FOOTNOTES:
[137] Allen’s Paradoxical Law, quoted from “Treatment of Diabetes Mellitus,” p. 18, by Joslin.
[138] “Treatment of Diabetes Mellitus,” p. 305, Joslin.
[139] “Food for the Sick,” by Strouse and Perry.
[140] Courtesy of Dr. Joslin and Thomas Groom & Co., Boston.
[141] The giving of coffee or clear broth, with or without whisky, does not materially affect the starvation and serves to make the patient more comfortable during this trying period.
[142] Dr. Joslin has given a very complete schedule in his “Treatment of Diabetes Mellitus,” from which the above schedule is taken.
[143] Hill and Eckman’s “Starvation (Allen) Treatment of Diabetes.”
[144] See 5% vegetable, p. [383].
[145] Table used by Dr. Joslin in his treatment of diabetes mellitus. It is convenient, and many changes in the diet may be made by substituting one food for another of like carbohydrate content. This table can be purchased on cards from Thomas Groom & Co., Boston, Mass.
[146] Table devised by H. O. Mosenthal showing accessory diets rich in carbohydrates. “Medical Clinics of North America,” July, 1917.
[147] “h” represents household measure.
[148] Mosenthal: “Medical Clinics of North America,” July, 1917.
[149] “Starvation Treatment of Diabetes,” by Hill and Eckman.
[150] “Practical Dietetics,” by Alidia Pattee.
[151] “Food for the Sick,” p. 62, by Strouse and Perry.
[152] Sweetened with saccharin.
[153] “Starvation Treatment of Diabetes,” by Hill and Eckman.
[154] Courtesy of R. Eckman and D. M. Stewart, University of Michigan Hospital, Ann Arbor, Michigan.
CHAPTER XXI
DISEASES OF THE LIVER
Much of the so-called biliousness from which the human family is so prone to suffer is nothing more or less than one of Nature’s danger signals by means of which man may understand that some part of the delicate organism called the human body is being overworked. Close investigation of these conditions has proved that it is the liver which has been overtaxed, in many cases to such an extent that in a measure it slows down, as any overtaxed machine will do, and has become clogged with material which, owing to its condition, it is not able to prepare properly and send out on time.
Work of the Liver.—When one considers the vast amount of work performed by this organ, one marvels that so little trouble is manifested. In another part of this text the functions of the liver were defined. It was found to be the largest secretory organ in the body, producing a constant supply of bile by means of which the fats were dissolved and the digestion and absorption of the other food materials facilitated. We likewise found that the greater part of the fuel foods was transformed within this organ into available energy, either for immediate or future use.
As a Detoxifying Agent.—To the liver must also be credited the detoxifying of the various poisons produced within the body during the process of metabolism or brought in by way of food. Too much cannot be said as to the value of the liver in this respect, the importance of which is made known as soon as anything happens to the organ to put it even temporarily out of commission.
Causes of Liver Disorders.—Is it any wonder, then, that with such abuses as overeating and drinking, especially of those foods rich in fats and carbohydrates which depend upon the liver for their availability in the body, Nature cries aloud for help and for the comparative rest of this, her largest organ?
The taking of alcohol in excess has been found to bring about tissue changes in the liver. Hence it must be avoided by individuals with a tendency to biliousness or to any disease in which the liver is involved.
The Bowels.—The bowels are as a rule constipated, and one of the first means of relief is the overcoming of this condition. The method of doing this depends upon the individual, and the treatment must be decided on by the physician.
Dietetic Treatment.—The dietetic treatment consists in abstaining from food or reducing the amount to a minimum while the attack lasts and while the intestines are being thoroughly emptied. All stagnant material which has clogged the bowels and which has been subjected to the activities of putrefactive bacteria must be gotten rid of. The diet must be especially low in fat. Oyster or clam broth, soft-cooked eggs, toast, cereal, or rice, with a little milk instead of cream and very little sugar, tea, and baked apple or stewed prunes are given.
Convalescent Diet.—After the attack the diet may be gradually increased until it is again normal. Moderation must be observed in the amount of food eaten; no highly seasoned or spiced foods, pickles, or condiments, such as peppers, mustard, or horseradish, should be taken. Salads should be dressed without oil. Lean beef, lamb chops, fish, chicken, sweetbreads, quail, squab, eggs (except fried or hard cooked), green vegetables (except radishes, onions, water-cress, and celery) in abundance, a small amount of potato, rice, or tapioca, fresh and cooked fruit with little, if any sugar, junket, custards, fruit jellies, weak tea and coffee should constitute the diet. Certain individuals find that milk increases the tendency to constipation; this is probably due to the small amount taken; large quantities do not as a rule produce this effect. Buttermilk, koumiss, and modified milk are advised in severe cases.
Diet for Constipation.—Individuals inclined to biliousness should endeavor to overcome the constipation which is one of the most prominent features. This is done by proper diet more successfully than by drugs (cathartics): bran bread, vegetable soup, fresh fruit, stewed fruit, fruit beverages, plenty of water. The following menus are suggested:
Advice to Patient.—The above menus are merely suggested. The diet may be selected from the list of foods already mentioned. The patient must be warned against overeating and drinking. Pastry, rich cakes and puddings, confectionery, gravies, etc., must be avoided. In certain individuals beer will induce a bilious attack. By them it should be avoided.