The method of cooking, which is in reality preparing the food for digestion, thus becomes a powerful factor in dealing with diseased conditions. In most foods, and in animal foods especially, cooking develops the agreeable flavors and makes them more palatable. It also enables them to become more readily masticated and therefore more easily digested. The nutritive elements of food are extracted for assimilation by the action of the various digestive fluids of the body. In many diseases the glands that secrete these digestive fluids are weak or inert, and need stimulating, and here attractive cookery and artistic serving play an important part. When food is pleasing to the eye the nerves of sight and taste are excited. These nerves act reflexly on the nerves of the stomach, stimulating the gastric glands. Eating is, therefore, made more enjoyable, a greater flow of digestive juices is produced, and the result is better digestion, better assimilation and increased strength.
Classes of Diets
Four grades of diet for patients are ordinarily recognized in a hospital. Besides these we have the different grades of food, served to the different classes of employes on the working staff, making as a rule seven different classes of dietaries for the hospital housekeeper to provide each day. Usually there are dishes on the regular diet that may be used for the semi-solid or the light diets, and also for the officers’ and employees’ tables. And as a general rule there are special forms of liquid diet prepared each day, that may be added to the other dietaries, thus making it possible to cook many of the dishes in bulk, which is always the more economical way.
For patients on fluid or liquid diet, such articles must be provided as beef tea, beef juice, chicken broth, mutton broth, gelatine, barley water, cocoa, certain forms of strained gruel, albumen water, koumyss, buttermilk, whey and sweet milk served in its natural state or in its almost numberless combinations that vary the flavor.
For those on semi-solid diet such foods as oatmeal gruel, custard, ice cream, rice, tapioca, sago, and sometimes milk toast are used in addition to the foods included in fluid diet.
For patients on light diet such additions are made as bread, toast, some fruits, certain kinds of fish, such as oysters, clams and the white-fleshed fishes, poultry and game.
Regular diet in a hospital may include all the above articles with beef, mutton and other meats added, certain vegetables and all fruits.
For patients in the transition stage with weakened digestive functions, the shorter fibred meats are usually served in small quantities, before beef, mutton and other meats more difficult of digestion. But even in the regular diets, much discretion needs to be used. Many articles that are permitted in health have no place on the hospital dietary. Boiled cabbage, or cucumber pickles, or boiled dumplings, might be relished by the heartier of the patients on regular diet, but would be entirely unsuitable for the majority, and therefore not an economical food to serve. Even though digestion is not seriously impaired, the functions because of lack of exercise are sluggish, and it is unwise to put unnecessary tax on the excretory organs. So that though doctors may give full permission for the patient to “eat anything,” the housekeeper’s common sense will prevent her from incorporating in the hospital dietary many articles of food allowed in health.
The foods included in each class of diets and the limitations should be thoroughly understood by the whole working staff of the hospital. It is well to have printed lists conspicuously posted in different parts of the hospital. On no account should milk be allowed to be given to hearty patients on full diet, or to any patient on that class of diet unless specially ordered by the physician in charge. This rule needs special emphasis or milk bills may be greatly increased with no special benefit to any one.
As a rule the patient who is on an exclusive liquid diet must be dealt with individually and with great discrimination. The amount and kind of diet will be prescribed by the physician. But in these cases special preparation becomes very important. Milk frequently forms a large part of the fluid diet, as it is one of the very few complete foods.