CORNELL UNIVERSITY LIBRARY David Albert Hauck Endowment RM 2i9.F7°6"'"'""""'"'""-"'"^ Food for the invalid; the convalescent; 3 1924 012 176 826 Cornell University Library The original of tliis book is in tine Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924012176826 FOOD FOR THE INVALID; THE CONVALESCENT; THE DYSPEPTIC ; AND THE GOUTY, FOOD FOR THE INVALID ; THE CONVALESCENT; THE Dyspeptic ; AND THE GOUTY. J. MILNER FOTHERGILL, M.D, Edin., MEMBER OF THE KOTAL COLLEGE OF PHYSICIANS OF LONDON. SENIOa ASSISTANT PHYSICIAN TO THE CITY OF LONDON HOSPITAL FOH DISEASES OF THE CHEST (VICTORIA PARK). ASSISTANT PHYSICIAN TO THE \VE3T LONDON HOSPITAL. ASSOCIATE FELLOW OV THE COLLEGE OF PHYSICIANS OF PHILADELPHLi " May good digestion wait on appetite ; and health on both.' MACMILLAN AND CO. v 1880. The Right of Tra/aslation amd Reproduction is Reserved, R. Ci-AY> Sons, and Taylor, bREAD STREET HILL, EX. TO THE SHADE OF EDWAED GIBBON, @.f)£ fl^tstorian. WHOSE GASTEONOMIC PEOCLmTIES HAVE PRESERVED FOE US THE FEASTS OF ANCIENT ROME, THI& WORK BY THE AIJTHOE. PREFACE. , This little book came into the world rather oddly. Speaking to Mr. Macmillan one day ahout printing a pamphlet on "Food for Invalids," for private use, he suggested that it had better take the form of a book: if such a thing were useful to me it would be useful to others ! Busy practitioners will probably find it very useful, and save them much time to boot. Invalids and their friends will also, in all probability, find it of service to them; as the initials attached to each article of food will guide them in their choice. A few preliminary remarks on food and its destina- tion, and on digestion, add, it is believed, to its general utility. I have to thank Dr. H. C. Wood, of Philadelphia, for his co-operation. Such a work, in addition to original matter, has involved the selection from already existing recipes. Plain and simple dishes were essential to my scheme : therefore Cre-fydd's Family Fare and Mrs. Frederick's Hints to Housewives peculiarly recommended themselves, while many general observations in Mrs. Frederick's excellent work seemed of especial value. To the writers of these books I acknowledge my obligations. 23, Somerset Street, PoKTMAN Square, W., 1880. CONTENTS. PAqE iNTEOpUCnON 1 The Invalid in Bed 21 Nursery Food 24 Op Food Generally 25 Recipis .29 FOOD FOR THE INVALID, INTKODUCTIOK The attention now paid to our food is not a mere fashion. Our increasing wealth permits of organisms being reared to maturity which must have perished under earlier and more trying conditions. It also leads to much of what is either biliousness or gout, as the case may be, viz., conditions where the system is taxed by the accumulation of waste matter derived from the albuminoids of our food. What are albuminoids we shall shortly see ! The excessive demand upon the nervous system in the battle of modern life is leading to much visceral disturbance, of which dyspepsia is only a part ; and we are beginning to learn to see that derangement of the liver and of the kidneys is a not xmcommon outcome of mental worry. The relations of mental worry to diabetes are well and generally recog- nised. Then, again, there is a growing incapacity to 2 FOOD FOR THE INVALID. digest fat which is truly alarming, and which has given a distinct prominence to artificial digestive agents. Beyond all this there is the effect of illness and acute disease upon the digestion to be considered and taken into account. Consequently there is a distinct necessity for a hook devoted to the food for persons who are out of health, or whose digestive powers are feeble. How far the writer is competent to write such a book it is for the readers to decide ; but the subject of food is necessarily one which attracts the attention of all who are specially devoted to that division of medicine, viz., the treatment of disease. By a suitable dietary many maladies may be avoided ; by appropriate food many troubles, as indigestion, biliousness, gout, and diabetes, may be greatly alleviated, and in a number of cases even cured. An immense amount of human misery is due to an unsuitable dietary. Time has sanctioned our present eating arrangements, and it is almost impiety in the eyes of many to impugn our existing culinary com- binations. The ghosts of many devoted cooks, who have given themselves heart and soul to the task of providing what is attractive and toothsome, still hover around' us ; and must be treated with respect. I do not wish to say one word that would give offence to these departed worthies, whose devotion and ahomdon have earned for them imperishable reputations, and the grati-i tude of hungry humanity. But it is just possible to suggest that their guides were the palate first and the digestion next. They lived in twilight ; and the day- break of physiological knowledge is doubtless disturb- ing to them. The light of chemistry and physiology is causing a flutter among them. Our food-combinations INTRODUCTION. 3 now are to be indicated by our advancing knowledge of the wants of the organism, the requh-ements of the tissues, and the effects of modern life upon the viscera. Our dietaries, in other words, must become more scientific. In the present transition state of our information about food in relation to the needs of the body, it is necessary to select from our extant cookery-books what is required, so far as is possible. That is no easy task to essay : but a beginning must be made, and errors and omissions may be corrected and amended in future editions, and perhaps by other writers. It is impossible to appraise correctly and with any approach to accuracy the amount of information possessed by each reader ; so it appears that the most prudent course is to write as if the subject were new to all : if in so doing any umbrage is given to those who do know something about food, an apology is tendered to them at the outset. For what do we require food? (1) In order to maintain the body temperature, or to manifest force, i.6. to exert ourselves in work or other form of muscular activity ; (2) and to build up our tissues in growth, and repair them in adult life. Tor these ends different forms of food are required. Just as there is in a steam-engine the metal framework and the coals which heat the water into steam which sets the metal machine into motion ; so there are in the body the tissues and the fuel The bony framework, the skeleton, is moved by muscles, which in turn are set in action by the nerves. These correspond to the metallic portions of the engine, which are not themselves consumed, but wear out and need repair. The fuel of the body, like that of the steam-engine, is hydrocarbonaceous. That B 2 4 FOOD FOB THE INVALID. is, it consists of hydrogen and carbon, which readily unite with oxygea This is the fuel of the body jjar eaxellence. The vegetable world builds up these hydrocarbons ; the animal world burns them by oxidation. Animals produce carbonic acid gas, as the result of the com- bustion of their food ; vegetables deoxidise this carbonic acid and store up carbonaceous material, and give off free oxygen. At an early period of the earth's history the atmosphere was highly charged with carbonic acid gas. A luxuriant vegetable growth cleared the air of carbonic acid gas tOl a warm-blooded animal became a possibility. The vegetable world is practically without motion; but it stores up the material which renders motion in animals possible. And thus they live side by side with each other; one could not live without the other. The animal could manifest no force without oxygen ; without the animal to produce carbonic acid the vegetable world would perish. Then from water is derived the hydrogen compounds. Just as the plant takes the carbon of carbonic acid and gives off the oxygen ; so it takes the hydrogen of water and gives off the oxygen. From these two — carbon and hydrogen — are built up starch, sugar, and fat. These then are the hydrocarbonaceous elements which essentially con- stitute our food — ^the equivalent of the coal in the steam-engine. Then there are the tissues of the body. The essential feature in the tissues of the body is that they contain nitrogen. Liebig told us that the peculiarity of nitrogen is that, when in combination with other elements, it interferes with their capacity to unite with oxygen. INTRODUCTION. 5 When in comTDination, with carbon and hydrogen, they do not unite readily with oxygen, as they do when the nitrogen is not present. The tissues then heing nitrogenised do not themselves bum; while oxidising processes go on in them. The metal work of the engine is not consumed by the fire from the oxidis- ing coal ; in health the tissues of the body are not consumed by the heat produced by the oxidising hydro- carbons. It is well for the reader to grasp this broad law fully ; for this division of foods is the basis of aU we know about what a dietary ought to consist of. It should contain hydrocarbonaceous material for the working of the body ; and a sufficiency of nitrogenised material for the growth and repair of the tissues. Beyond this, phosphorus for the nervous system, iron for the blood, hydrochloric acid for the gastric jiiice, and alkalies for the liver, are rec[uisite in limited quan- tities. From the salt (chloride of sodium) of our food we get at once the flavouring agent acceptable to the palate ; and the hydrochloric acid for the gastric juice and the soda for the formation of the bHe-salt in the liver. For health various salts, of potash, soda, and lime are requisite, which are furnished in the different articles of our dietary. Without these latter disease would fasten upon us, as seen in the scurvy, which was the terror of old navigators ; and which is cured by vegetables at once and as by magic. The addition of the potato to our food-list has done away with the diseases due to a salt-meat dietary in winter, and which made the fast of Lent, when vegetables were the chief Article of food, so desirable after the long winter on salted provisions. The sour-kraut and the pickled 6 FOOD FOE THE INVALID. gherkins of the Continent were of cardinal importance before the introduction of the potato dethroned them, and left them on a lower platform of utility. There are, too, spices and condiments which are agreeable to the palate ; which keep up the appetite, and prevent too much disengagement of gas in the alimen- tary canal during the processes of digestion and assimi- lation. Such then are the chief constituents of our food. We can now trace them along in their career in the body. Hydrocarbons are quickly disposed of; a certain surplusage being stored up as fat, on which the body can live in times of starvation. The average amount of this garnered store is equal to about ten days' combustion : i.e. the body can live ten days upon itself. Starch is converted by the action of the saliva and the juice of the pancreas (the sweetbread) into sugar, and is stored up from each meal in the liver as glycogen. Glycogen is an insoluble form of sugar, which is given off gradually according to the body re- quirements, from the liver ; and burnt to maintain the body temperature and to generate force. Fat is burnt in precisely the same way ; and is a very concentrated form of fuel. In very cold regions large quantities of fat are required to maintain a body temperature com- patible with life. Fat is found as fat, butter, and oil These hydrocarbons are, then, the fuel of the body par excellence. They are, however, also essential to healthy tissues ; and a deficiency of fat is one factor in the pro- duction of the depraved form of tissue known as tubercle. The most dangerous and intractable form of phthisis is that which commences with a loss of the power to digest fat. INTRODUCTION. 7 Then there are the albuminoid or nitrogenised divisions of our food. These are requisite for tissue growth and repair; but in their oxidation a certain amount of heat is produced. Albumen is found largely in the vegetable world. All seeds contain albumen. The white of all eggs, (birds, reptiles, and fishes), is very- pure albumen. Albumen contains carbon, hydrogen, some oxygen, and its essential characteristic, nitrogen, with a little sulphur. It is found in various forms as albumen ; as caseine in milk, cheese, and the legumes ; as the muscular portions of the animal framework, the viscera, and the skin. It is a complex substance chemically. When swallowed, albuminoids are digested in the stomach mainly, and pass into the blood, from whence they reach the tissues. - As said before, these albuminoid substances containing nitrogen do not readily oxidise. The Uver is the furnace in which waste and surplus albuminoids are burnt by oxidation. When sufficiently oxidised, they give the bile acids, and the solids of the urine (not being salts) as Uthates and urea. Now it is the imperfect oxidation of this albuminoid surplusage which produces biliousness and gout, i.e. gout in its widest sense, viz. a waste-laden condition of blood, more properly described by the word lithiasis. Gout, a term once used to designate a disease of the joints, has now a much wider range of appHoa- tion; and, as "irregular" and "suppressed" gout, has come to be used, in its broad sense, to indicate a condition of the blood. In biliousness the blood is surcharged with bile-salts, of albuminoid descent and nitrogenised lineage ; just as much as the lithic acid, or Lithates, which are known and spoken of now as "gout- 8 FOOD FOR THE INVALID. poison." Such being the origin of these imperfectly oxidised waste matters, it is ohvious that in the treat- ment of biliousness and gout alike, it is essential to cut down the albuminoid elements of the food to the minimum of tissue wants. As long as these are in excess in the food, so long will the conditions remain little affected by medicines. Taraxacum for the liver, and potash for the kidneys, are all very well ; but a correct and intelligently designed dietary is the main thing. When of old the doctor sagely shook his head and said, " Liver and kidneys," he was not the fool it has been recently the fashion to regard him. He saw through a glass darkly, but nevertheless cor- rectly. He was in the dark, true ; but daybreak was not far off. Though our knowledge about the history of albuminoids in the body is far from what we could wish it to be, the matter is being rapidly cleared up ; and especially is this true of the medical aspect of the subject. In excess of albuminoid waste do we find the cause of much of the maladies to which adult life is subject. Why do we systematically eat more albu- minoid food than we require? it may pertinently be asked. The answer, " Because these substances are agreeable to the palate," is not a complete answer. The albuminoid waste in the blood gives us the subjective sensations of energy, of " feeling up to the mark," of being equal to work, which are so pleasant to all. Com- pare the energy of the carnivoroxis animals with the comparative lethargy of herbivorous creatures. This sensation of capacity and energy is, however, bought with a price ; and its Nemesis is found in biliousness and gout. Dominie Sampson was another man after INTRODUCTION. 9 Meg Merrilees had compelled him to eat some of the contents of her stew-pot ; and liebig compares the mental attitude of three persons — one of whom has had a substantial meal of meat; a second who has dined on fish ; and the third who has had some bread and an onion. The beef of the British warrior has always been coimted as an element in his bravery. There are, then, two very potent reasons why we eat too much albu- minous food; one, because it is pleasant to eat, and, another, because it produces an agreeable mental con- dition. But when we have " too much of a good thing," and the blood is surcharged with waste, then the mental attitude is unpleasantly affected ; there is the irascibility of gout, which is not merely the effect of pain ; and the melancholy of biliousness. Melancholia is "black-bile," and preserves the fossil idea of low spirits being due to " bile-poison " in the blood. This is true, so far as it goes, but melancholy, or the condition of " low spirits," is not due solely to " bile poison." Probably the following disquisition is a little over ;the heads of some readers, but it cannot be omitted. Without it the whole of the attempt to make our cookery-books more scientific would end in nothing. The necessity for more accurate knowledge on this subject is seen in the irrational practice which obtains in the sick-room. A generation ago a sick person would have been regarded as strangely neglected if calf s foot jelly had not been provided ; now the patient must be dosed with beef-tea, the stronger and more concentrated the better : and yet neither has a high food-value. In fact, there is little force-producing material (hydrocarbon) in either. Twenty years ago 10 FOOD FOR THE INVALID. a number of books on food appeared, in ■whicli starch, sugar, and fat were described as having no food-value at all; while albumen had the full 100 per cent, of food-value credited to it. A little real physiological knowledge soon reversed matters; and starch, which used to be sneered at, and which is stUl spoken of disrespectfully by persons who do not know 'better, is taking its true place. From starch to sugar, and from sugar to fat : that is the natural history of the fuel-food of man. "Bile-poison" and "gout-poison" are the avenging fates of a dietary too rich in albu- minoids. In most persons the system is not readily deranged, and excess is not swiftly followed by punish- ment ; while in others the punishment follows close on the heels of the offence. These latter are quickly taught the relations of cause and effect; a rich meal means a bilious attack next day ; a good dinner with subacid wines a red-hot great toe at no distant period. But, sad to say, the voice of the avenging fate is only audible to a very fine ear, and is never heard by ordinary persons; they go on eating and drinking, guided, or rather led on, by their palate and their appetite, which latter they whet with bitters. But in the far distance there is "gout-poison" and "bile- poison"; the danger-signals are up, but they are not heeded until they have been passed : and then these individuals become wise after the event. It is a pleasant course they foUow : why meet trouble half- way ? Events that are in the distance may not happen. Quite so ! The feet of the avenging deities are shod with wool ! Their footstep is noiseless, or niearly so ; why heed it ? It is just this seeing evils far ahead, and INTEODUCTION. 11 then learning to avoid them, which constitutes the physician's knowledge as to the production of the maladies due to excess of albuminoid waste. Without this he is a poacher, a trespasser on the cook's domain ; an intruder, who adds impudence to his dishonesty when he ventures to write a cookery-hook ; or perhaps, as regards a large portion of it, to compile one. As it is possible that the statement, that "bile- poison," like "gout-poison," is of albuminoid descent may be challenged by those who, carried away by the fact that food rich in fat and sugar gives rise to " bilious attacks," it may be as well to append the chemical formulae of the different substances, for the information of those interested in the matter. As they are taken from Prof. Michael Foster's standard work, A Text Book of Physiology, they are beyond suspicion of doubt as to correctness. Albumen consists of from H N C s 20-9 6-9 15-4 52-7 0-8 23-5 7-3 16-5 54-5 2-0, to In addition to this, there are small quantities of salts, of soda and potash, the chief being common salt. Of the bile series, cholic acid has a formula H.C^H3,0, + N,0, while glycocholic acid has a formula Taurocholic acid has the formula 12 FOOD FOR THE INVALID. containing nitrogen and also sulphur. All evidently derivatives from all)umen. The forms in which waste albuminoids pass out by the renal secretion are as uric acid and urea. Uric acid has a formula This is what is recognised as "gout poison." It is found in the body in union with soda, magnesia, and ammonia ; and as urate of soda is the material of the chalk-stones found in the joints of the gouty and on the ears. The more advanced and more oxidised form of waste is the more soluble urea, which has a formula (N.H^,CO. These renal solids are admitted to be of albuminoid descent by aU ; but our accurate information about the liver is of too recent a date for even the bulk of the pro- fession, to say nothing of the laity, to be acquainted with the bile acids which are found in union with soda. This disquisition may perhaps not be interesting to the bulk of readers, but there are a number who will appreciate it. With a large number of persons the avoidance of these albuminoid elements is a matter of cardinal importance. It is with the intent of avoiding excessive albuminoid waste that the dietaries arranged here consist so little of "brown meats." When the convalescent has got so far that he can eat and digest a beefsteak with oyster sauce, he is clearly off the sick- list ; and the fare of ordinary cookery-books once more interests him. For a certain period, however, he is safer with the articles given here, as being more easily digestible. It is not contended that in chemical INTEODUCTION. 13 composition the flesh of fish differs from that of heasta ; it is a question of degree. A meal of fish gives less albuminoid waste than necessarily results from a meal of brown meats. Fish is much more largely water than " flesh." The amount of albuminoid matter required for the repair of the tissues of the body, to meet daily wear and tear, is very smaU. Physiologists have not yet determined it with any approach to ac- curacy ; but it is certain enough that it does not neces- sitate anything like the amount of meat" which is con- sumed by most persons. Where the system has been much reduced by acute disease, as fever, then a liberal dietary is required for the rebuildiag of the tissues. The appetite is ravenous and the digestion good. Just as children when rapidly growing require a dietary in which meat is conspicuous; so the convalescent from fever must have a dietary rich in albuminoids, in order to repair the wasted tissues. But, except under these circumstances, our food is rich in albuminoids beyond our absolute wants. This is a matter of primary importance, and which is never forgotten in the selection of the forms of food given hereafter. Then as to the question of digestion. In the stomach albuminoids alone undergo digestion. If surrounded by too much fat the digestion of albuminoids is interfered with. Consequently the dyspeptic must avoid many dishes given here, which are admirably adapted for a gouty person with a good digestion. For good digestion mastication is essential. If persons " bolt " their food, or from want of teeth cannot properly masticate it, then indigestion follows ; because the food is not in a proper state for solution when it reaches the stomach. The 14 FOOD FOR THE INVALID. stomach of man does not, like that of the lobster tribe, contain teeth, and so cannot grind and pull to pieces the food. If this disintegration has not been accom- plished the stomach is unequal to perfect digestion, and the digestive act is slow and painful. Brown meats are close of fibre, and the fibres are not readily separated, a matter of moment in the digestive act. If the fibres readUy fall asunder, then the dissolving action of the gastric juice is favoured ; but if the meat is in masses, it can only act upon the outer surface. In dieting the dyspeptic this merely mechanical matter should ever be borne in mind. The same fact obtains about wheaten bread. The albuminoid matter of wheat is chiefly in the form of gluten, which when separated from the rest of the flour is a sticky substance. " The grain of wheat differs from that of the other cereals principally in the peculiar physical characters possessed by its chief nitro- genous constituents, and especially gluten, possessing in the moist state strongly adhesive properties. These are found to be practically of great value in bread-making, causing the dough to retain more strongly the carbonic acid evolved during fermentation, whereby the bread is rendered porous and light ; and this is one of the chief reasons why the flour of wheat is preferred for bread- making to that of all other grains." — {Food and its Adulterations, by Arthur Hill Hassall.) It is this ad- hesive quality which gives trouble to the dyspeptic about wheaten bread. It does not fall readily to pieces in the stomach. Especially is this a source of trouble to babies ; and most " baby-foods " consist mainly of baked flour. After once being cooked and then again being reduced to a finely divided form, wheat flour INTRODUCTION. 15 loses its adhesive quality, i.e. the gluten has become changed, and the particles do not adhere together as hefore. A lady friend of mine who cannot digest with comfort a suet pudding as ordinarily prepared, can enjoy that suet pudding when her cook has mixed a number of fine bread-crumbs into the flour. The delicate stomach of the infant, adapted to the digestion of milk, which, while it curdles in the stomach, in health, rapidly dis- solves again, is unequal to the violent movements set up by particles which do not readily dissolve. The infant cries with the pain of the digestive act when ordinary bread is put into its mUk ; it crows with delight when a properly prepared flour is digesting easily. For nursery purposes oatmeal and maize flour are preferred, because they do not contain this adhesive gluten. The miKture of maize flour with wheaten flour is then clearly indicated for nursery purposes ; and for pastry for those whose digestion is not strong. The action of the saliva upon starch is to quickly convert it into sugar. Consequently, as sugar is soluble, this leaves the nitrogenised portion of the flour to be readily acted upon in the stomach. When the saliva is defective in an infant, or, at least, insufficient to pro- duce the conversion of starch into sugar, it is now customary to give the infant " maltiue." Maltine is a sweet molasses sort of thing which can be added to the baby's food a brief period before it has to be taken, for the conversion is quick. The starch being thus largely converted into sugar, the digestive act in the stomach goes on without painful efforts. The treatment of dyspepsia in adults is carried out on precisely the same 16 FOOD FOE THE INVALID. . principles, and baby's food and maltine are equally good for them. But when wheaten flour is rubbed up with butter, or other fat, in a state of fine subdivision, as in the preparation of pastry, then the troubles of the stomach are aggravated. The fat is not dissolved by the saliva, and so it can act little upon the starch. When the flour reaches the stomach the solution of the nitrogenised materials is impeded by the presence of both fat and starch. No wonder then that pastry is carefully shunned by dyspeptics ! How far the introduction of a certain amount of maize flour to the wheat flour, in making pastry, will reduce the labour of the stomach, is a matter which must be settled practically by experience. The non-adhesive character of maize flour renders it very probable that good results will foUow from such admixture ! The mechanical part of digestion is then a matter to be attended to. The stomach does not act upon starch, sugar, or fat ; its action is solely upon albuminoids ; and the mixtures of fat and flour, as in pastry and sauces, in most dyspep- tics, interferes with the action of the gastric juice upon the albuminoids ; and consequently their food requires to be very plain. That is, the solution of albumin- oids must not be hampered by the presence of starch and fat. The albuminoid material must, too, be of a character that does not present mechanical obstructions to be overcome, i.e. it must readily separate into small particles; so that the gastric juice may easily act upon it. Dyspepsia exists in two forms ; which may, and commonly are, found together. (1) Defective muscular INTRODUCTION. 17 action, in which case it is necessary to bear in mind ■what has just been said above, and the food should be such as to necessitate little muscular movement of the stomach for its disintegration. (2) Defective secretion of gastric juice, and imperfect solvent action. In order to remedy this state of matters it has been found con- venient to avail ourselves of the gastric secretion of animals ; and especially the omnivorous pig. Indigestion is not a trouble to which the pig is liable, at least so far as we know, consequently his gastric juice is pressed into the service of man. As pepsin we convert the digestive powers of the pig to our purposes. Pepsin in the presence of an acid rapidly dissolves albuminoids. Given with an acid during the digestive act, it aids materially in the solution of the albuminoids; and frequently converts the digestive act from a painful to a painless process. The conversion of albuminoids into a soluble form is also rendered much more perfect by the action of this artificial digestive agent. In the dietetic management of dyspepsia it is very important to ascertain with precision ■\vhere the digestive act is at' fault. If this could always be done accurately, the management of the case would be comparatively easy. As it is, it is rather a sort of " educated guessing," and a certain amount of experiment is unavoidable in each case. Such, then, are the means of rendering easier the digestive act, when imperfect, which have been in vogue for some few years. Eecent investigation into the digestive act has led to some excellent practical results. The pancreas, or sweet-bread, whose function until recently was scarcely even a matter of speculation, has c 18 FOOD. FOR THE INVALID, been found to hold a most important position in di- gestion. Its secretion converts starch into sugar; it dissolves albuminoids in an alkaline medium; and it emulsionises fat, so that the minute particles of fat can be taken up by the intestine. The conversion of starch into sugar is arrested in the acid stomach; but when the food begins to pass out of the stomach a new activity is set up. The stomach during the digestive act is in active motion, rolling the food in it over and over, and so bringing every particle more or less into contact with the solvent gastric juice. To prevent escape during this period the stomach is closed by two rings, one at each outlet ; one at the foot of the gullet, the other at the intestinal orifice. This latter outlet from the stomach is closed by the pyloric ring. When the food in the stomach is pretty well disintegrated and dissolved, the more fluid portions pass the partially relaxed pyloric ring ; leaving the less digested portions to be further acted upon. At last the ring thoroughly relaxes, and the contents of the stomach are thrust out into the intestines. When the contents of the stomach pass into the intestine the alkaline bile neutralises the acid from the stomach, and makes the food alkaline. Then the action of the pancreas comes into play. The starch is rapidly converted into sugar once more ; the albuminoids go on in their conversion; the fat is emulsioned. The digestive act is in full play all around. It is clear, then, that imperfect action of the pancreas is a most serious matter. It can be stimulated by ether ; a fact which has been utilised in practice. But the great outcome of our physiological knowledge is INTRODUCTION. 19 the utilising the pancreatic secretion of our useful friend, the pig. Dr. William Eoberts, of Manchester, has done much to advance the practical aspect of artificial di- gestive agents in his Croonian Lectures before the Eoyal College of Physicians this year. He has shown that it is possible to extract the pancreatic secretion of animals in an active potent form. In the presence of an acid this solvent is rendered inert — it is kiUed, in fact, by an acid. So when the digestive act in the stomach is over, or nearly so, he gives this pancreatic extract with an alkali, and so guides it safely through the acid stomach to the alkaline area beyond in the intestine; and so dexterously aids the action of the pan- creatic fluid of the body. By the action of this artificial pancreatic juice we are able to aid in the digestion of fat, a matter of great importance. In the commencing sentences I pointed out the seriousness of the growing incapacity to assimilate fat, and the troubles which follow in its wake. How to render fat readily digestible will be one of the main objects aimed at in the subse- quent portion of this book. The great advantage of cod-liver oil lies in its being the most easily digestible of all fats ; and in many cases cod-oil can be digested when no other fat, not even as cream, can be assimilated. One fact will be very noticeable in the forms of food subsequently given, and that is the prominence given to fat ; and the practical way of administering it so as to be neither objectionable to the palate nor offensive to the stomach, and yet, at the same time, in an easily assimilable form. Cod-liver oil is not palatable ; and where cream can be digested, a wineglassful of cream with a teaspoonful of maraschino or cura9oa, is to be preferred. c 2 20 l"OOD FOR THE INVALID.' The digestion of fat is one of the most important matters of our food. Not only is it a fuel-food, of the highest value, but it is also essential to proper healthy tissue formation; not only for tissue, growth, but for tissue repair. The value of cod-liver oil in the treat- ment of phthisis is" now generally recognised ; if fat can be assimilated then the spread of the disease may often be arrested. By the resort to cod-Hver oil the oncome of the disease is stayed. To enable the system to digest fat is to avert many maladies. "With fat and starch the bilious are comparatively well; for neither can produce the nitrogenised bile acids. They, however, lead to biliousness indirectly. If a meal be taken in excess of the needs of the body, the readily oxidisable hydrocarbons are burnt off first in the body ; as said before, the combination of nitrogen with other elements interferes with their oxidation, Consequently the non- oxidis'able matters are left over imperfectly oxidised ; and that is why a rich meal renders a bilious person " bilious," Sugar and fat do not furnish bile acids, but they lead to their production indirectly. These bile acids are useful in the emulsionising of fats; and probably one factor in the digestibility of cod-liver oil is that, being derived from the liver of an animal, it contains bile elements. Pdjt6 defoie gras is a most digestible food as well as toothsome, and so is the imitation form (No. 79), which, is very suitable for persons with a weak digestion, from the liver elements present in it. The views taken- here are heretical to persons of a certain age ; but they are not contravened by that fact. These preliminary remarks will enable the reader to: INTRODUCTION. 21 understand the rationale of tho choice manifested in the different forms of food to be given in detaU here- after. It will explain why soups which are pot rich in stock are selected in preference to those that are. The gelatinous matter of stock, though it is agreeable to the palate, is not readily digestible, and furnishes a quantity of the albuminoid waste which it is so desirable to avoid. If is much better, in place of the stock, to add half- a-pint of cream to those soups which will carry it; and that means in nearly all cases. The impression that the strength of meat is contained in stock is ill- founded. "What we have to aim at is to convey fuel- food to the system, with only that amount of albuminoids which is essential for tissue-repair. With such preliminary remarks for the guidance of the reader, we may now proceed to the more practical part of the inquiry. It wiU be well to commence with the invalid in bed. The Invalid in Bed. The invalid in bed includes two conditions, (1) of fever ; (2) of debility. It may be well to consider the fever patient first. Here there is much thirst to be allayed, consequently it is well that the food be in fluid form ; indeed, other food cannot well be taken. The first thing is of course milk. Milk may be given plain or with seltzer water, and may be iced. Equal parts of milk and seltzer water form a very pleasant drink (No. 2). In typhoid fever especially, it is desirable to avoid too great curdling of the mOk, and when this occurs it 22 FOOD rOK THE INVALID. is well to change th& milk for some other fluid, or to give it already digested ' (No. 84). White wine whey (No. 15) may be given instead. In order to prevent the curd of mUk curdling into a solid mass, it may be well to add a little fine biscTiit powder, or oatmeal, to the milk and seltzer water (No. 2). Then comes beef tea, now universally in vogue ; as said before, its nutritive value is very small. It may be taken lukewarm, or cold, or iced. It is easily made (No. 6). Too great a quantity need not be made at once ; nor is there any particular advantage to be gained by making it so particularly good and strong, as some persons imagine. The prevalent impressions about beef tea show how little real knowledge exists about our food as regards our requirements. Beef tea is a stimulant rather than a food. A person may be hungered to death on it. It is a pleasant, palatable, refreshing beverage when weU made. As a vehicle for farinaceous matters, or with a teaspoonful of cream in it, it is useful as a food. Liebig's extract, and the other extracts, are all pleasant beverages ; and may be taken hot, lukewarm, or cold, or iced, as occasion requires, or the taste of the patient directs. A more nutritive material is furnished by the form No. 7, where the water can be added warm, or, if preferi-ed, a cold drawn extract may be made with cold water. Preparations of meat juice, are in the market, especially Valentine's, which are very suitable for the invalid. Then mutton may be used (No. 8), or chicken (No. 10), or mixed ^ In order to ascertain if the milk curdles in the stomach, and does not re-dissolve, the stools of a typhoid fever patient should be examined (after disinfection) for any milk-curd. INTRODUCTION. 23 meat. All these are useful, or the patient may prefer eel broth (No. 125). It may be questioned how far the digestion of starch and its conversion into sugar is carried on when high fever is present. Consequently the great matter is a drink which contains a quantity of sugar, distinct if small. This must also have an acid taste to please the patient's palate. Such a drink is furnished in No. 25, where there are sugar and vegetable acid, and a certain amount of albumen, and is much relished. Effervescing lemonade is very grateful ; but there are circumstances where an aerated water is contra-indi- cated as filling the stomach and bowels too full of gas. An infusion of tamarinds forms a pleasant drink (No. 31), or apple water (No. 30), or lemonade (No. 30), or black currant water (No. 32), or the Potus Imperialis (No. 35). "When the temperature has fallen, then the beef tea may be made more nutritive by the addition of oatmeal to it. This class of fluid-food stands by itself; after the high fever is over then the patient may proceed to the other foods. During pyrexia, milk, plain, diluted, or already partially digested, may be used. The partial digestion of milk, and milk gruel, out of the body, is a great step forward in our management of diseased con- ditions. We are mainly indebted to Dr. Wm. Eoberts, as said before, for the information we possess on this subject. His preparations are given in Nos. 84, 85. What forms of food are to be given from time to time ; and when the patient may proceed to have some solid food ; and what this should be ; are matters to be decided by the medical man in each case: who car 24 rOOD FOE THE INVALID. " tick " with a pencil the different articles he lyishes the patient to have. When the patient in bed comes under the class (2), — debility, then any of the different articles can be given according to the directions of the medical attend- ant : who must always be the dictator of the situation, and his orders and instructions should be carried out with military obedience. NuKSEEY Food. This subject requires some consideration of its own, and is one of growing importance. Up to a recent period, oatmeal porridge and milk was the food of the nursery par excellence ; and is still so where the parents possess good sense, and the children good digestions — conditions which do not co-exist in every household. Oatmeal porridge (No. 50) does not agree with every child, and if it distinctly disagree, then something may be substituted for it, as hominy porridge (ISTo. 52). Though brought up on oatmeal porridge, and' having the most affectionate remembrance of it, and still liking it, it must be admitted that my preferences lean towards hominy porridge. The peculiar value of oatmeal is the amount of fat in oats. But in this respect maize stands far ahead of it, being the richest in fat of all the cerealia; while it contains albuminoid matter in as high a proportion as does wheat. , Preparations of maize are peculiarly indicated for the nursery. In another way, Indian corn, or maize, is useful. Maize flour alone will not make bread. It is not sufficiently "sticky" to hold well together, consequently the admixture of INTEODUCTION. 25 some maize flour with wheaten flour is indicated, where puddings and pastry are required for children with weak digestions. The admixture of maize flour causes the pudding or pastry to readily fall into minute particles ; and so aids the action both of the saliva upon the starch, and the gastric juice upon the albuminoids. It takes away the embarrassment of the digestion by favouring disintegration; the mechanical "cause of indigestion being so removed. Different pre- parations for the nursery are given in Wos. 46-63. Corn meal when properly prepared affords a very elegant addition to our food resources. It is more nutritious, or, at least, more fattening than wheat flour, containing more oily materials, and yielding, according to popular belief in America more sustenance to the animal heat. It should rarely be used as an exclusive article of diet, as it is distinctly loosening in its effects upon the bowels. It should be always thoroiighly cooked ; its reputation of being indigestible rests chiefly upon its improper preparation. There are two distinct kinds of corn meal ; the yellow, chiefly coming from the Western United States; the white, chiefly grown in the Southern States. The white corn meal is the better of the two varieties, though the yellow meal may be employed, and is certainly as sweet in its taste as the white. Corn meal at all musty or " heated " is not fit for human food. It should be per- fectly sweet and dry; and for family use should be purchased of the best quality and in small quantities as wanted. If kept on hand it should be in closed tins, or tight firkins with closely fitting lids, standing in a dry spot. The fineness of grinding affects the bread, 26 FOOD FOE THE INVALID. coarse meal making a more open spongy bread, fine meal a close compact one ; some palates prefer one, some the other variety. The different crushed cereals now put on the market are very toothsome and keep well. They can he procured from the Cereals Manufacturing Co., 83, Murray Street, New York, U.S.A., and are sold by most leading grocers. They are already steam-cooked, and consist of " crushed white wheat," " barley food," " oatmeal," " maize,'' " cereal milk," and " cereal cream." Directions for use are supplied with them. Boiled with equal quantities of milk and water so as to form porridge, they are excellent, and can be eaten with milk, sugar and butter, or treacle and butter. An economical dish can be made by cracking any bones that may be at hand, and stewing them with rice for an hour or two. The marrow fat is very digestible, and the bones so often wasted would, so cooked with rice, furnish a good meal. Probably a little pepper and salt would improve the dish. Op Food Generally. In the arrangement of the bulk of this work, ordinary cookery books are followed. But as the readers of cookery books have nothing to guide them in the selection of their dishes, it has been thought desirable to provide some sort of guide. Consequently initials are attached to all preparations after No. 43 to guide the reader broadly. Thus "I" stands for "Invalid," "C" for "Convalescent," "D" for "Dyspeptic," "G" for "Gouty," and " E " for " Economical." But if a gouty reader -be INTRODUCTION. 27 also a dyspeptic he had better avoid the dishes marked " G " ; unless " D " also be present. The ordinary meat dishes of family life are con- spicuous by their absence. All dishes consisting of meat once cooked and warmed, are to be studiously avoided by all unless their digestion be perfect. There is only one way of " using up " cold meat that is (comparatively) unobjectionable, and that is — to remove every particle of the meat, to mince this fine, with some pepper and salt ; then to place a waU of well- mashed potato in a pie dish, or soup plate ; put in the minced meat; then place over the meat a crust of mashed potato, and put in the oven tUl the meat is warm through ; and not one moment longer. The bones may then be cracked and stewed with rice. Prominence is given to sandwiches. These should be carefully made of stale bread, cut thin ; the butter well rubbed in, so as to get it finely subdivided ; then the jam, or meat paste should be spread evenly over the bread. Then each little sandwich should be neatly cut in four, so as to give it the most appetising appearance, and served up to the invalid, adult or child, in reason- able quantity. If too great a quantity be prepared at once, it destroys the patient's appetite : while what is left grows stale. Invalids should always have their food supplied in that quantity that it should be a little short of what they can eat ; so that they grumble, and complain that they could have eaten a little more. Too much prepared at once is bad. Then as to these sandwiches, if so prepared with jam, they are sufficient for a small meal, especially if accompanied by a glass of milk. S8 OOD 'FOR THE INVALID. When patients cannot take milk then the difficulties of feeding them are much increased. Here if the sandwiches are prepared with potted meat, or pate de foie gras, and a tumblerful of beef tea for a beverage^ are given, the patient gets a fairly nutritive meal. Then for an invalid the foed should be freshly pre- pared ; and, if possible, no more should be taken to the sick-room than can be at once eaten. If any remain over let it at once be taken to a cool place, away from the sick-room. The practice of allow- ing food, milk, fruit, jelly, &c., to remain in a sick- room is utterly abominable and .unjustifiable. It does not become more appetising by being looked at. It does not improve; while it certainly does acquire a taint from the atmosphere of a room. A glass half full of milk, a tumbler half full of ice, with a metal spoon in it to help to melt it quickly ; some jelly on a saucer; some grapes, or preserved peaches in another saucer, with the sunshine streaming in on a summer afternoon into the sick chamber ; is a painful sight sadly too frequently witnessed. Who could have any appetite, or wish to live under such circumstances ? The ice should be kept down stairs, wrapped up in a piece of flannel, and covered with sawdust : and a chip should be cracked off it, put into the lemonade, or milk and seltzer, or whatever it is, allowed to dissolve ; and then the whole should be taken to the patient in that quantity that it can be swallowed at once. Perfect cleanliness is essential to give food an ap- petising appearance. Ignorance in a sick-room is very objectionable, even when combined with any amount of family affection. BECIPES. 1. Milk. This should be fresh and pure; if at all stale it should he boiled and then allowed to cool. 2. Milk and Seltzer Water. Put together equal . quantities of milk and seltzer : drink whUe fresh. It may be iced. 3. Milk and Lime Water. Where it is desirable to give diluted milk without effervescence and the disengagement of gas, lime water may be substituted for seltzer water with advantage. Lime water is made by placing a piece of quicklime into a gallon of water. Stir up, then let it stand, remove the scum from the surface, and then decant for use. It is of fixed strength. 30 FOOD FOR THE INVALID. 4. Milk and Lime. When it is desirable to have more fixed alkali, then chalk in powder can be added : say as much as will lie upon a sixpence to the half-pint. Stir up before drinking. 5. Milk and Magnesia. Where there is a necessity for a laxative, it is well to substitute magnesia in powder for the chalk. 6 Beef Tea. Cut up a pound of lean beef into pieces the size of dice ; put it into a covered jar with two pints of cold water and a pinch or two of salt. Let it warm gradually, and simmer for a couple of hours, care being taken that it does not reach the boiling point. 7. Nutritious Beef Tea. To a pint of beef tea or mutton broth (not too strong) add two tablespoonfuls of powdered biscuit, or bread crumb ; boU for five minutes, stirring well all the time. RECIPES. SI 8. Mutton Broth. Cut up one pound of lean mutton into dice, to this put one quart of cold water, then let it simmer on the hob for three hours : take off the scum as required, and add a pinch of salt. Strain off the fluid, let it stand till it is cold, then remove the fat, if any. 9, Veal Broth. This is prepared in the same way, using veal for mutton. ■ 10. Chicken Broth. A young bird should be selected, and after disjointing it place it in a stewpan with a quart of water and boil two hours. Then take off the broth, let it cool, and then skim it. 11. Beef Tea with Oatmeal. Mix two tablespoonfuls of oatmeal very smooth with two spoonfuls of cold v/ater, then add a pint of strong boUing beef tea. BoU together for five or six minutes, stirring it weU all the time. Strain it through a sieve and serve. 32 FOOD FOR THE INVALID. 12. Mixed Meat Tea. One pound of lean beef, one pound of lean veal, one pound of lean mutton, aU. very fresh, and cut up into small pieces. Put the meat into a bright stewpan, witft three pints of water, a salt-spoonful of salt, and simmer gently, skimming often, for four hours, then strain. Twenty minutes before serving moisten a teaspoonful of Du Barry's Eevalenta Arabiea with a "wineglassful of cold water, and stir into half-a-pint of the tea ; boil slowly for twenty minutes. Note. — Du Barry's Eevalenta Arabiea will be found an excellent food for invalids and convalescents. 13. Barley Water, Put an ounce of pearl barley into an enamelled sauce- pan with a quart of cold water, and boil for two hours and a half. Stir it occasionally, and skim frequently. Strain through muslin into a jug ; sweeten with sugar^ candy dust, and, if the invalid may take acids, add the strained juice of a lemon, 14. Rice Water, , Put two ounces of rice into an enamelled saucepan with three pints of water, and boil for two hours and a EECIPBS, 33 half. Stir it frequently and skim. Strain into a jug through a fine wire sieve ; rub through the part that is glutinous, but not what may be firm. Put in no flavouring, unless ordered by the medical man. 15. White Wine Whey. To half a pint of boiling milk add one or two wine- glassfuls of sherry ; steain through a fine sieve, sweeten with sifted sugar, and serve. 16. Beef Juice for the Sick. Cut one pound of beef in small pieces, put it into a bottle and cork it up ; set the bottle into a little cold water, let it stand over the fire till it boils. For invalids who cannot take beef tea, beef juice frozen in_ an ice-cream freezer is often relished by fever patients. 17. Chicken Tea. Cut up a fowl in small pieces. Put it into an earthen vessel with some salt and three pints of water ; let it boil three hours, set it to cool, then take off the fat. 18. CALF'S Foot Broth. Take two feet ; break them up ; put them into a pot with two quarts of water, one carrot, a little mace, and D 34 FOOD FOR THE INVALID. salt. Boil two or three hours until only one quart of fluid is left. When done strain, add a cup of good •wine and one teaspoonful of Indian, or oat-meal. 19. Egg and Brandy. Beat up three eggs to a froth in four ounces of cold spring water, add two or three lumps' of sugar, and pour in four ounces of brandy, stirring all the time. A portion of this may be given at a time. 20. Milk, Egg, and Brandy. Scald some new milk, but do not let it boU. It ought to be put into a jug, and the jug should stand in boiling water. When the surface looks filmy it is sufficiently done, and should be put away in a cool place in the same vessel. When quite ^cold, beat up* a fresh egg with a fork in a tumbler, with a lump of sugar ; beat quite to a froth, add a dessert-spoonful of brandy, and fill up the tumbler with scalded milk. 21, Milk and Brandy. Put one teaspoonful of brandy in a bowl or cup, add powdered sugar and a very little nutmeg to taste. Warm a breakfast-cupful of new milk, and pour it into a spouted jug ; pour the contents from a height over the brandy, sugar, &c. The milk must not boil. EECIPBS. 35 22. Egg and Sherry. Beat up with a fork an egg till it froths, add a lump of sugar and two tablespoonfuls of water ; mix well, pour in a wineglassful of sherry, and serve before it gets flat. 23. Caudle. Beat up an egg to a froth, add a wineglassful of sherry, and half-a-pint of gruel; flavour with lemon- peel and nutmeg, and sweeten to taste. Another Caudle. — Mix well together one pint of cold gruel with a wineglassful of good cream ; add a wine- glassful of sherry and a tablespoonful of noyeau, and sweeten with sugar-candy. 24. A Gruel. Beat up an egg to a froth, add a wineglass of sherry, flavour with a lump of sugar, a strip of lemon-peel, and a little grated nutmeg. Have ready some gruel, very smooth and hot, stir in the wine and egg, and serve with sippets of crisp toast. Arrowroot may be made in the same way. D 2 36 FOOD FOR THE INVALID. 25. An American Drink. Put the juice of a lemon to a pint of water in whicli an ounce of sugar has been dissolved, then add the white of an egg and froth up. It may be iced. 26. Farina Gruel. Stir two tablespoonfuls of farina into a quart of water in a milk saucepan, let this boil until it has grown quite thick ; add a pint of milk, a little salt, and let it boil fifteen minutes longer, turn out into a bowl, and sweeten to taste. 27. Oatmeal Gruel. Put a pint of boiling water into a saucepan ; into this stir a couple of tablespoonfuls of oatmeal until quite smooth ; let this boil well for ten or fifteen minutes, season with salt, then strain through a strainer; and add a little port wine and sugar if the patient may have it. 28. Oatmeal Soup. Put two ounces of oatmeal m a basin, pour over it a pint of cold water, stir it and let it stand a minute ; then pour over it, quickly stirring aU the time, a pint of RECIPES. 37 good broth, pour through a fine strainer into a saucepan, taking care none of the coarse part of the meal goes into the soup. Boil the soup for ten minutes, season, and serve. 29. Toast Water. This useful beverage, like many other , simple things, is too frequently very badly made, and has acquired an evil reputation from the crumbs of charcoal-like charac- ter, or little sodden morsels of bread, which too often are found floating on the surface. To remedy these defects, take care that the crusts from which toast water is to be made shall be only a nice deep brown ; never allowing them to catch fire or blacken in the toast- ing, and letting them grow quite cold before immersing them in nice fresh-filtered water. Whenever from any cause there are morsels of bread floating on the water, strain it through muslin. The drink should be made an hour before it is wanted, and never be used after standing twelve hours. 30. LEMONADE. Four lemons, quarter of a pound of loaf sugar, and three pints of boiling water ; rub some sugar on the rinds of two of the lemons till it is yeUow. Strain the juice of the four ; put the sugar and juice into a jug, and pour over the water. Cover it till cold. 38 FOOD FOR THE INVALID. 31. Tamarind Water. Boil two ounces of tamarinds with a quarter of a pound of stoned raisins in three pints of water for an hour ; strain it, and when cold it is fit for use. 32. Arrowroot and Black-Currant Drink. Take two large spoonfuls of black-currant preserve, boil it in a quart of water, cover it, and stew gently for half an hour, then strain it, and set the liquor again on the fire; then mix a teaspoonful of arrowroot in cold water and pour the boiling liquor upon it, stirring meanwhile ; then let it get quite cold. 33. Indian Meal Water Gruel. Mix a tablespoonful of com meal smoothly in half a teacupful of cold water. Stir it into a teacupful of boiling water, add a little salt, and let it boil untU the meal is thoroughly cooked, and then sweeten it. 34. Indian Meal Milk Gruel. Sweeten a quart of milk and stir in two tablespoonfuls of corn meal. This must be carefully cooked as the meal EECIPES. 39 is apt to scorch, and must be stirred whilst cooking. A little nutmeg grated on top after it is done makes a pleasant flavour. If the gruel is desired thick more meal will be needed. 35. Cream of Tartar. potus impeeiaus. (-4 Cooling Brink.) Put half an ounce of cream of tartar, the juice of one lemon, and two tablespoonfuls of sifted sugar into a jug, and pour over a quart of boiling water. Cover till cold. 36. Apple Water. Cut up one pound of apples, each one into quarters, bake them, and put them into a jug, with half a pound of brown sugar, pour one gallon of boUing water over; let it get cold, pulp the apples, and pass the liquor through a cullender ; bottle for use, taking care not to cork the bottle, and keep it in a cool place. 37. Apple Toast and Water. A piece of bread slowly toasted till it gets quite black and added to the above makes a very nice and refreshing drink for invalids. 40 FOOD FOR THE INVALID. 38. Apple Barley Wate^. A quarter of a pound of pearl tarley instead of toast added to the atove, and boil for one hour, is also a very nice drink. 39. Apple Rice Water. Half a pound of rice, boiled in the above until in pulp, passed through a cullender, and drunk when cold. All kinds of fruits may be done the same way. A little ginger, if approved of, may be used. 40. For Spring Drinks. Ehubarb, in the same quantities, and done in the same way as apples, adding more sugar, is very cooling. Also green gooseberries. 41. For Summer Drinks. One pound of red currants, bruised with some rasp- berries, half a pound of sugar, added to a gallon of cold water ; well stirred, allowed to settle, and bottle. RECIPES. 41 42. Mulberry. The same, adding a little lemon- peel. A little cream of tartar or citric acid added to these renders them more cooling in summer and spring. 43. Milk Lemonade. Dissolve six ounces of loaf sugar in a pint of boiling water and mix with them a quarter of a pint of lemon- juice and the same quantity of sherry, then add three- > quarters of a pint of cold milk, stir the whole well together and pass it through a jelly-bag. 44. Cold Milk Toast. Place in a flat pan some slices of stale bread, let them get dry and of a nice brown in a good oven ; then pound almost to a powder in the mortar, fill a bowl half fuU and pour over them some cold milk, salted. This can be eaten with salt or sugar. (I. 0. D. G. E.) 45. Powdered Biscuit and Milk. Powder an arrowroot biscuit and stir it into the half or three-quarters of a pint of mUk. Take it cold or warm, adding sugar to taste. (I. C. D. G. E.) 42 FOOD FOE THE INVALID. 46. Milk Pudding. Take two tablespoonfuls of clean rice or sago ; soak in warm water for two hours ; then drain off the water. Stir the rice in a pint of milk, add a little sugar and bake or boH for an hour. (I. C. D. G. E.) 47. Milk Porridge. One pint of boiling water ; mix a large spoonful of flour in a little cold water. Stir it into the water whUe boihng ; let it boil fifteen minutes ; then add a teacup- ful of milk and a little salt. Give one boU. (I. C. D. G.) 48. Strengthening Drink. Beat the yolk of a fresh egg with a little sugar : add a very little brandy ; beat the white to a strong froth ; stir into the yolk ; fiU up the tumbler with new milk. (I. C. D. G.) 49. Tapioca Jelly. One cup best tapioca put to soak with a pint of cold water ; when soft put in a saucepan with one cup of sugar, the rind and juice of one lemon, a little salt, one pint more water ; stir until it boils ; turn into a mould ; set to cool ; add one glass of wine, if desired. (I. C. D. G.) You can make arrowroot or sago in the same way. EECIPES. 43 50. Porridge — Oatmeal. If you want to make it quickly for a family, take twelve ounces of fine meal, half an ounce of salt, and three pints of water. Dissolve the salt in the boiling water, add the meal after having rubbed it smooth in a little cold water, stir it all the time, and allow it to boil aU over the surface of the water for twenty minutes, or more. Pour it into saucers, and serve with mdlk, and either salt, or sugar, or treacle. The proper way is to eat first a spoonful of porridge, and then one of mUk, but I do not think many people take that trouble. (I. C. D. G. E.) 51. Whole Meal Porridge. You can get the whole meal at many bakers' shops now, and it is very delicious when properly made. Take one quart of boiling water, and sprinkle in gradually half a pound of wheat-meal ; boil till quite soft, then serve with milk and treacle or brown sugar. (I. C. D. G-.) 52. Hasty Pudding for Children's breakfast. Boil half a pint of mUk, beat two dessertspoonfuls of flour into a paste with cold milk ; add it to the boUiny milk and keep stirring it always in the same direction till it is done. 44 FOOD FOE THE INVALID. 53. EGYPTIAN Porridge. Take three tablespoonfuls of lentil flour, a saltspoonful of salt, and one pint of water. Now mix your flour and salt into a paste with the water, and boil ten minutes, stirring aU the time. (I. C. D. G. E.) 54. Coarse Porridge. Have ready some boiling water on the fire with a little salt in it ; then sprinkle in the coarse oatmeal, and boil it for two hours. People from Yorkshire and Scotland will not touch the fine oatmeal, which they say is only fit for gruel, and for sick people. (I. 0. D. G-. E.) 55. Sago. Put half an ounce of sago into an enamelled sauce- pan with three-quarters of a pint of cold water, and boil gently for an hour and a quarter. Skim when it comes to the boil, and stir frequently. Sweeten with a dessertspoonful of sifted loaf sugar. If wine be ordered, two dessertspoonfuls; and if brandy, one dessert- spoonful. (I. 0. D. G.) 56. Tapioca Milk. Half an ounce of the best tapioca to a pint and a quarter of new milk. Simmer gently for two hours RECIPES. 45 and a quarter, stirring frequently. Sweeten with a dessertspoonful of sifted sugar. (I. C. D. G.) 67. Rice Milk. Wash a tablespoonful of the best rice, and boil it an hour and a half in a pint of new milk ; rub through a fine sieve. Sweeten with a dessertspoonful of sifted sugar. Boil up again for two minutes. (I. C. D. G.) 58. Arrowroot. Mix two teaspoonfuls of the best arrowroot with half a wineglassful of cold water; add a pint of boiling water ; put it into an enamelled saucepan, and stir over the fire for three minutes. Sweeten with three tea- spoonfuls of sifted loaf sugar. Add (if permitted to take it) either a wineglassful of white wine or a table- spoonful of brandy. (I. C. D. G.) 59. Arrowroot Milk. Mix two teaspoonfuls of arrowroot with a wineglass- ful of new milk ; add half a pint of boiling milk ; put it into an enamelled saucepan, and stir over the fire for three minutes. Sweeten with a dessertspoonful of sifted loaf sugar. (I. C. D. G.) 46 FOOD FOR THE INVALID. 60. INDIAN Corn Flour. Mix a dessertspoonful of " Brown and Poison's " Indian corn flour with a wineglassful of new milk ; add half a pint of boOing milk, and stir over the fire for four minutes. Sweeten with a teaspoonful of sifted loaf sugar. Add a tablespoonful of good cream. (I. C. D. G.) 61. Cocoa Nibs. Two ounces wiU make two moderate-sized breakfast cups. Put it into a tin coffeepot (bright inside) with a quart of water, and boil for five hours. Pour it into a jug, and when cold take off the fat ; boil up the cocoa, and send to table with boiling milk. If prepared cocoa be used " Cocoatina " wiU be found the best. It requires double the quantity given in the " Directions for use." Prepared by Schweitzer and Co., 86, King's Eoad, Brighton. (I. C. D. G.) 62. Hominy Porridge. Put to soak one and also two small boiled onions, chopped ; stew all together for an hour, stirring frequently to prevent the meat going into lumps. A quarter of an hour before serving add half a saltspoonful of salt, a quarter of a saltspoonful of pepper, and one dessert- spoonful of ketchup. Serve hot, and garnish with small pieces of toast. (I. C. D.) 294. Scrambled Eggs. Break six eggs into the frying-pan with a little milk, a tablespoonful or more of butter, a little salt, pepper, and a very little nutmeg ; stir until thoroughly mixed and the eggs begin to set ; then take off the "fire, serve on buttered toast sprinkled with chopped ham, parsley, or asparagus, either being very nice; or, if preferred, alone in a deep dish with sippets of toast. (I. C. D.) 295. Eggs in the Nest. Beat to a froth the whites of six eggs which have been seasoned as for an omelette, and pour into a buttered baking tin ; pour across it at equal distances six spoon- fuls of cream, into each of which drop a yolk whole ; bake, but not too briskly, and serve hot. (I. C. D.) KECIPES. U9 296. HOMINY AND Cheese. Put half a pound of hominy in water over night ; next day boil it with a pint of milk for half an hour ; then add half a pound of finely-chopped cheese, mixing it thoroughly ; then put the whole into a stew- pan, or pie-dish in the oven for ten minutes. (I. C. D.) 297. Cheese Straws. • Half a pound of dried flpur, a quarter of a pound of butter, a quarter of a pound of grated Parmesan or Gruyfere cheese, a teaspoonful of flour of mustard, a salt- spoonful of cayenne, and a saltspoonful of salt. Eub the butter into the flour, then mix the whole well together. Beat the whites of two eggs with a quarter of a pint of cold water, and stir in enough to form a firm paste ; knead the paste well, then roll it out the eighth of an inch thick, and cut it into straw-like strips, about five inches long. Bake in a quick oven till of a pale brown colour (about five minutes). Pile them on a dish, and serve either hot or cold. Must be kept in a dry place. (I. C.) !50 FOOD FOR THE INVALID. 298. Cheese Sandwiches. Pound eight ounces of cheese in a mortar, mix in two ounces or less of butter, spread it on two pieces of bread as a sandwich, and sprinkle over it a little salt and cayenne. It may also be put in a pot and covered with butter. CI. C. G.) INDEX. INDEX. Albumen, 7 chemical formula of, 11 Albuminoid food, excess of dangerous, 8 American drink, 86 Anchovy Sauce, 93 Sauce with boiled haddock, 103 toast with white sauce, 100 Apple barley-water, 40 rice-water, 40 Apple RuBse, 66 stewed, 60 -~ toast and water, 39 water, 39 Arrowroot, 45 milk, 45 pudding, 66 and black-currant drink, 33 Artificial digestion, 54 Asparagas, 138 B. BAEI.ET-WATEB, 32 Beans, French or scarlet, 136 haricot, 145 soup, pur6e d'Haricot, 124 Beef, juice for the sick, 33 juice with toast, 53 potted, 53 pounded, 54 tea, 30 nutritious, 30 its nutritive value, 9, 32 — • with oatmeal, 31 Beetroot stewed, 144 " Bile-poison " caused by too much albuminoid food, 10 Biscuit, powdered, and milk, 41 Black-currant and arrowroot drink, S8 Brandy and egg, 34 and milk, 34 egg and milk, 34 Bread jelly, 61 Brill, 101 Broth, calf's foot, 33 chicken, 31 eel, 72 veal, 81 Calf's foot broth, 33 foot jelly, its nutritive value, 9 head, stewed, with oyster sauce, 121 liver larded, 121 sweetbread baked, 114 stewed, 114 Caper sauce for fish, 105 Carrot soup, 126 Carrots h la Frangaise, 136 Carrots, spring, 136 winter, 137 Cauliflower, 135 Caudle, 35 Celei-y, stewed, 140 Cereals, 26 Cheese and hominy, 149 sandwiches, 150 straws, 149 Cherries, stewed, 60 Chicken, boiled, with mushroom sauce, 120 broth, 31 jelly, 119 tea, S3 Chocolate cream, 56 Cholic acid, chemical formula of. 11 154 INDEX. Coarse porridge, 44 Cocoa niba, 46 Cocoa-nut cream, 56 Gocoatina, 46 Cod, boiled, and oyster sanee, 95 fried, and oysters, 95 hard roe, 97 liver and rice, 97 liver and tapioca, 97 liver oil easily digested, 19 roe and cod-liver, 98 sound, melt, and friU, 99 — — with potato wall, 96 Corn bread, baked, 47 ■ steamed, 48 Commeal, 25 ~- breakfast cake, 48 bread boiled, 47 pudding, 49 Corn-starch pudding, 50 Cream, 51 cocoa-nut, 56 chocolate, 56 gooseberry, 58 mixed fresh fruit, 58 of Tartar, 39 _ raspberry, 57 soup, 128 spinach, 67 whipped, 56 Cumberland pudding, 68 Currant and raspberry water, 40 Curry soup, 128 Custard, 65 farm, 59 rich boiled, 64 without eggs, with fruit, 64 Digestion, artificial, -54 Drinks for fever patients, 21 Dyspepsia, 16 E. Eel, boiled, for convalescents, 76 boiled, with parsley sauce, 74 broth, 72 fried, 75 soup, 72 stewed, 72 with Tartar Sance, 74 Egg and brandy, 34 and sherry, 35 ——brandy and miUc, 34 sauce, 108 Eggs in the nest, 148 scrambled, 148 sweet, 65 Egyptian porridge, 44 Endive and crees salad, 132 Enemata, preparation of nutritive, 55 English sauce, 85 F. Farina gruel, 36 Farm custard, 59 Fat, 6 Fennel sauce, 103 Fever patients, drinks for, 21 Figs, stewed, 62 Fish cakes. 111 pie, savoury, 113 salad. 111 . salt. 107 Flour, wheaten, 14 Food generally, 26 required to maintain the body- temperature, 3 required to build up and repair tissues of the body, 3 Fowl boiled with parsley sauce, 117 fricasseed, 118 Mayonnaise of, 119 G. Genoa Sauce, 94 Glycocholio acid, chemical formula of, 11 Glycogen, 6 Goose -pudding, 71 Gooseberry fool, 58 cream, 58 -water, 40 Gout, 7 ** Gout-poison," caused by too much albuminoid food, 10 Grits, or breakfast hominy, 49 Gruel, 35 farina, 36 Indian meal water, 38 :_ Indian meal milk, 38 oatmeal, 36 Haddock, baked, 83 boiled with anchovy sauce, 103 Haricot beans, 145 : and onion sauce, 145 Hasty padding, 43 Herrings, baked, 80 boiled, 80 fresh, 81 mustard sauce for fresh, 80 -roUed, 81 Hodge-podge, 146 INDEX. 155 Hollandaise sauce, 107 Homiuy and cheese, 149 boiled, 49 cheese pudding, 47 porridge, 46 - pudding, 47 Hydrocarbons, ^ 6 Hydrochloric acid gastric juice, 5 required for the Indian com flour, 46 meal water gruel, 88 milk gruel, 38 Invalid in bed, 21 Iron required for the blood, 5 John Dory with caper sauce, 105 Milk and rice, 45 and selzer-water, 29 and vermicelli soup, 129 egg and brandy, 34 lemonade, 41 porridge, 42 pudding, 42 ■ soup, 127 toast, cold, 41 with vegetable soup, 129 Mince coUops, 147 Minced meat and bread crumb, 122 Mixed meat-tea, 82 Mock Pat6 de Pole Gras, 52 whitebait, 82 Mulberry water, 41 Mushrooms, 143 soTip, 144 stewed, 144 stewed with pigeons, 117 Mussels, pickled. Ill , plained boiled, 109 scolloped, 110 stewed, 110 Mutton broth, 31 Leeks, 140 Lemon jelly, 71 Lemonade, 87 Lentils, stewed, 145 Lentil soup, 127 Lime and milk, 80 water and milk, 29 Ling, fresh, 99 Lobster patties, 107 potted, 109 salad, 132 sauce, 100 soup, 78 Mackerel, boiled, 102 broiled, 101 soused, 102 Magnesia and milk, SO Maize flour, 15 Mastication essential for good digestion, 13 Matrimony pudding, 67 Mayonnaise of fowl, 119 sance, 106 Mealy puddings, 147 Meat, minced, 27 minced, and bread crumb, 122 Milk, 29 and brandy, 84 and lime, 30 - and lime-water, 29 and magnesia, 30 and powdered biscuit, 41 Naples Sauce, 94 Nitrogen in tissues of the body, 4 Normandy pippins, 63 Nursery food, 24 O. Oatmeal gruel, 36 porridge, 43 padding, 70 soup, 36 with beef-tea, 31 Onions, boiled, 141 ■ Portugal, curried, 142 roasted, 142 - stewed, 141 -(white) soup, 125 Oyster loaves, patties, 90 pie, 90 sauce, 96 sauce end boiled cod, 95 soup, 76,77 Oysters and fried cod, 95 boiled, 89 — fried, 91 grilled, 91 on toast, 91 stewed, 89 (to feed), 68 — to scallop, 89 156 INDEX. p. Pancreas, the, 18 Parsnips, 137 " Pastry " made from wheaten flour not easily digested, 16 Pat^ de foie gras, easily digested, 20 mock, 52 Pea-soup, 125 Pears, preserved, 61 Peas, green, 135 Peptouised milk, 54 milk gruel, 55 Phosphorus required for the nervous system, 5 Pigeons and stewed mushrooms, 117 stewed, 116 Plaice, boiled, 84 Porridge, coarse, 44 — • Egyptian, 44 hominy, 46 milk, 42 oatmeal, 42 whole meal, 42 Potato salad, 132 soup, 126 wall and cod, 96 Potatoes, S, 142 — mashed, 142, 143 Potted beef, 58 lobster, 109 shrimps, 109 ■ tongue, 53 trout, 108 'Pounded beef, 54 Prawn soup, 77 Preparation of nutritive enemata. 55 Preserved pears, 61 . quinces, 61 Prunes, stewed, 63 Quinces, preserved, 61 Baspbebby and currant water, 40 cream, 57 Red mullet, baked, 79 sauce for, 79 in paper, 78 Rhubarb, stewed, 60 water, 40 Bice and cod-liver, 97 ( ground) pudding, 67 milk, 45 pudding, 70 water, 32 * S. Sago, 44 soup, 127 Salads, 130 dressing, 130, 131 endive and cress, 132 lobster, 132 potato, 132 strawberry, 59 vegetable, 132 Tfater-creas, 131 winter, 131 Salmon padding, 92 in potato paste, 92 Salt fish, 107 Salts, various, requisite for health, 5 Sandwiches, 27, 52 anchovy, 93 Sauce, caper, 105 egg, 108 English, 85 for red mullet, 79 genoa, 94 Hollandaise, 107 lobster, 100 Mayonnaise, 106 Naples, 94 oyster, 96 shrimp, 93 Savoury fish pie, 113 Scalloped fish, 112 Sea-kale, 139 Seltzer water and milk, 29 Semolina pudding, 69 Sherry and egg, 35 Shrimp sauce, 93 Shrimps, potted, 109 Sick-room, general dii-ections to be ob- served in the, 28 Skate, boiled, 104 white sauce for, 104 dissolved butter for, 104 Smelts, fried, 106 Snow pudding, 50 Soda required for formation of bile-salt in the liver, 5 Sole, au vin blanc, 88 boiled, 85 buttered, 86 filleted au gi'atin, 87 with mussel sauce, 87 : with white sauce, 86 Soup, 122 bean, pur6e d'haricot, 124 carrot, red, 126 cream, 128 curry, 128 eel, 72 lentil, 127 lobster, 78 milk, 127 millc with vermicelli, 129 INDEX. 157 Soup, mushroom, 144 onion, white, 125 oyster, 76, 77 -— pea, 125 potato, 126 ■ prawn, 77 sago, 127 spinach, 123 vegetable, 124 verlnicelli and milk, 129 Spicea, use of, 6 Spinach, 183 : cream, 67 Boup, 128 ■ — with poached eggs, 134 Sprats, balced, 82 ■ hroiled, 82 Starch, 6 its value, 10 Stock for brown or white fish soups, 76 Strawberry salad, 59 Strengthening drink, 42 Suet pudding, 68 with treacle, 69 Sweet eggs, 65 Sweetbreads, calf s, baked, 114 -stewed, 114 - plain, 113 - roasted, 115 - with white sauce, 114 Tamarind water, 33 Tapioca and cod-liver, 97 jelly, 42 • • milk. 44 pudding, 70 Tartar sauce with eels, 74 Taurocholic acid, chemical formula of. 11 Tissues of the body, 4 Toast-water, 87 Tongue, potted. 53 Tripe for convalescents, 115 fricasseed, with onions, 116 Trout, boUed, 103 potted, 108 Tarbot, boiled, 99 en coquettes, lOl Turnips, 137 U. 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