~Diarrhea and Tympanites.~--Constant attention and study of various typhoid patients taking a maximum amount of food a day has proved that the diarrhea and tympanites which at times occur in these as well as other cases are due to too much of one or another of the food constituents rather than to the general amount of the diet. Diarrhea may then be traced to an excess of cream, and the tympanites to an excess of lactose, and a reconstruction of the dietary will often obviate the trouble.
~Increasing the Diet.~--It is always advisable to "go slow" in adding new foods to the diet; milk, cream, eggs and lactose are the principal articles constituting the diet. To this are added fine cereal gruels, well-cooked rice, rice custard, tapioca custard, junket, ice cream, wine or fruit jellies, toast, eggs (soft-cooked, poached, creamed, or raw, in milk), or fruit beverages, cocoa, buttermilk, koumiss, certain proprietary infant foods such as Mellin's Food, Eskay's Food, Racahout and malted milk, with a well-baked potato, milk, cream or buttered toast added as the condition and appetite warrant.
~Milk Diet.~--The following milk diets[100] were devised by Dr. Coleman to be given in certain cases of typhoid fever during the acute stage. These formulas consist of milk, cream and lactose and furnish from 1000 to 3000 calories per day.
Milk, 1000 c.c. (1 qt.) 700 Cream, 50 c.c. (1-2/3 oz.) 100 Lactose, 50 gm. (1-2/3 oz.) 200
This furnishes eight feedings, each containing
Milk, 120 c.c. (4 oz.) 80 Cream, 8 gm. (2 dr.) 15 Lactose, 6 gm. (1-1/2 dr.) 24
Milk, 1500 c.c. (1-1/2 qt.) 1000 Cream, 240 c.c. (8 oz.) 500 Lactose, 125 gm. (4 oz.) 500
This furnishes seven feedings, each containing
Milk, 210 c.c. (7 oz.) 140 Cream, 30 c.c. (1 oz.) 60 Lactose, 18 gm. (4-1/2 dr.) 72
Milk, 1500 c.c. (1-1/2 qt.) 1000 Cream, 480 c.c. (1 pt.) 2000 Lactose, 250 gm. (8 oz.) 1000
This furnishes eight feedings, each containing
Milk, 180 c.c. (6 oz.) 120 Cream, 60 c.c. (2 oz.) 120 Lactose, 30 gm. (1 oz.) 120
~Varying the Diet.~--It has been found possible, even advisable, to vary the above diets in many cases. The disease extends over such a long period that if a fluid diet is adhered to the patient would grow exceedingly tired and even disgusted if milk alone was given, hence a mixed fluid diet such as is used in the Presbyterian Hospital, New York City is suggested.[101]