6/0 APPENDIX 



The main thing's one must watch and deal with are diet, vomiting, 

 diarrhoea, constipation, pure air, the maintenance of oxygen for the 

 blood, sweating, renal secretion, rest and sleep, the control o( pain, 

 pyrexia, elevation of the head, sustenance of the heart and care during 

 convalescence. These will now be dealt with seriatim. 



(1) Diet. 



It should consist of carbohydrates, proteins, fats, water, sodium 

 chloride and vegetable salts, in a word it must be complete. The feeding 

 must be adapted to the condition of the patient thus: — 



The patient may not be able to take food by the mouth or rectum 

 owing to diarrhiea and vomiting, hence one must feed by giving 

 salines intravenously or subcutaneously at a temperature of 

 100° F. in the funnel. Give at least one pint in twelve hours. 

 This is, of course, not a complete food or anything like it, but 

 it is the best that can be done for the time. 



The patient may not be able to take food by the mouth owing to 

 vomiting but can take it by the rectum. Then give peptonized 

 milk, 100 c.c. for an infant, 125 c.c. for a child and 250 c.c. for 

 an adult every six hours. If rejected give a suppository and 

 repeat the food. Raise the buttocks to assist by gravity the 

 entrance of the food. 



Rectal feeds vary enormously as regards constituents and each 

 will use that which in his experience has proved most useful. 



There is much controversy as to the absorption of foods per 

 rectum but in such cases as those mentioned it is best to give 

 them. 



When the patient can take some food by the mouth it must be an 

 incomplete food at first, such as junket, raw meat juice, white 

 of egrg. Beef teas and broths are not good foods. 



A little alcohol in special cases, albumen water and whey. 



When this can be retained begin with complete foods as follows: — 



No. I Diet. 



Milk about four pints in twenty-four hours. 



For infants during the first six weeks of life 2 water and i milk. 

 ,. ,, second six weeks i ,, i ,, 



,. ,, next four months i ,, 2 ,, 



For adults ... ... ... ... ... i ,, 5 >> 



If curds are formed add barley water, rice water, arrowroot 

 water, aerated water or lime water. Add sodium bicar- 

 bonate, 10 grains (o"65 grm.) to the pint of milk. 



The milk may be boiled or prepeptonized. 



Allenbury's food may be given. A'egetable juices, as lemon 

 squash, lime juice, &c. 



Nasal feeding may be required in some cases. 



No. 2 Diet. 



Milk, two pints daily with arrowroot, cornflour, rice, tapioca 

 and bread. Egg- albumen, cream and butter. Stewed 

 apples, fresh fruit, tea and weak coffee, pounded raw meat. 

 Beef tea and soups. 



