As a rule hardly one-half, or at the most two-thirds of the normal quantity of nourishment necessary for the preservation of life, may be introduced into the organism in case of acute febrile disease. I have already indicated that there is no particular danger in such partial "inanition" (starvation) for a short period, but that, accordingly, the qualitative side of the nourishment becomes more important the longer the fever lasts. It has also been mentioned that the organism reduces its work of decomposition, gradually adapting itself to the unfavorable conditions of sustenance, and thus meets our efforts to maintain its material equilibrium.
It is important always to make use of any periods of remission and intermission, during which the patient has a better appetite and can digest more easily, to give him a good supply of food. It is also well to administer as much nourishing food as possible in the beginning of an illness, which is likely to be lengthy, provided the patient is not yet wholly under the effects of the febrile disease. The food must then be gradually reduced in the course of the illness.
As to quality, the diet must be selected from forms II and III (as below), and will consequently consist of glutinous soups, in some cases with the addition of a nutritive preparation of egg, meat jelly, milk and possibly thin gruel and milk.
The quantity of food which the patient may receive can only be given approximately, as follows:
For adults—(to constitute a sustaining diet). Soup ½ pint, milk and milk gruel ⅓ pint, meat 3 oz., farinaceous food the same, 2 eggs, potatoes, vegetables, fruit sauces 2 to 2½., pastry and bread 2 oz.
These quantities must be considered as the maximum for each portion. The quantity of beverage at each meal must also be very limited, not exceeding 3 to 6 oz., so that the stomach is not overburdened unnecessarily nor its contents too much diluted.
The reduced meals are harmonized with the object of sufficient general nourishment by eating more frequently, about five to six times a day. Patients with fever should have some food in small quantity every 2 to 3 hours. It is important that the patient be fed regularly at fixed times. This will be found advantageous both for the patient and for nursing.
Form II comprises purely liquid nourishment, "soup diet." Consommé of pigeon, chicken, veal, mutton, beef, beef-tea, meat jelly, which becomes liquid under the influence of bodily heat, strained soups or such as are prepared of the finest flour with water or bouillon, of barley, oats, rice (glutinous soup), green corn, rye flour, malted milk. All of these soups, with or without any additions such as raw eggs, either whole or the yolk only, if well mixed and not coagulated are easily digested. (Besides albumen preparations, Dech-Manna powders, dry extract of malt, etc., may be added).
Form III comprises nourishment which is not purely liquid. Milk and milk preparations (belonging to this group on account of their coagulation in the stomach):
(a)—Cow's milk, diluted and without cream, dilution with ½ to ⅔ barley water, rice water, lime water, vichy water, pure water, light tea.