coomb's malted food for 
 
 infant feeding, 202. 
 Com, 83. 
 Cornflour, 84. 
 Com meal, 84 ; starch, 84. 
 Cow heel, 60. 
 Cow's milk, 34, x88, 190. 
 Crab, 69. 
 Cranberry, 91. 
 Crayidsh, 69. 
 Cream, 35, 40, 227, 316, 333 ; 
 
 varieties of, 40, 41 ; ice 
 
 cream, 43. 
 Cress, X03. 
 Crustacea, 66, 69. 
 Cucumbers, xox. 
 Cures, milk, 286, 287, 288. 
 Currant, gx ; wine, 133. 
 Custard, baked, 403, 408 ; 
 
 powders, 146. 
 
 Dandelion Leaves, 103. 
 
 Date, 9x. 
 
 DAjeuner, 131. 
 
 Desiccated malt, 159, 
 
 Dextrine, sx. 
 
 Dextrose, 31. 
 
 Dhoora, 85. 
 
 Diabetes, 331. 
 
 Diabetic cookery, 439. 
 
 Diabetin, 7^. 
 
 Diarrhoea in infants, x86 ; 
 
 rice water for, 400. 
 Diastase, 154^ 158. 
 Diastftsed farina, x6o, 203, 
 
INDEX. 
 
 443 
 
 Diathesis in gout, 3x2. 
 
 Diet, cause of disease, 267 ; 
 during childhood, 21X ; 
 lactation, 233 ; preg- 
 nancy, 230 ; school life, 
 331 ; economical, 363. 
 
 Diet, fluid, 277, 200. 
 
 Diet, for aduk life, 223 ; 
 for child of one year, 205 ; 
 for child from eighteen 
 months, 306 ; for child, 
 weak digestion, 219 ; for 
 a delicate child, 2x8 ; for 
 fattening, 352 ; for fevers, 
 275 ; for nervous child, 
 221 ; for old age, 225 ; 
 for rheumatism with 
 intestinal fermentation, 
 326 ; for rheumatism with 
 putrefaction, 337 ; for 
 tuberculous child, 2x8 ; 
 for tuberculosis for work- 
 ing classes, 363. 
 
 Diet, lacto- vegetarian, 243, 
 2C)4 ; Haig, for ^out, 318 ; 
 light, 285 ; light, dry 
 character, 294; light, solid, 
 291 ; light, tables for, 
 
 Digestion, 19. 
 
 Dinner, X35 ; cheap, 244, 
 
 255, 257, 261, 262. 
 Diphtheria, contamination 
 
 of milk, 39. 
 Distilled water, 109. 
 Dried foods, 165. 
 Drinking water, zo8. 
 Drugs for constipation, 185. 
 Ducks, wild, 64. 
 Dulcin, 77. 
 
 Edam Cmbese, 44. 
 
 Eel, 66, 68. 
 
 Effect on digestion, 29. 
 
 Egg drinks,|54 ; plant, 103 ; 
 raw, 52. 
 
 ^gg^f 5^ i advisable for 
 children, 2x4 ; digestibil- 
 ity of, 52 ; in ifout, 317 ; 
 iron in, 17 ; idiosyncrasy 
 to, 53 ; methods of cook- 
 ing, ^03, 405, 411, 428, 430. 
 
 Egyptian lentilsi 89. 
 
 Emprote, 148, 240. 
 
 Endive, 102. 
 
 Ethers in wine, 122. 
 
 Eucasin, 50. 
 
 Faces, ax. 
 Farina, 82. 
 Farinaceous foods, 188 ; for 
 
 fevers, 280; infant feed- 
 ing, 203. 
 
 Farola, 82. 
 
 Fat, X4 ; for diabetics, 334 ; 
 in crsam, 40. 
 
 Fats, advisable in children, 
 2x4 ; for vegetarians, 241 ; 
 in margarine, 43 ; in tu- 
 berculosis, 358. 
 
 Feeding bottles, care of, 193. 
 
 Feeding cup, use of, 282. 
 
 Feeding of infants, artifi- 
 cial, 1 88. 
 
 Ferments, 20, 21, X53. 
 
 Fevers, diet for, 275. 
 
 Filberts, 95. 
 
 Fillet of veal, 60. 
 
 Fish, 66 ; boiling of, 375 ; 
 dinner, chea^, 257 ; in 
 season, 66 ; pickled, 66. 
 
 Fishes' fat, 66 ; lean, 66. 
 
 Flank of beef, 59. 
 
 Flat fish, 68. 
 
 Flesh, composition of, 55. 
 
 Flesh of young animals, 55. 
 
 Florador, 82. 
 
 Flounder, 68. 
 
 Flour, 79, 80 ; bleaching 
 of, X69; cookery of, 386 ; 
 from i^e, 86. 
 
 Fluid diet in tuberculosis, 
 361. 
 
 Fondants, 77. 
 
 Food, absorption of, 19 ; 
 adulteration, 167; canned, 
 x66 ; constituents of, 11 ; 
 cooked in paper bags, 392'; 
 diseases caused by^ x^2 ; 
 from vegetable ■ proteins, 
 147 ; preservatives, 165 ; 
 requirements of children, 
 213 ; serving for invalids, 
 281 ; smoked, 165 ; stuffs to 
 avoid in childhood, 216 ; 
 uncooked diet, 243. 
 
 Foods allowable for dia- 
 betes, 332 ; obese sub- 
 jects, 351 ; cheap, 251 ; 
 containing parasites, 173 ; 
 dried, 165 ; farinaceous, 
 for infant feeding, 203 ; 
 in milk, X48 ; inorganic, 
 zx ; patent, 141 ; pro- 
 prietary, X41. 
 
 Formalin, X 68. 
 
 Formic acid, X2x. 
 
 Fortified wines, x22. 
 
 Frame food, 81, 203. 
 
 Freezing food, 166. 
 
 Fresh air in tuberculosis, 
 358. 
 
 Fretfulness, 183. 
 
 Fruit, 90; drinks, 401 j for 
 diabetics, 340 ; juices, 
 use in fever, 280 ; soup, 
 93; syrups, 93. 
 
 Fruits, acid, c)i ; anti-scor- 
 butic,^ 93 ; in childhood, 
 2z6 ; in old age, 329; pre- 
 serving of, 93. 
 
 Frumenty, 82. 
 
 Frying, 375 ; dry, 375 ; wet, 
 
 „ 375: 
 Fungi, 96. 
 
 Gams, 65. 
 
 Garlic, 102. 
 
 Gastric juices, 20. 
 
 Gelatine, 14,414; food adul- 
 terated by, Z69 ; in infant 
 feeding, X94 ; jelly, 400 ; 
 use of, in fevers, 279. 
 
 Germ of wheat, 79, 80. 
 
 German beers, xx7 ; greens, 
 xox ; lentils, 89. 
 
 Germs in milk, to destroy, 
 xga 
 
 Gigot of mutton, 6z. 
 
 Gin, XI 6. 
 
 Ginger ale, Z09 ', beer, 109 ; 
 wine, X23. 
 
 Glidine, 147, 336. 
 
 Gloucester cheese, 44. 
 
 Glucose, 77 ; syrup, Z70. 
 
 Glucoses, 76. 
 
 Gluten, 14, 80 ; bread, home- 
 made, 339 ; flour, 336 ; 
 macaroni, 340. 
 
 Goat's milk, x88. 
 
 Gooseberry, gi. 
 
 Gorgonzola cheese, 44. 
 
 Gourds, lox. 
 
 Gout, 3ix_. 
 
 Grain whisky, xi6. 
 
 Grand bouillon, 380. 
 
 Granola, 82. 
 
 Granose, 82 ; flakes, 242. 
 
 Grape-fruit, gx ; nuts, 242. 
 
 Grapes, 91. 
 
 Grape sugar, 77. 
 
 Green peppers, Z02 ', vege- 
 tables, loi ; walnuts, 95. 
 
 " Greens " or kale, loi. 
 
 Grilling, 374. 
 
 Groats, 85. 
 
 Grouse, 64, X73. 
 
 Gruel, 426. 
 
 Gruels, diabetic, 337, 429 ; 
 peptonized, 407. 
 
 Guava, gi. 
 
 Haddock, 66, 67. 
 Hjug diet for gout, 318. 
 
444 
 
 INDEX. 
 
 Halibut, 66, 68. 
 
 Hams, 65. 
 
 Hare, 64, 173. 
 
 Haricot beans, 88. 
 
 Hazel nuts, 95. 
 
 Height table of children, 
 
 213. 
 Herring, 66, 68. 
 Hickory nuts, 95. 
 Hock, 121. 
 Homax, or Hoffs malt 
 
 extract, 159. 
 Homely measures, 253. 
 Hominy, 84, 427. 
 Honey, 76, 170. 
 Horlick's food, malted, 
 
 160, 201. 
 Horse radish, 102. 
 Hough of beef, 59. 
 Hovis flour, 81 ; food, z6o. 
 Humanized milk, 47, 188, 
 
 200. 
 Hungarian wines, 122. 
 
 IcB Crbam, 42. 
 Iceland moss, 96. 
 Imperial cheese, 44 ; drinks, 
 
 401. 
 Indian meal, 84. 
 India pale ale, Z17. 
 Indigestion, treatment of, 
 
 303. 305- 
 Infant, diet after weanmg, 
 
 20^; failure to gain in 
 
 weight, 183. 
 Infant feeding, 177, 188, 
 
 et seq. ; gelatine jelly for, 
 
 400. 
 Infant growth, weight, x8z. 
 Inflammation of kidney, 
 
 milk in, 38. 
 Invalid bovril, 143. 
 Invalid food, 160, 408. 
 Invalids, serving of food, 
 
 z8i. 
 Invert sugar, 76, 77. 
 Irish malt whisky, 1x6. 
 Irish moss, jelly, 430. 
 Iron, 17. 
 Isinglass, 66. 
 Italian wines, 122. 
 
 Jams, adulteration of, 170. 
 Jellies, peptonized, 155 ; 
 
 various, 409, 411, 413, 
 
 414. 
 Jerusalem artichoke, 98. 
 johannis, xxo. 
 John Dory, 68. 
 
 Kalari Biscuits, 336. 
 
 Kephir, 45 ; cure, 387. 
 Ketchup, 96. 
 Kidney, 63 ; diet on, 27a 
 Knuckle of veal, 60. 
 Komules, 242. 
 Koumiss, 45, z88, 287. 
 KFonthal, no. 
 Kiimmel, 1x7. 
 
 Lactalbumih, 35, X97. 
 Lactation, diet during, 185, 
 
 232. 
 Lactic cheese, 389. 
 Lactose, 35, 77. 
 Lacto-vegetanan diet, 243, 
 
 294. 
 Lacumen, 49. 
 Lacvitan, 49. 
 Lamb, 62. 
 
 Lard, adulteration of, 169. 
 Lean meat cakes, 298, 416. 
 I^g of mutton, 61. 
 Legumes, 87. 
 Legumin, 14, 147. 
 Lemco, 143. 
 Lemon, 91 ; adulteration of, 
 
 172. 
 Lemonade, 109, 402. 
 Lemon pudding, 420. 
 Lemon squash, 401. 
 Lemon whey, 399. 
 Lentils, 89, 365. 
 Lettuce, xoa. 
 Levulose, 77. 
 Lichenin, 96. 
 Lichens, 96. 
 Lime, 91. 
 Lime juice, adulteration of, 
 
 172. 
 Lime phosphate in milk, 36. 
 Lime water in milk, 37 ; in 
 
 infant feeding, X94. 
 Ling, 67. 
 Liqueurs, 1x7. 
 Liquids in old age, 229. 
 Liquor pepticus, ,154. 
 Litnia water, X09. 
 Liver, 63. 
 Lobster, 69. 
 Loin of mutton, 62. 
 Loin of veal, 60. 
 London Nut Food Co., 240. 
 
 Macaroni, 83 ; gluten, 
 
 340- 
 M'Ewan's beer, 1x8. 
 Mackerel, 66, 69. 
 Madeira, ethers in, X23. 
 Map;nesia for infants, 194. 
 Maize, 83, 84, 427, 
 Maizina, 84. 
 
 Malic add, laz. 
 
 Malt, 154; liquors, 117; 
 soup, 188 ; whisky, xx6. 
 
 Msdted cereals, zox. 
 
 Malted foods (table), 439. 
 
 Malted milk, 398. 
 
 Malted proprietary foods, 
 160. 
 
 Maltine, 159. 
 
 Maltose, 2X, 76, 158, 240. 
 
 Manhu whole-meal flour, 
 242. 
 
 Mannite, 77. 
 
 Maple sugar, 76. 
 
 Mapleton's butter, 241 ; 
 vegetable proteins, 239. 
 
 Mare's milk, 188. 
 
 Margarine, 43. 
 
 Marmite, 240. 
 
 Marrow bones, 59, 420. 
 
 Marsala, ethers in, X23. 
 
 Marws,'i4G. 
 
 Mason's beef-tea, X43. 
 
 Mastication, 20, 207. 
 
 Mayonnaise sauce, 422. 
 
 Meals, 28, X29; British, 
 X3X ; cheap, 249, 251, 253 ; 
 for children, 217 ; for 
 diabetics, 342 ; for gouty, 
 313; for industrial classes, 
 136 ; for obesity, 349 ; for 
 old age, 227 ; for school 
 children, 222 ; French, 
 131 ; hurried, 28 ; in fluid 
 diet, 290 ; in tuberculosis, 
 359 ; in tuberculosis, ex- 
 pensive feeding, 360 ; in- 
 expensive, 363. 
 
 Meat, acids in, 57 ; albu- 
 mins, 336 ; and hot-water 
 diet, 997 ; broths, x88 ; 
 broths for infants, 204 ; 
 diet in tuberculosis, 362 ; 
 dinner, choap, 258 ; dishes 
 in old age, 228 ; econom- 
 ical, in tuberculcKis, 365 ; 
 extracts, 142, X58 ; ex- 
 tracts, composition of 
 (tables), 43^ ; extractives, 
 57 ; foods in childhood, 
 215; jelly, 413; juices, 
 144, 384, 41X, 4x7; infu- 
 sion, 38X ; lozenges, 146 ; 
 peptonized, 407; proprie- 
 tary foods, 141 ; teas, 137, 
 142, i43i 381, 38a, 408. 
 
 Meatose, 240. 
 
 Meatoxj X46. 
 
 Mellin's food for infant 
 feeding, 20X. 
 
 Melon, xoi. 
 
INDEX. 
 
 445 
 
 Milk, 33, 148, z68 ; al- 
 bumins, 336 ; bovril, 398 ; 
 care of, 192 ; cereal, 398 ; 
 coffee, 398 ; citrated, for 
 infant feeding, igS ; diet, 
 285 ; diet, cure for obe- 
 sity, 350 ; diet in fevers, 
 277 ; diluents, to prepare, 
 ^g8 ; dried, 49, 188 ; foods 
 in cereal additions, 148 ; 
 in diabetes, 333 ; in fever, 
 38 ; in gout, 316 ; in old 
 age, 227 ; iron in, 17 ; 
 lemonade, peptonized, 
 407 ; malted, 398 ; mix- 
 ■ ture for infant feeding 
 (table), 195 ; peptonized, 
 406 ; peptonized efferves- 
 cent, 407 ; peptonized for 
 infant feeding, 198 ; pos- 
 set, 398 ; preparations for 
 infant feeding, 188, 201 ; 
 product^ predigested, 
 156 ; recipes for, 397 ; 
 cures, 286, 288 ; sterilizers, 
 191. 
 
 Milk, condensed, 46, 4J7, 48 ; 
 advantages of, 48 ; infant 
 feeding, 200. 
 
 Millet, 84. 
 
 Mineral salts, 15. 
 
 Mineral waters, 109. 
 
 Mint, Z02. 
 
 Molasses, 76. 
 
 MoUusca, 66. 
 
 Moseley's malted food, 160. 
 
 Mosquera beef meal, 145. 
 
 Mouth, digestion in, 19. 
 
 Muffler's food, 147, 
 
 Mulberry, 91. 
 
 Mullet, 66. 
 
 Mush, 84. 
 
 Mushroom forcemeat, 431. 
 
 Mushrooms, 96. 
 
 Mushrooms au gratin, 432. 
 
 Mussel, 69. 
 
 Mustard, adulteration of, 
 170. 
 
 Mutton, 61 ; foreign, 6x. 
 
 Myosin, 13, s^- 
 
 Natural Wines, 123. 
 Neave's food, 203. 
 Neck of beef, 59. 
 Nine holes of beef, §9. 
 Nursing, centra-indications 
 
 for, 182. 
 Nut cream butters, 241. 
 Nut. kernels, ground, 242 ; 
 
 oil, 43 ; vego, 240. 
 Nutarian diet, 237. 
 
 Nutroa food for infant feed- 
 ing, 202. 
 Nutrogen, 24a 
 Nutrose, 90. 
 
 Nuts, 91, 94, 95. 
 Nuttolene, 340. 
 
 Oat Flour, 85. 
 
 Oatmeal gruel, 426 ; iron 
 in, 17; in tuberculosis, 
 365 ; porridge, 426 ; 
 water, 400 ; water in in- 
 fant feeding, 194. 
 
 Oats, 85. 
 
 Obesity, 347 ; milk diet 
 cure for, 350 ; patent 
 remedies for, 352 ; Salis- 
 bury diet for, 350. 
 
 Old age, diet in, 225. 
 
 Old Marsala, sugar in, z2i. 
 
 "Old Tom" gin, 117. 
 
 Olive, 91, 
 
 Omelets, 391, 402, 404 ; sa- 
 voury, 406, 431 ; sweet, 
 405, 406. 
 
 Onion, 98, loi, 102. 
 
 Oral sepsis, 29. 
 
 Orange, 91. 
 
 Orangeade, 401. 
 
 Orange jelly, 414. 
 ■Oswego, 84. 
 
 Overeating, effects of, 268. 
 
 Ovo, 146. 
 
 0x0, 143. 
 
 Oyster, 6q, 424, 435 426 ; 
 poison from, 173. 
 
 Paget*s Malted Farina, 
 
 160. 
 Falmitin, 43. 
 Pancreas, 154. 
 Pancreatic secretion, 21. 
 Pancreatin, 154. 
 Pancreatized milk cereal, 
 
 398. 
 Panopeptone, 158. 
 Paper-bag cookery, 392. 
 Parasites contained in food, 
 
 T, '". 
 
 Parmesan cheese, 44. 
 Parsley, 103. 
 Parsnips, 97. 
 Partridge, 64. 
 Pasteurization of milk, 191. 
 Pastry, 390, 391. 
 Patent foods, 141. 
 Peach, 91. 
 Pea-nut, 90. 
 Pear, gi. 
 
 Peas, go; in tuberculosis, 
 365. 
 
 Pecan nuts, 95. 
 
 Pectoses, 73. 
 
 Pemmican, 145. 
 
 Pepper, adulteration of, 170. 
 
 Pepsencia, 154. 
 
 Pepsin, Z54 ; in stomach, so. 
 
 Peptone preparations 
 
 (table), 438. 
 
 Peptones, 20; predigested, 
 zs6. 
 
 Peptonized blancmange, 
 Z55 ; broths, 408 ; cocoas, 
 ZX3 ; foods, preparation 
 of, 406 ; gruels, 407 ; 
 jellies, Z55 ; milk, x88 ; 
 milk for infant feeding, 
 zgS. ^ 
 
 Peptonizing foods, 154. 
 
 Periwinkle, 6^. 
 
 Perry, ethers in, Z33. 
 
 Personal idiosyncrasy, 28. 
 
 Pheasants, 64. 
 
 Phosphorus, Z7. 
 
 Physiology of nutrition, 9. 
 
 Pilchards, 6g. 
 
 Pineapples, gz. 
 
 Pine kernels, 95, 241. 
 
 Pistachio, 95. 
 
 Plaice, 68. 
 
 Plants, salts of, 74. 
 
 Plasmon, 50, 336 ; biscuits, 
 34o;diabeticbiscuits, 335. 
 
 Plum, gz. 
 
 Polenta, 84. 
 
 Popcorn, 84. 
 
 Pork, 65. 
 
 Porridge food, value of, 86. 
 
 Porridge oats, 85. 
 
 Porridges, diabetic, 429. 
 
 Porter, zz8. 
 
 Port, ethers in, 122 ; mod- 
 eration in, 124 ; sugar in, 
 
 Z2I. 
 
 Postum, 243. 
 
 Potash water, zog. 
 
 Potassium, z6; phosphate 
 in milk, 36. 
 
 Potato, 97. 
 
 Potato and cheese mould, 
 427. 
 
 Potato salad, 424. 
 
 Potatoes, value in tubercu- 
 losis, 366. 
 
 Pot-au-feu, 380k 
 
 Poultry, 64. 
 
 Prairie oyster, 53. 
 
 Prawns, 69. 
 
 Predigested foods, Z53 ; 
 meats, X56 ; milk'products, 
 156. 
 
 Preservatives, 167. 
 
446 
 
 INDEX. 
 
 Prolacto bread, 336. 
 
 Proprietary foods, 141, 147 ; 
 for infant feeding, x88, 
 igg ; (table), 437. 
 
 Protein, 51 ; advisable in 
 children, 214; constituents 
 of, 12 ; in tuberculosis, 
 358 ; of legumes, 87 ; of 
 naVk, 35 ; of wheat, 80 ; 
 requirements, 24. 
 
 Proteins, vegetable,y3, 239. 
 
 Protene, 336 ; biscuits, 335 ; 
 bread, 335, 339; company's 
 preparation, 50. 
 
 Protose, 2^0. 
 
 Provision of Meals Act 
 (1906), 250. 
 
 Prune, 91., 
 
 Ptarmigan, 64. 
 
 Ptomaine poisoning, 172. 
 
 Ptyalin, 20. 
 
 Pudding, almond cake, 43 ; 
 cocoanut, 337. 
 
 Puddings, arrowroot, 410; 
 diabetic, 337* 4*9! for 
 young children, 206 ; in 
 childhood, 216 ; making 
 of, 390 ; milk, 391 ; starch 
 free, 433. 
 
 Pulled bread, 82. 
 
 Pulses, 87 ; for vegetarians, 
 241. 
 
 Pumpernickel, 388. 
 
 Pumpkin, loz. 
 
 Pur6e, 380. 
 
 Purin free diet, 237. 
 
 Puro, 144, 147. 
 
 Pylorus, 20. 
 
 QuiNCB, gz. 
 
 Rabbits, 64. 
 
 Ralston's food, 242. 
 
 Raspberry, 91. 
 
 Raw beef jelly for infant 
 
 feeding, 203. 
 Raw beef juice, 188, 203, 
 
 417- 
 
 Raw meat cookery, 4x6. 
 
 Refrigerating food, 166. 
 
 Rennet, Mackays, 197. 
 
 Rest, influence of, food re- 
 quired, 27. 
 
 Revalenta arabica, 89. 
 
 Rheumatism, 31 z ; chronic, 
 
 323- 
 
 Rheumatoid arthritis, 323. 
 
 Rhubarb, 102. 
 
 Rib of beef, 59. 
 
 Rice, 86; water, 194, 400, 
 
 401. 
 
 Ridge's food, 203. 
 Rislacto biscuits, 336. 
 Roasting, 373. 
 Robbs's baby biscuits, 203. 
 Robinson's barley, 203. 
 Roborat, 147, 240. 
 Roots, 96, 
 
 Roquefort cheese, 44. 
 Round of beef, 60. 
 Rubner, 23. 
 Rum, Z16. 
 Rump, 59. 
 Runner of beef, 59. 
 Rusks, ^8g. 
 
 Rusk, time to digest, 22. 
 Russel's anti-corpulent pre- 
 paration, 352. 
 Rye. 86. 
 
 Saccharin, 77. 
 
 Sago, 98 ; pudding, 410. 
 
 Salads, 424 ; celery, 424 ; 
 French bean, 424 ; French 
 beans and tomatoes, 424 ; 
 potato, 424 ; tomato, 424 ; 
 vegetables, 102. 
 
 Salisbury diet, 297 ; for obe- 
 sity, 350; modified, 299. 
 
 Saliva, ferment in, so. 
 
 Salivary digestion, 2a 
 
 Salmon, 66, 68. 
 
 Salting food, x66. 
 
 Salts in food, 16. 
 
 Salutaris water, Z09. 
 
 Samp, 84. 
 
 Sanatogen, 50, 336. 
 
 Sand, adulterant, as an, 170. 
 
 Sanose, 50, 147. 
 
 Sardines, 69, 
 
 Sauces, 421 ; au beurre 
 noir, 422 ; Dutch, 423 ; 
 Italienne, 419. 
 
 Sauerkraut, loi. 
 
 Sausages, 65. 
 
 Sauterne, sugar in, i2x. 
 
 Savoro, 161. 
 
 Savory and Moore's food 
 for infant feeding, 202 ; 
 for invalids, 160 ; pepsin, 
 
 Savoy, zox. 
 
 Scalding milk, 191. 
 
 Scarlet fever, contamina- 
 tion of milk,_ 39. 
 
 Scones, diabetic,*430. 
 
 Scotch whisky, zz6. 
 
 Scott's oat flour, 203. 
 
 Sea-birds, flavour of, 56. 
 
 Seakale, loi. 
 
 Seasons, influence of, food 
 required, 27. 
 
 Seltzer water, 109, iio. 
 
 Semolina, 82. 
 
 Sex, food required, influence 
 of, 26. 
 
 Shallot, 102. 
 
 Sheep, division of, 61, 62. 
 
 Sherry, ethers in, 122 ; sugar 
 in, X2I. 
 
 Shin of beef, 59. 
 
 Shoulder of mutton, 62. 
 
 Shredded wluat, 83; bis- 
 cuits, 242. ^ 
 
 Shrimps, 69. 
 
 Sirloin of beef, 59. 
 
 Skate, 66, 68. 
 
 Skimmed milk cure, 386; 
 in gout, 317. 
 
 Sloe, 91. 
 
 Smelts, 68. 
 
 Smoked food, 165. 
 
 Snipe, 64. 
 
 Snowball eggs, 405. 
 
 Soda water, X09. 
 
 Sodium, 16 ; bicarbonate 
 in milk, 37 ; chloride, 17 ; 
 citrate in infant feeding, 
 X94 ; dtrate in milk, 37. 
 
 Sole, 68. 
 
 Somatose, 157. 
 
 Sorghum, 84. 
 
 Soufil^s, 391, 405. 
 
 Soup, 373; bean, 4x6; brown 
 vegetable, 4x5; clear, 4x2; 
 fruit, use in fevers, 93, 
 280 ; making, 377 ; meat 
 extract, 410 ; nutritional 
 value of, 376 ; oyster, ^25 ; 
 peptonized, X55 ; recipes 
 for, 4x2 ; varieties of, 378 ; 
 vegetarian, 386, 4x4 ; in 
 childhood, 915 ; in old 
 age, 228. 
 
 Soured milk cure, 288. 
 
 Soya beans, 89. 
 
 Spaghetti, 83. 
 
 Spices, adulteration o^ X70. 
 
 Spinach, 102. 
 
 Spirits, 115. 
 
 Spongecakes, diabetic, 340. 
 
 Sprats, 69. 
 
 Squash, lox. 
 
 Standard amounts, 23. 
 
 Standard bread, 389. 
 
 Standard of food, 24 ; meals, 
 24. 
 
 Starch, 74 ; digestion in 
 mouth, 20 ; food, adulter- 
 ated by, 169 ; free pud- 
 dings, 433 ; sugar, adul- 
 terant, as an, X70. 
 Stearin, 43. 
 
INDEX. 
 
 447 
 
 Steamed eggs, 411. 
 
 Steaming, 374. 
 
 Stewing, 376 ; of vegetables, 
 
 Stenlization of milk, 191, 
 
 192. 
 St. Galmier, izo. 
 Stilton cheese, 44. 
 Stimulants in old age, 229. 
 Stock, 378 ; brown, 37B, 379 ; 
 
 fish, 378, 3S0 ; second, 
 
 381 ; vegetable, 386 ; 
 
 white, 378, 380. 
 Stomach, 20 ; digestion, 
 
 time in, S2 ; milk in, 39. 
 Stout, It 8. 
 Strawberry, 91. 
 Sturgeon, cooking of, 66. 
 Succmic acid, isi. 
 Sucrol, 77. 
 
 Sucroses, varieties of, 76. 
 Suffolk cheese, 44. 
 Sugar of milk, 35, 178 ; in 
 
 wine, 121 ; in childhood, 
 
 216; adulteration of} 170; 
 
 sugar, 74, 75, 76. 
 Sugars, substitutes for, 77, 
 Supper for children, 317. 
 Sweetbreads, 63, 4x9; and 
 
 vegetables, 432. 
 Sweet potato, 97. 
 Sweets, in childhood* 2x6. 
 Syboes, 102. 
 Syrup, 76, 170. 
 
 Table for Weaning, 187. 
 
 Tannic acid, Z2i. 
 
 Tapioca, 98. 
 
 Tarragon, 102 ; creams, 433. 
 
 Tartaric add, 121. 
 
 Tartar in wine, 121. 
 
 Tartar sauce, ^22. 
 
 Tea, adulteration of,i7T; for 
 children, 217 ; made with 
 milk, 398 ; preparation 
 of, III ; varieties of, 132. 
 
 Teats, care of, 193. 
 
 Thea, no. 
 
 Theobroma cacao, 112. 
 
 Thirst quenchers, 92, 40X. 
 
 Tilia, 51. 
 
 Titnimen bread, 336. 
 
 Toast, 387 ; buttered, 388 ; 
 water, 400. 
 
 Tomato, 103 ; omelet, 406 ; 
 salad, 424. 
 
 Tomatoes, scalloped, 42S ; 
 stuffed, 432. 
 
 Tongue, 63. 
 
 Treacle, 76 ; adulteration 
 of, 170. 
 
 Tripe, 63, 417 ; and onions, 
 418. 
 
 Trisket, 82. 
 
 Trommer's diastatic ex- 
 tract of malt, 159. 
 
 Tropon, 147. 
 
 Trout, 67. 
 
 Tubercle diet for children, 
 367. 
 
 Tuberculosis, 357.I 
 
 Tuberculous contamina- 
 tion of milk, 39. 
 
 Tubers, g6. 
 
 Turbot, 66, 68. 
 
 Turkey, poison from, 173. 
 
 Turnip, 97 ; tops, 10^. 
 
 Typhoid contamination of 
 milk, 39. 
 
 Uric Acid free dietary, 
 
 237. 295. . 
 Uses of cooking, 371. 
 
 Veal, 60; jelly, 413; jelly, 
 savoury, 411. 
 
 Vegetable albumin, 2^0 ; 
 albumins for diabetics, 
 336 ; butters, 73 ; ex- 
 tracts, 240 ; foodfs, 73 ; 
 jellies, 73 ; marrow, loi ; 
 marrow, stuffed, 431 ; pron 
 teins, 73 ; soup, bro^n, 
 
 415- 
 
 Vegetables, advisable for 
 children, 215 ; composi- 
 tion of, 99 ; cooking of, 
 385 ; for diabetics, 341 ; 
 green, 98 ; in gout, 318 ; 
 in old age, 228. 
 
 Vegetarian cheese, 243 ; 
 dinner, cheap, 255 ; gela- 
 tine, 243 ; recipes, 426 ; 
 soup, ^14. 
 
 Vegetarianism, 237. 
 
 Vegota, 240. 
 
 Vegox, 147. 
 Vermicelli, 83 ; gluten, 
 
 340. 
 
 Vicheyj no. 
 
 Vienna bread, Bz. 
 
 Vincep, 145. 
 
 Vinegar, adulteration of, 
 
 172. 
 Virol, 146. 
 Virvis, 146. 
 Voit, 23. 
 Vomiting in infants, Z84. 
 
 Walnuts, 95. 
 
 Water, 17, 107 ; in infant 
 
 feeding, 194. 
 Water cress soup, 415. 
 Waters, mineral, log. 
 Weaning, 186; reasons for, 
 
 182. 
 Weight charts, 181, 213, 
 
 348. 
 Wheat, 79 ; preparations 
 
 of, 83. 
 Wheatena, 82. 
 Wheaten groats, 83; meal, 
 
 8z. 
 Whelk, 69. 
 Whey, 42, 188 ; cure, 42, 
 
 287, 399; in gout, 317; 
 
 to make, 399 ; use of, 
 
 Whipped jelly, 414. 
 
 Whisky, iz6 ; moderation 
 in, Z34 ; purity of, X24. 
 
 Whitebait, 68. 
 
 White sauce, 421. 
 
 Whiting, 66, 67. 
 
 Wine, Z18, I2X ; acids in, 
 Z2I ; alcohol in, x3o ; 
 cheap, Z19 ; ethers in, 
 122 ; jelly, 414; " plaster- 
 ing," Z19 ; purity of, Z24 ; 
 sparkling, 120 ; still, 120 ; 
 sugar in, isi ;_whey, 399. 
 
 Wines, composition of, 120 ; 
 red, I20 ; white, 120. 
 
 Wintox, 240. 
 
 Women, alcohol in, 127. 
 
 Woodcock, 64. 
 
 Work, mental, effect^ on 
 digestion, 30 ; physical, 
 effect on digestion, 30. 
 
 Yam, 97. 
 
 Zwieback, 389. 
 
 THE END, 
 
New and Revised Edition. Demy Svo, 6j6 pp. Price ioj6 net. 
 
 FOOD AND FEEDING 
 
 IN 
 
 HEALTH AND DISEASE 
 
 A MANUAL OF 
 
 PRACTICAL DIETETICS 
 
 BY 
 
 CHALMERS WATSON, M.D., F.R.C.P.E. 
 
 ASSISTANT PHYSICIAN, ROVAL INFIRMARY, EDINBURGH 
 EDITOR OF THE " ENCYCLOP^GDIA MEDICA " 
 
 "Dr. Chalmers Watson has dune well to write a standard book on ' Food 
 and Feeding,' for it is a long time since any satisfactory book on dietetics 
 has appeared in the English language. He has executed his task so well 
 that his treatise will be studied by many different classes of persons. The 
 educated cook, the managers of public kitchens and schools of cookery, the 
 nursing mother, the trained nurse, and the doctors whose duty it is to give 
 advice on the feeding of invalids in acute and chronic illnesses, will all learn 
 much from its perusal." — Aihtnteum, 
 
 OLIVER AND BOYD 
 
 EDINBURGH: TWEEDDALE COURT 
 LONDON : PATERNOSTER ROW, E.C.