In chronic tuberculosis, the patient should be instructed in the care necessary for his protection. He should be advised to report to the physician any symptoms occurring during the course of the disease, especially any hemorrhage. He must be reassured of the chances of recovery, even after hemorrhage has occurred. It is not well to encourage the habit of taking the temperature or weighing daily, since the knowledge of the fluctuations which inevitably occur in these conditions may worry the patient to such an extent as to interfere with his final recovery.

Rest, Sleep, and Fresh Air.—Moderation in physical exertion, wholesome food at regular intervals, plenty of rest and sleep, preferably in the open, and an effort made to look forward to a complete recovery will go far toward bringing about the desired result. The tuberculous patient who sets his mind on recovery, refusing to be discouraged by the numerous setbacks which may from time to time occur, has a much greater chance of living a long and useful life than the patient who makes no effort in this direction.

Reënforcing the Diet.—The following reënforced foods have been found valuable in the diet for tuberculosis, especially in those cases which are confined to bed and in which the effort to eat causes more or less gastric distress:

Milk, whole milk, milk and cream, milk diluted with Apollinaris water, peptonized, modified milk, reënforced with egg or egg white or reënforced with one to four tablespoonfuls of lactose, malted milk, buttermilk, cream, egg, and vichy, milk shake, milk punch, malted milk shake, chocolate or cocoa malted milk, albumenized fruit juices, egg and orange, egg and wine, reënforced, if desired, with lactose, albumenized broths, proprietary infant foods, such as Eskay’s Food, Nestlé’s Food, Mellin’s Food, Racahout, cream soups reënforced with lactose or egg, junkets, and ice cream.

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.