~Reënforcing the Diet.~--On account of the great increase in the rate of metabolism and because of the difficulty of furnishing the requisite number of calories in the diet, reënforcing agents such as lactose, eggs, some forms of casein, or beef preparations are used.
~Idiosyncrasies~ against certain foods are, at times, manifested by patients. Efforts must be made to determine whether they are real or imaginary before eliminating any food which may be of importance to their future welfare.
(a) Give a sample diet order, using liquids only. Raise the fuel value of the diet from 2000 to 3000 calories.
(b) Formulate a diet order, using the high calorie diet, fuel value 3500 calories.
[96] Warren Coleman, University and Bellevue Hospital Medical College, Visiting Physician, Bellevue Hospital, New York City.
[97] "Diet in Typhoid Fever," by Warren Coleman, "Journal of American Medical Association," Oct. 9, 1909, Vol. LIII.
[98] "Diet in Typhoid Fever," by Warren Coleman, reprint from "Journal of American Medical Association," June 9, 1909.
[99] Determined by calorimeter observation from the Russell Sage Institute of Pathology in affiliation with the Medical Division of Bellevue Hospital, under Warren Coleman and Eugene DuBois.
[100] "American Journal of Medical Sciences," January, 1912, by Warren Coleman.
[101] F. P. Kinnicut, "Diets Used in the Presbyterian Hospital," New York City.
[102] "Journal of American Medical Association," Aug. 4, 1917.
The dietetic treatment for tuberculosis must, as in any other pathological condition, depend largely upon the general condition of the patient, and the symptoms manifested at the time.
~Character of Disease.~--The disease may have reached an acute stage in which the rise of temperature is marked and the progress of the tuberculous symptoms rapid, or it may be found to be an old chronic condition in which the progress is slow.
Again, the patient may be found to be suffering from a tuberculosis which is neither acute nor very slow. Each of these stages requires slightly different treatment which, however, for the main part is much the same.
Individuals having an incipient form of tuberculosis have been known to develop an acute form of the disease upon being subjected to a strenuous treatment for some other and entirely different condition. This has been especially noticeable in certain individuals to whom the starvation treatment is given.