PNEUMONIA

The diet in pneumonia is of considerable importance, since in this condition the strength of the patient is taxed by reason of the character of the disease, and the only means of attaining endurance to carry him through this trying period is by providing proper nourishment.

Dietetic Treatment.—The same general outline of diet is used as in acute infectious fevers, milk forming the basis of the diet. The patient is given an abundance of water and other beverages in addition to the other fluid foods to relieve the thirst which is so often a common symptom in this disease.

It is sometimes found advisable, however, on account of the vomiting which may occur, to give a more concentrated form of nourishment, in which case liquid peptonoids, trophonine, and panopepton furnish a form of nourishment which is both strengthening and stimulating in character, and for these reasons particularly desirable. Freidenwald and Ruhräh advise against the use of starches and sugars in most cases of pneumonia.

Daily Diet Schedule.—The same fluid diets used in acute fevers and administered at two-hour intervals are advisable here. The following régime is used in pneumonia:

6 A.M.	6 oz. malted milk.
8 A.M.	6 oz. cocoa.
10 A.M.	4 oz. oatmeal or cornmeal gruel with 2 oz. cream.
12 M.	6 oz. chicken broth reënforced with 1 egg white.
2 P.M.	6 oz. malted milk chocolate.
4 P.M.	6 oz. albumenized orange juice.
6 P.M.	6 oz. chicken or beef broth, reënforced with egg white.
8 P.M.	6 oz. hot milk.

Night feeding consisting of milk, malted milk, or reënforced broth may be given at 12 M. and 4 A.M. if patient is awake.

The above diet may be varied by adding some of the beverages mentioned in the diet for tuberculosis or fevers.

Convalescent Diet Schedule.—As the acute symptoms subside and convalescence advances, the following diet may be instituted:

Breakfast	3 to 4 oz. cereal gruel with 2 oz. cream.
	1 soft-cooked egg.
10:30 A.M.	6 oz. chicken broth, reënforced with egg, or 6 oz. albumenized orange or grape juice.
1 P.M.	6 oz. oyster soup with rolled crackers.
	¼ cup wine jelly with 1 tbs. cream.
	1 glass (6 oz.) milk—2 parts milk, 1 part cream.
3 P.M.	Milk shake (4 oz. milk, 1 egg white).
Supper	4 oz. farina with 1 oz. cream.
	6 oz. cocoa.
9 P.M.	6 oz. malted milk.
Hot milk, broth, or malted milk may be given during thenight at 12 or 4 A.M. if patient is awake.

Breakfast	4 oz. orange juice on cracked ice.
	3 or 4 oz. strained oatmeal with cream or butter.
	1 slice soft toast.
	6 oz. cocoa.
10 A.M.	1 soft-cooked egg on toast.
	6 oz. milk.
Dinner	6 oz. cream of celery soup.
	2 oz. rice.
	4 oz. custard (soft or baked).
	6 oz. milk or cocoa.
3 P.M.	5 oz. cream, egg, and vichy.
Supper	1 soft-cooked egg.
	1 small baked potato.
	6 oz. cocoa or malted milk.

III

Breakfast	Stewed prunes.
	3 or 4 oz. cream of wheat with 1 oz. cream.
	1 soft-cooked egg.
	1 slice of toast with butter.
	6 oz. cocoa or milk.
10:30 A.M.	Eggnog (1 egg, 4 oz. milk, 2 oz. cream, 1 tbs. whisky or sherry wine).
Dinner	Cream of spinach soup.
	2 oz. mashed potatoes.
	2 oz. green peas.
	1 slice toast with butter.
	2 oz. rice or tapioca custard.
3 P.M.	6 oz. albumenized fruit juice.
Supper	1 slice toast.
	1 poached egg.
	6 oz. cocoa or hot milk.
	2 or 3 oz. stewed fruit or prune whip.

The diet may be reënforced with lactose and meat added only when convalescence is well established.

Tuberculosis Nursing.—The nurse must keep in mind that the lungs are in a condition more or less out of commission, and their work of excretion is forced upon the kidneys. For this reason, as well as on account of the increased strain upon the heart, it is necessary to keep the diet light and avoid all foods which may in any way exert an unfavorable influence upon either the kidneys or the heart.

Milk Diet.—A strict milk diet has been found necessary in certain cases of pneumonia, but this is used only while the febrile condition lasts, after which the diet is gradually increased, as in the case of acute nephritis and in diseases of the heart, to meet the needs of the individual.