Chapter II Care and Feeding of Convalescents
Convalescence depends much upon the proper food. Fevers require that the patient’s strength should be kept up. If the body has been overfed on certain articles, these must be stopped, and those elements which are needed must be administered in the form of food, water, air and so on. The fever is nature’s method of throwing off disease,—and if properly guided it does not become dangerous. A physician should be sent for at once. The diet prescribed for the patient and the directions in regard to quantity, temperature and time of administration should be carried out in every detail, just like other directions in regard to nursing. Many a patient has been seriously injured or even killed through the administration of foods which were forbidden by the doctor. At times there is a special desire for a particular kind of food. It may be an indication that the system requires it, and such craving should always be reported to the doctor, and if possible the physician will suggest such a food or some substitute which will answer the purpose.
The temperature of the food should be tested before serving. Blood warm is generally the best. The tray should not be loaded with a variety of foods. The patient should not be tempted with food unless forced feeding is indicated.
If the tongue is coated, give a little water with lemon juice before breakfast, especially if milk foods are to be eaten. If the appetite is not keen, do not take milk foods for breakfast.
Vomiting
If vomiting occurs or is continued for any length of time, it may be checked by giving cold weak tea or black coffee at frequent intervals, or a few drops of brandy in a tablespoonful of ice water. In many cases it is better for the patient to have his breakfast in bed for some time after recovery, especially if the exertion of dressing is tiresome or the temperature of the room is unsuited to the patient’s condition. A mild warm room is preferable to an overheated one.
Diet
Diet for the sick may be classified as liquid, semi-liquid and solid foods. A liquid diet is generally given only during acute illness or after operations. The kind of food, as well as the amount and intervals at which it should be given, are usually prescribed by the attending physician. Therefore, only a few suggestions are given.
If nourishment by enema is necessary, predigested substances are the best; peptonized milk and malt extracts or well prepared, strained gruels of bran and oats, or of bran alone, to which one to two teaspoonsful of brandy have been added. Black cereal coffee or weak black coffee are often excellent where stimulation is desired. The amount should be from one to three ounces at a time, and the temperature should be luke warm. It must be injected very slowly.
If the patient is of a nervous temperament, or suffers from irritability of the stomach, he should have as little animal food as possible, especially for breakfast. As a rule a well prepared water gruel satisfies the demands of the body until the noon hour. It acts as a sedative and rests the whole body, and in this way more nervous energy can be expended for digestion at the noon meal.
There are some exceptions; for example, if a patient has had a restless night and is exhausted, he may have a cupful of freshly prepared whey or bran-tea with milk or cream before his breakfast. As a rule such conditions should not appear during convalescence, and may be prevented by intelligent nursing and avoidance of unnecessary company.
The greatest care should be taken not to allow a patient to eat rapidly or to take large quantities at one time, and also to avoid foods which produce fermentation.
Suggestive Menus
1. Breakfast
A cup of whey with or without lemon, and albumen water.
10 to 11 A. M.
Five to ten ounces of milk, diluted with gruel or tea.
Dinner
Gelatine prepared from barley, rice, bran or legumes and a little zwieback.
3 to 4 P. M.
Cocoa or milk (5 to 10 ounces) with zwieback.
Supper
Malt coffee with hot cream and milk-sugar and zwieback.
If food is required at 10 p. m. or during the night, whey, blackberry juice, broth, apple water, orange juice, egg-wine, tea, coffee or lemonade may be given if allowed.
2. Breakfast
Water gruel prepared from barley or bran, rye or steel cut oats, cream of wheat or rice. Malt coffee with triscuit.
10 to 11 A. M.
Broth with the yolk of an egg or fresh milk with crackers or crusts.
Dinner
Gelatine of wheat or toast with sterilized cream and zwieback or ryenuts.
3 to 4 P. M.
Milk, coffee, cocoa or eggnog with zwieback or crackers.
Supper
Chicken or clam broth with one or two tablespoonsful of cream, ryenuts or zwieback.
Allow the patient to return to simple solid foods gradually. If he tires easily of one thing, as much variety as possible should be introduced into the diet, but as a rule no more than three or four articles should be served at one meal.
3. Breakfast
Onion gruel, bread gruel, codfish gruel or cornmeal gruel.
10 to 11 A. M.
Milk or barley water with cream and toast.
Dinner
Toast with poached egg. Asparagus with lemon or cream dressing.
3 to 4 P. M.
Malt coffee, black or with cream, zwieback or unleavened biscuits with butter.
Supper
Strained pea soup or cream of tomato soup with zwieback or raw celery.
4. Breakfast
Bread soup prepared with prunes or imported root beer. (Excellent for constipation.)
10 to 11 A. M.
Milk or veal broth with the yolk of an egg, and crusts or zwieback.
Dinner
Puree of dried green peas, beachnut bacon, zwieback, raw celery.
3 to 4 P. M.
Cold water or malt coffee.
Supper
Beer or wine gruel or boiled custard with zwieback.
5. Breakfast
Gruel of Cook’s flaked rice or shredded wheat with butter, or hot sterilized cream.
10 to 11 A. M.
Whey or broth.
Dinner
Spinach on toast, two eggs, beachnut bacon.
3 to 4 P. M.
Raw bran, oatmeal water, almond milk or hot or cold water.
Supper
Sago gruel prepared with blackberries, apples or huckleberries (strained), and zwieback with butter.
6. Breakfast
Cereal gruel prepared with two-thirds water and one-third milk or one-fifth cream.
10 to 11 A. M.
Water, whey or tea of beans, peas, lentils or bran.
Dinner
A raw or baked apple with fish. Lettuce with mayonnaise dressing.
3 to 4 P. M.
Water, bran water or milk.
Supper
Soup of carrots, peas or asparagus with toast.
7. Breakfast
Cereal coffee, bran or legume tea, one slice of whole wheat toast, or stale bread. One egg.
10 to 11 A. M.
Vegetable water or whey.
Dinner
Green pea soup with raw celery. Raw oysters and crackers with butter.
3 to 4 P. M.
Almond milk, bran water or cold or hot water.
Supper
Baked apple with sterilized cream. Cream of celery soup with toast.
8. Breakfast
Milk or water gruel with crusts.
Dinner
Apple salad and lettuce with sweet breads. Orange juice.
Supper
Cream of tomato soup or clam broth with toast and raw celery.
9. Breakfast
Melon. Codfish cakes, raw apples or ambrosia.
Dinner
Pea or lentil soup. Squab on toast with tomato or apple salad and lettuce.
Supper
Cream toast or fruit soup or whey soup.
10. Breakfast
Lettuce or watercress or celery with or without dressing. Baked potatoes, one or two eggs and beachnut bacon.
Dinner
Broth with egg. Cream cheese with apple salad, black toast, olives.
Supper
String beans, creamed chipped beef, crackers or triscuit.
11. Breakfast
Green grapes, banana salad with lettuce and French dressing.
Dinner
Three ounces of strained tomato juice, young peas with bacon or white fish, triscuit with butter and black cereal coffee.
Supper
Sliced pineapple with gelatine and cream. Black toast.
12. Breakfast
Gluten gruel, cream of wheat, or whey gruel.
Dinner
Beefsteak with egg and spinach. Toast with butter.
Supper
Milk or fruit soup or green cooked vegetables with bacon.
13. Breakfast
Asparagus with French or cream dressing, chipped beef or boiled codfish with one or two tablespoonsful of raw wheat or rye flakes.
Dinner
Strained tomato juice with buttered toast, or a piece of cucumber. Lamb chops with sprouts and the yolk of an egg.
Supper
Cook’s flaked rice gruel with cream or butter and the yolk of an egg.
14. Breakfast
Lettuce, creamed potatoes with parsley and boiled ham.
Dinner
Tomato and lettuce salad with dressing. Scrambled eggs with string beans and bacon.
Supper
Baked apples in gelatine with cold sterilized cream and unsweetened graham crackers.
15. Breakfast
Fruit salad of peaches or apricots with almond cream and grapenuts or ryenuts.
Dinner
Boiled beef or chicken with mushroom sauce and rice.
Supper
Pea soup with buttered toast. Raw celery.
16. Breakfast
Lettuce, egg toast with cranberry or apricot sauce.
Dinner
Tomato soup. Lima beans with the yolk of an egg and lemon. Raw celery and parsley.
Supper
Green grapes and black toast with butter or fruit pudding with sterilized hot or cold cream.
Additional Menus
I — Light Rice With Egg and Soda Crackers — 233 Calories
Wash two tablespoonsful of rice, boil rapidly in one pint of water with a little salt until the grains burst. Then boil slowly in the oven or on the stove (uncovered) until the rice is dry. Remove from the fire and add one teaspoonful of butter, the yolk of one egg and a few drops of lemon juice. Serve plain with two soda crackers or one small round zwieback.
| Calories. | ||
|---|---|---|
| Rice | 2 tablespoons | 100 |
| Yolk of egg | 1 | 48 |
| Butter | 1 teaspoon | 35 |
| Crackers | 2 | 50 |
| 233 |
II — Light Rice With Egg and Cranberry Sauce — 263 Calories
Prepare the same as No. I. Pour two tablespoonsful of cranberry sauce over the rice.
Cranberry Sauce, Sterilized — 190 Calories
Put one cup of cranberries into a pint jar, add two and one-half tablespoonsful of sugar and sufficient water to fill the jar; screw tight and cook in a water bath for 40 minutes or longer. Let cool and run through a colander.
III — A Large Glass of Mixed Milk and Cream With Cranberry or Tomato Toast — 525 Calories
Heat two small round or one long zwieback and soften with two tablespoonsful of tomato or cranberry sauce. Serve on a plate and drink the milk with it.
| Calories. | ||
|---|---|---|
| Milk | 8 ounces | 165 |
| Cream | 4 ounces | 230 |
| Zwieback | 2 small | 100 |
| Fruit Juice | 2 tablespoons | 30 |
| 525 |
IV — Cream Toast of Whole Wheat Bread or Shredded Wheat — 390 Calories
Dissolve one tablespoonful of milk sugar in one-half or three-fourths cup of boiling water and pour over one slice of whole wheat bread or biscuit. Let stand a minute, then add four ounces of hot cream, and serve.
| Calories. | ||
|---|---|---|
| Cream | 4 ounces | 230 |
| Biscuit | 1 ounce | 100 |
| Milk Sugar | 1 tablespoon | 60 |
| 390 |
V — Cornmeal With Egg and Cranberry Sauce — 271 Calories
Cook three tablespoonsful of cornmeal in one pint of water with a little salt, for 30 or 40 minutes.
Remove from the fire. Then add one teaspoonful of butter, the yolk of one egg and a few drops of lemon. Pour on a soup plate and serve with two tablespoonsful of cranberry sauce and one soda cracker or two black crusts.
| Calories. | ||
|---|---|---|
| Cornmeal | 3 tablespoons | 108 |
| Yolk of egg | 1 | 48 |
| Butter | 1 teaspoon | 35 |
| Crackers or Crusts | 2 | 50 |
| Cranberry Sauce | 2 tablespoons | 30 |
| 271 |
VI — Apple Soup No. 1, With Two Black Crusts — 440 Calories
Heat a tablespoonful of olive oil and one of butter, mix with a tablespoonful of white flour, gradually add one pint of boiling water and stir.
When done, wash and grate one red Oregon apple with the skin. Add the grated apple to the soup, also a pinch of salt, a teaspoonful of sugar and a stick of cinnamon. Let all boil for about 10 minutes. Remove from the fire, add another teaspoonful of butter and a few drops of lemon; mix well, pour on a soup plate and serve with two crusts.
If the stomach is very delicate, the soup must be strained.
| Calories. | ||
|---|---|---|
| Apple | 1 large | 100 |
| Flour | 1 tablespoon | 30 |
| Olive Oil | 1 tablespoon | 100 |
| Butter | 1 tablespoon | 105 |
| Butter | 1 teaspoon | 35 |
| Sugar | 1 teaspoon | 20 |
| Crusts | 2 | 50 |
| 440 |
VII — Apple Soup No. 2, With Black Crusts — 535 Calories
Prepare as the foregoing. Add one-half cup of hot cream before serving; mix well. Omit the extra teaspoonful of butter, oil and lemon.
VIII — Apple Soup No. 3, With Black Crust — 488 Calories
Prepare as No. 1. When done, dilute the yolk of one egg with a tablespoonful of water on a soup plate, stir well and gradually add to the soup, also add a teaspoonful of butter and a few drops of lemon.
IX — Apple Soup No. 4, With Black Crusts — 515 Calories
Prepare as No. 2, omitting the sugar. This is good for diabetic patients.
X — Apple Soup No. 5, With Black Crusts — 468 Calories
Prepare as No. 3, omitting the sugar. This is also good for diabetic patients.
XI — Veal Soup With Sago. Zwieback With Butter — 478 Calories
Wash and soak three tablespoonsful of sago in one-half a cup of cold or warm water for several hours. Then boil it in one cup of water with a little salt. When the sago becomes too thick, add one cup of veal stock. Let it all boil together until the sago is done. Then remove from the fire, add a teaspoonful of butter and combine with the yolk of egg as directed for Apple Soup No. 2; also add a few drops of lemon. If flavoring is desired, boil a finely cut carrot and some parsley in the water before the sago is added. Remove the vegetables before serving. Celery is also good for flavoring. Onion does not combine well with sago. A great variety of vegetables in soup is not good for patients.
Use different ones each time, and the patient will relish it better.
| Calories. | ||
|---|---|---|
| Sago | 3 tablespoons | 90 |
| Broth | 1 cup | 100 |
| Butter | 1 teaspoon | 35 |
| Yolk of egg | 1 | 48 |
| Zwieback | 2 small | 100 |
| Butter | 1 tablespoonful | 105 |
| 478 |
XII — Veal Soup With Cream. Crusts or Zwieback — 453 Calories
Prepare like the foregoing, omitting the lemon, butter and egg, and using three ounces of hot cream.
XIII — Veal Soup With Green Peas and Zwieback
Soak one-fourth of a cup of dry green peas in soft water over night. Boil them in about one pint of water until tender. Then add one cup of veal stock and more water if the peas are dry. Let all boil for one-half an hour longer, then strain.
If the soup is for very young children or invalids, do not press much of the pulp through. Put one zwieback on a soup plate, pour some of the soup over it, then add one or two ounces of hot cream and serve.
The broth may be mixed with the cream and served in a cup, and the zwieback eaten with it.
XIV — Cream of Celery Soup No. 1 — 293 Calories
Wash the celery stalks, scrape and cut into one-inch pieces. Boil in a very little water, with a pinch of salt. When tender, put the celery into one cup and the water into another cup. Squeeze the juice of one-half lemon on the celery stalks and let stand for 10 or 15 minutes. Heat a tablespoonful of butter and mix with a tablespoonful of mixed flour, and add the hot celery water. If there is not sufficient fluid, add more boiling water. When done, remove from the fire, add another teaspoonful of butter, then add the celery; mix well.
If the lemon makes it too sour, pour some boiling water over the celery, and let it drain through a colander. When ready to serve, combine the soup with the yolk of an egg, as directed in Apple Soup No. 3.
If vegetables cause fermentation, they are less liable to do so if treated with acids as directed above.
| Calories. | ||
|---|---|---|
| Celery | 3 stalks | 25 |
| Butter | 1 tablespoonful | 100 |
| Mixed Flour | 1 tablespoonful | 35 |
| Yolk of Egg | 1 | 48 |
| Butter | 1 teaspoon | 85 |
| 293 |
XV — Cream of Celery Soup No. 2 — 343 Calories
Prepare and finish like the foregoing. Add one-half cup of beef, mutton or veal broth in place of hot water.
XVI — Cream of Celery Soup No. 3, With Two Black Crusts. 436 Calories
Prepare like No. 1, omitting lemon, egg and extra butter, and using three ounces of hot cream instead.
XVII — Cream of Celery Soup No. 4, With Two Black Crusts
Cook the celery as directed in No. 1. Add two teaspoonsful of cornstarch with water, and three ounces of hot cream.
XVIII — Cream of Asparagus Soup With Black Crusts
Prepare in the same manner as cream of celery soup, in four different ways.
XIX — String Bean Soup, With or Without Zwieback
Select young, tender string beans, wash, trim and shred fine or break into one-half inch pieces. Cook in a very little water. Finish like Cream of Celery Soup, with or without lemon, egg or cream.
Add plenty of chopped parsley just before removing from the fire. This soup is very purifying to the liver and intestines, but should not be given to fever patients.
XX — Cream of Cauliflower Soup With Black Crusts
Prepare the same as Cream of Celery Soup. The use of lemon is important for people who suffer with gas and flatulent dyspepsia.
XXI — Whey Gruel No. 1, With Zwieback
Heat one and one-half cupsful of sweet or slightly sour whey to the boiling point. Melt a tablespoonful of butter, mix with a tablespoonful of mixed flour and add the hot whey gradually. Boil a few minutes. Remove from the fire, add the yolk of an egg and a few drops of lemon juice. If sour whey is used, add a tablespoonful of cane-sugar while it boils, or mix the gruel with a few soaked or stewed prunes or with dried currants. Add cream in place of egg and butter, if desired.
XXII — Whey Gruel for Two Persons — 503 Calories
Wash one-fourth of a cupful or four tablespoonsful of sago several times with cold and warm water until the water becomes clear, then soak in one-half cup of cold or warm water for several hours over night. Bring two cups of whey to a boil with the peeling of one-half a lemon or a piece of cinnamon bark. Stir in the sago, let boil 20 minutes, and add one-fourth teaspoonful of salt. Remove from the fire and add a teaspoonful of butter, the yolk of an egg diluted with a tablespoonful of cold water, and a few drops of lemon, or leave out the egg, butter and lemon, and add three ounces of hot cream. Mix well, pour on soup plates and serve with soda crackers or zwieback, or one-half of a raw red Oregon apple. One tablespoonful of sugar may be added if allowed. Sour whey may be used instead of sweet whey.
| Calories. | ||
|---|---|---|
| Sago | ¹⁄₄ cup | 120 |
| Whey | 2 cups | 200 |
| Butter | 1 teaspoon | 35 |
| Yolk of egg | 1 | 48 |
| Zwieback | 2 | 100 |
| 503 |
XXIII — Cornstarch Gruel With Whey
Dissolve two tablespoonsful of cornstarch in a little cold water. Add one cup of water to a pint of whey, heat and stir in the cornstarch and boil 10 to 15 minutes. Finish the same as sago gruel. Rice flour, arrowroot, white flour or mixed flour may be used instead.
TABLE OF COMMONLY USED FOODS, GIVING CALORIC VALUE.
| Almonds, 10 large | 100 |
| Apples, 1 medium | 92 |
| Bacon, 1 pound | 2260 |
| Broth, 1 cup | 100 |
| Bananas, 1 large | 100 |
| Barley, 1 tablespoon, raw | 90 |
| Beans, dried, ¹⁄₂ cup, raw | 300 |
| Beefsteak, ¹⁄₄ pound (round) | 160 |
| Bran, 1 cup | 220 |
| Butter, 1 tablespoon | 105 |
| Blue Fish, 1 pound | 400 |
| Carrots, 1 large | 50 |
| Celery, 12 stalks | 100 |
| Codfish, 1 pound | 400 |
| Cornmeal, 1 tablespoon | 36 |
| Crackers, 1 Uneeda | 25 |
| Cheese, 1 pound American | 1800 |
| Cream, ¹⁄₂ cup from separator | 230 |
| Cucumbers, 1 large | 40 |
| Currants, 1 cup (dried) | 700 |
| Dates, 10 | 260 |
| Eggs, 1 whole | 60 |
| Eggs, 1 yolk | 48 |
| Eggs, 1 white | 12 |
| Figs, 10 large white | 600 |
| Rice-flour, 1 tablespoon | 55 |
| Wheat-flour, 1 tablespoon | 30 |
| Mixed flour, 1 tablespoon | 35 |
| Cornstarch, 1 tablespoon | 40 |
| Gelatine, 1 tablespoon | 80 |
| Greens, 1 cup | 40 |
| Grapenuts, 1 tablespoon | 30 |
| Honey, 1 tablespoon | 100 |
| Kumyss, 8 ounces | 100 |
| Lamb chops, 1 small | 100 |
| Lemon, 1 whole | 16 |
| Lettuce, 1 head | 40 |
| Macaroni, 1 cup (raw) | 300 |
| Milk, 8 ounces | 165 |
| Oats, rolled, 1 cup (raw) | 300 |
| Oats, steel cut, 1 cup (raw) | 900 |
| Orange, 1 large | 100 |
| Oil, 1 tablespoon | 100 |
| Peanuts, 15 | 100 |
| Peaches, 1 | 50 |
| Peas, ¹⁄₄ pound (dried) | 350 |
| Peas, green, 1 cup | 150 |
| Prunes, 5 (dried) | 100 |
| Potatoes, 1 large | 100 |
| Raisins, 10 large | 100 |
| Raspberries, 1 cup | 60 |
| Rice, 1 tablespoon | 50 |
| Syrup, 1 tablespoon | 50 |
| Sugar, 1 tablespoon | 60 |
| Tomatoes, 1 large | 50 |
| Walnuts, 8 | 100 |
| Wheat, rolled, 1 cup (raw) | 250 |
| Whey, 1 cup | 100 |