TABLE
| Key: | |
| A | Protein Gm. |
| B | Fat Gm. |
| C | Carbohydrate Gm. |
| D | Calories |
| Material | Measure | A | B | C | D |
| Apple | 1 medium (150 gm.) | .5 | .50 | 16.0 | 70 |
| Almonds[149] | 10 small (10 gm.) | 2.0 | 5.00 | 2.0 | 63 |
| Apricots (dried) | 1 oz. (30 gm.) | 1.5 | .28 | 17.5 | 78 |
| Asparagus | 6 large stalks (74 gm.) | 1.3 | .14 | 2.5 | 16 |
| Bacon (raw)[149] | 4 slices, 6 in. long, 2 in. wide | 10.0 | 64.00 | 636 | |
| Bacon (cooked)[149] | 4 slices, 6 in. long, 2 in. wide | 10.0 | 32 to 46 | 388 to 468 | |
| Beef juice[150] | 100 gm. | 4.9 | .60 | 25 | |
| Beef roast[149] | 1½ in. × ⅛ in. | 6.0 | 7.00 | 89 | |
| Cheese (Neufchâtel)[149] | 1 cheese 2¼ in. × 1½ in. × 1¼ in. | 16.0 | 23.00 | 1.0 | 284 |
| Cream, gravity 16% | 1 glass (7 oz.) | 5.0 | 32.00 | 10.0 | 359 |
| Cream, 40% | 30 c.c. (2 tbs.) | .6 | 12.00 | 1.0 | 114 |
| Cracker (Uneeda biscuit) | 1 biscuit | 1.0 | .50 | 1.0 | 16 |
| Dry peptonoids[150] | 1 tbs. | 6.0 | 8.0 | 57 | |
| Egg | 1 medium (45 to 50 gm.) | 54.0 | 4.20 | 60 | |
| Fowl | 3½ oz. (100 gm.) | 19.3 | 16.30 | 224 | |
| Grapefruit | ½ | 5.0 | 20 | ||
| Ham (lean) | 50 gm. | 12.4 | 7.10 | 113 | |
| Lemon juice[151] | 3 tbs. (43 gm.) | 4.2 | 19 | ||
| Lemon Jelly[152] | 3 oz. (90 gm.) | 2.6 | 1.4 | 16 | |
| Milk (whole) | 1 glass (8 oz.) 240 c.c. | 7.9 | 9.60 | 10.0 | 158 |
| Oatmeal[153] | 1 tbs. (50 gm.) | 1.0 | 6.0 | 33 | |
| Oatmeal | ½ cup (3.6 oz.) | 2.1 | .10 | 8.2 | 50 |
| Potato[153] (size large egg) | 1 (100 gm.) | 2.0 | .8 | 83 | |
| 5% vegetable[153] uncooked | 1 tbs. | 2.5 | 10 | ||
| 5% vegetable (boiled once) | 1 tbs. | 1.7 | 7 | ||
| 5% vegetable (boiled thrice) | 1 tbs. | 1.0 | 4 | ||
| Orange | 1 large | 1.7 | .20 | 22.7 | 100 |
| Orange[153] | 1 medium | 1.0 | 13.0 | 57 |
Increasing the Diet.—The following menus show the manner in which the diet is increased after the starvation treatment:
First Day
Approximately 150 grams of vegetables with tea or coffee; value: protein 2, fat trace, carbohydrate 4.
| Breakfast— | String beans | 20 grams |
| Celery hearts | 20 grams | |
| Lunch— | Spinach | 25 grams |
| Lettuce | 25 grams | |
| Supper— | Tomatoes | 25 grams |
| Cucumbers | 25 grams |
Second Day
Three eggs, 150 grams of 5% vegetables, tea or coffee; value approximately: protein 18, fat 12, carbohydrate, 4, calories 198.
Third Day
Approximately 19 grams protein, 15 grams fat, 5 grams carbohydrate, 230 calories.
| Breakfast— | 1 egg | |
| String beans | 50 grams | |
| Tomatoes | 25 grams | |
| Coffee | ||
| Dinner— | Cauliflower | 50 grams |
| Celery | 50 grams | |
| Tea | ||
| Supper— | Asparagus | 75 grams |
| Lettuce | 50 grams |
Fourth Day
Approximately 26 grams protein, 15 grams fat, 10 grams carbohydrate, 279 calories.
| Breakfast— | 1 egg | |
| String beans | 75 grams | |
| Coffee with cream | 15 c.c. | |
| Dinner— | Tomato bouillon | 6 oz. (180 c.c.) |
| 1 egg | ||
| Asparagus | 75 grams | |
| Lettuce | 25 grams | |
| Tea | ||
| Supper— | 1 egg | |
| Celery | 50 grams | |
| Cauliflower | 100 grams |
Fifth Day
Approximately 20 grams protein, 46 grams fat, 15 grams carbohydrate.
| Breakfast— | Egg omelet (1 egg) | |
| Butter | 10 grams | |
| Vegetable hash | 100 grams | |
| Coffee or tea | ||
| Cream | 15 grams | |
| Dinner— | Chicken broth | 180 c.c. |
| 1 poached egg | ||
| Tomatoes | 100 grams | |
| Tea | ||
| Supper— | 1 soft-cooked egg | |
| Spinach | 100 grams | |
| Cucumbers | 50 grams | |
| Tea or Coffee | ||
| Cream | 15 grams |
Sixth Day
Approximately 33 grams protein, 35 grams fat, 12 grams carbohydrate, 495 calories.
Seventh Day
Approximately 38 grams protein, 45 grams fat, 17 grams carbohydrate, 625 calories.
| Breakfast— | ½ grapefruit | |
| 2 eggs | ||
| Butter | 10 grams | |
| Coffee | ||
| Cream | 15 grams | |
| Dinner— | Beef broth | 180 grams |
| 1 lamb chop | 50 grams | |
| Cauliflower | 100 grams | |
| Tomato | 150 grams | |
| Lettuce | 50 grams | |
| Butter | 10 grams | |
| Supper— | 1 egg | |
| Tuna salad | 50 grams | |
| String beans | 100 grams | |
| Butter | 5 grams | |
| Tea |
Eighth Day
Approximately 32 grams protein, 16 grams fat, 20 grams carbohydrate, 625 calories.
The following menus are used after the diet has been more or less increased:
First Day
| Breakfast— | 1 soft-cooked egg |
| 2 slices of bacon | |
| 1 bran muffin, 5 gm. butter | |
| Coffee with 15 c.c. of 40% cream | |
| Lunch— | 6 oz. tomato bouillon |
| 2 oz. (60 gm.) roast lamb | |
| 60 gm. string beans | |
| 50 gm. lettuce and celery salad | |
| 25 gm. lemon jelly with 15 gm. cream | |
| Dinner— | 60 gm. chicken |
| 75 gm. asparagus | |
| 4 olives | |
| 50 gm. cauliflower | |
| 30 gm. ice cream | |
| 1 Lister roll, 5 gm. butter | |
| Black coffee |
Second Day
Third Day
| Breakfast— | 1 soft-cooked egg |
| 2 slices bacon | |
| 1 Casoid flour and bran muffin with 5 gm. butter | |
| Coffee with 15 gm. cream | |
| Lunch— | 100 gm. cabbage |
| 40 gm. corned beef | |
| 50 gm. tomato salad | |
| 1 soya meal muffin, 8 gm. butter | |
| Tea | |
| Dinner— | 60 gm. beefsteak |
| 75 gm. asparagus | |
| 75 gm. spinach | |
| 30 gm. tomato aspic | |
| 30 gm. soft (diabetic) custard | |
| Black coffee |
Fourth Day
Fifth Day
| Breakfast— | ½ grapefruit |
| 1 soft-cooked egg | |
| 1 bran muffin with 8 gm. butter | |
| Coffee, 15 gm. cream | |
| Lunch— | 40 gm. broiled beefsteak |
| 75 gm. spinach | |
| 75 gm. boiled onion | |
| 1 soya meal muffin with 8 gm. butter | |
| Tea | |
| Dinner— | 6 oz. tomato bouillon |
| 80 gm. baked fish with parsley sauce | |
| 75 gm. Brussels sprouts with 5 gm. butter | |
| 1 Lister roll with 5 gm. butter | |
| Coffee jelly, 30 gm., with 15 gm. whipped cream |
Sixth Day
A departure from the now almost universally used “Allen-Joslin Starvation Diet,” is seen in the “Newburg-Marsh High Fat Diet.”
The use of a high fat diet in the treatment of diabetes is based primarily on one fact—namely, that if the food eaten is not sufficient for the needs of metabolism, the body itself supplies the deficiency. Fat is used as long as it lasts, body protein being drawn upon for fuel when this is exhausted. It is of distinct advantage to the patient to have a diet of sufficient fuel value to run his body machine and permit him a moderate degree of exercise. For by this means he is not obliged to use his own body substance to carry on metabolic processes. We thereby avoid the condition of extreme emaciation (though it is to be emphasized that gain in weight is to be carefully guarded against) with its constant lowering of the general health.
The system of feeding consists of a series of four diets, examples and standards of which are given below. The diet is made up of protein on the basis of approximately ⅔ of a gram per kilogram of body weight at the time the patient leaves the hospital, a quantity of carbohydrate known to be well tolerated and the balance of the calories in fat.[154]
Diabetic Diet No. 1
| Key: | |
| A | Weight Gm. |
| B | Protein Gm. |
| C | Fat Gm. |
| D | Carbohydrate Gm. |
| E | Calories |
| 18-22 Proteins | |||||
| 12-15 Carbohydrates | |||||
| 800-1000 calories | |||||
| Food | A | B | C | D | E |
| Dinner: | |||||
| Fish | 50 | 8.9 | 5.1 | 82 | |
| with Butter | 10 | .1 | 8.5 | 77 | |
| Cabbage | 50 | .8 | .1 | 2.8 | 16 |
| with mayonnaise | .7 | 38.2 | 353 | ||
| Tomatoes | 100 | 1.2 | .2 | 4.0 | 23 |
| Broth—Tea | |||||
| Supper: | |||||
| String beans | 80 | 1.8 | .2 | 5.9 | 33 |
| with bacon | 10 | 1.0 | 6.5 | 62 | |
| Spinach soup— | |||||
| Spinach | 10 | .2 | .3 | 2 | |
| Cream | 10 | .2 | 4.0 | .3 | 38 |
| Broth to fill bowl | |||||
| Celery | 20 | .2 | .7 | 4 | |
| Broth—Tea | |||||
| Breakfast: | |||||
| Omelet— | |||||
| 1 egg | 6.7 | 5.2 | 74 | ||
| with butter | 10 | .1 | 8.5 | 77 | |
| Coffee | |||||
| 21.9 | 76.5 | 14.0 | 842 | ||
Diabetic Diet No. 2
| Key: | |
| A | Weight Gm. |
| B | Protein Gm. |
| C | Fat Gm. |
| D | Carbohydrate Gm. |
| E | Calories |
| 25-30 Proteins | |||||
| 18-22 Carbohydrates | |||||
| 1200-1600 calories | |||||
| Food | A | B | C | D | E |
| Dinner: | |||||
| Pork chops | 60 | 10.0 | 18.0 | 202 | |
| Cabbage | 100 | .2 | .3 | 5.6 | 32 |
| (Use pork drippings) | |||||
| Spinach | 100 | 2.1 | .3 | 3.2 | 24 |
| with butter | 20 | .2 | 17.0 | 154 | |
| Broth—Tea | |||||
| Supper: | |||||
| Asparagus salad— | |||||
| Lettuce | 10 | .1 | .3 | 2 | |
| Asparagus | 80 | 1.2 | .1 | 2.1 | 13 |
| Mayonnaise | 50 | .7 | 38.8 | 338 | |
| Tomatoes | 100 | 1.2 | .2 | 4.0 | 23 |
| with butter | 10 | .1 | 8.5 | 77 | |
| Nut charlotte— | |||||
| Walnuts, chopped | 10 | 1.8 | 6.4 | 1.3 | 70 |
| Cream | 50 | 1.1 | 20.0 | 1.5 | 190 |
| Broth—Tea | |||||
| Breakfast: | |||||
| Bacon | 20 | 2.1 | 13.0 | 125 | |
| with 1 egg | 6.7 | 5.2 | 74 | ||
| Coffee with cream | 30 | .7 | 12.0 | .9 | 114 |
| 28.2 | 139.8 | 18.9 | 1438 | ||
Diabetic Diet No. 3
| Key: | |
| A | Weight Gm. |
| B | Protein Gm. |
| C | Fat Gm. |
| D | Carbohydrate Gm. |
| E | Calories |
| 30-35 Proteins | |||||
| 25-30 Carbohydrates | |||||
| 1600-2000 calories | |||||
| Food | A | B | C | D | E |
| Dinner: | |||||
| Beef tenderloins | 80 | 13.0 | 19.5 | 227 | |
| with butter | 10 | .1 | 8.5 | 77 | |
| Asparagus | 100 | 1.5 | .1 | 2.8 | 18 |
| with butter | 10 | .1 | 8.5 | 77 | |
| Squash | 100 | 1.4 | .5 | 9.0 | 46 |
| with butter | 10 | .1 | 8.5 | 77 | |
| Broth—Tea | |||||
| Supper: | |||||
| String bean salad— | |||||
| Lettuce | 10 | .1 | .3 | 2 | |
| String beans | 50 | 1.1 | .1 | 3.7 | 26 |
| Pimento | 10 | .2 | .4 | 2 | |
| Onion | 10 | .2 | 1.0 | 5 | |
| Mayonnaise | 30 | .5 | 23.3 | 228 | |
| Tomatoes | 120 | 1.4 | .2 | 4.8 | 28 |
| with butter | 20 | .2 | 17.0 | 154 | |
| Chocolate pudding— | |||||
| Cream | 100 | 2.2 | 40.0 | 3.0 | 381 |
| Cocoa, ½ tsp | 1 | .2 | .3 | .4 | 5 |
| Broth—Tea | |||||
| Breakfast: | |||||
| Bacon | 30 | 3.2 | 19.4 | 187 | |
| with 1 egg | 6.7 | 5.3 | 74 | ||
| Coffee with cream | 30 | .7 | 12.0 | .9 | 114 |
| 32.9 | 163.2 | 26.3 | 1728 | ||
Diabetic Diet No. 4
| Key: | |
| A | Weight Gm. |
| B | Protein Gm. |
| C | Fat Gm. |
| D | Carbohydrate Gm. |
| E | Calories |
| 50-60 Proteins | |||||
| 30-40 Carbohydrates | |||||
| 2000-2500 calories | |||||
| Food | A | B | C | D | E |
| Dinner: | |||||
| Veal steak (roast) | 100 | 19.9 | 10.8 | 177 | |
| Onions | 126 | 1.9 | .4 | 11.9 | 49 |
| with cream | 50 | 1.1 | 20.0 | 1.5 | 190 |
| Tomatoes | 150 | 1.8 | .3 | 6.0 | 35 |
| with butter | 30 | .3 | 25.5 | 231 | |
| Fruit salad— | |||||
| Lettuce | 10 | .1 | .3 | 2 | |
| Celery | 50 | .6 | 1.6 | 9 | |
| Grapefruit | 80 | .6 | .2 | 8.1 | 37 |
| Whipped cream | 30 | .7 | 12.0 | .9 | 114 |
| Tea—Broth | |||||
| Supper: | |||||
| Cream of celery soup— | |||||
| Celery | 50 | .6 | 1.6 | 9 | |
| Cream | 75 | 1.6 | 30.0 | 2.2 | 285 |
| Broth to fill bowl | |||||
| Boiled ham | 30 | 6.1 | 6.7 | 85 | |
| Custard— | |||||
| 2 egg yolks | 4.7 | 10.0 | 109 | ||
| Cream | 90 | 2.0 | 36.0 | 2.7 | 343 |
| Tea | |||||
| Breakfast: | |||||
| Eggs (2) | 13.4 | 10.5 | 148 | ||
| with butter | 30 | .3 | 25.5 | 231 | |
| Coffee with cream | 20 | .4 | 8.0 | .6 | 76 |
| Broth | |||||
| 56.1 | 195.9 | 37.4 | 2130 | ||
Nurse’s Directions for Collecting and Testing the Urine in Diabetes Mellitus.—The first urine voided in the morning at 7 A.M. should be thrown away, after which the entire quantity during the ensuing twenty-four hours, including that at 7 A.M. the following morning, should be collected in a thoroughly clean, wide-mouth bottle sufficiently large to contain the entire quantity. This should be kept in a cool place to prevent decomposition. After the urine has been measured, four or five ounces are removed for testing purposes. There is no necessity for having an elaborately equipped laboratory for making the simple tests of the diabetic urine. The nurse is only required to make the simple tests, leaving the more elaborate one for the physician. The articles necessary for these tests must be kept perfectly clean in order to make the tests accurate. The bottle in which the urine is collected must be washed and sterilized daily before the collection begins. One small three-inch white enameled or porcelain dish, one 10 c.c. graduated pipette, 6 test tubes, 1 small alcohol lamp or Bunsen burner, 1 box of sodium carbonate, 1 box talcum, and the reagents necessary for making the test, namely, Benedict’s solution, Fehling’s solution, and Haines’s solution.