Chapter VII: Part I: Explanatory Lessons (3)

A man who digs in a field day after day expends a certain amount of muscular energy. A lawyer, statesman, or author who works with his brain instead of his hands uses nervous force, but very little muscular. Brain and muscle are not nourished exactly by the same materials; therefore, the demand in the way of nutriment of these two classes will not be the same.

The lawyer might find a feast in a box of sardines and some biscuit, while the field laborer would look with contempt upon such food, and turn from it to fat pork and cabbage. This is no mere difference in refinement of taste, but a real and instinctive difference in the demands of the two constitutions. Sardines supply to the brain-worker the material he needs, and the pork and cabbage to the laborer the heat and energy he expends.

In health the sense of taste is the best guide to what is demanded by the system, and may as a general rule be followed; but in sickness that will not do, as the sense of taste in particular is disturbed by most forms of disease.

When a patient is very ill only the simplest foods will be used, and those will be prescribed by the physician; but when a patient is out of danger, and the necessity for variety comes, then the nurse, by preparing or suggesting dishes, may do much toward restoring the person to health and strength.

As a very large percentage of diseases arise from imperfect nutrition (as large as eighty per cent. being given by some writers), the sense of taste is usually very much disturbed and dulled in illness; therefore those kinds of food which are savory, and at the same time easy of digestion and nutritious, should be selected. The savory quality is very important. A person in health may endure badly cooked food and monotony in diet; a person recovering from an illness cannot but suffer by it.

A nurse will find a pleasant field for the exercise of ingenuity in selecting and preparing such dishes as shall (1) be suited to the digestive powers of the patient; (2) shall be savory; (3) shall be sufficiently varied to supply all those materials which the depleted and exhausted body needs; and (4) shall be in such judicious quantity as shall increase nutrition, but never overtax the digestive powers.

The decision of No. 1 (food suited to the digestive powers) is the most difficult, and here again the doctor will advise for particular or peculiar diseases.

There are certain things which from their natural composition are more easy of digestion than others, such, for instance, as milk, eggs slightly coagulated and raw, beef tea with the _juices in solution_, cocoa milk, and cocoa, coffee, jellies, gruels, porridge from prepared grains (except oatmeal) when _thoroughly_ cooked, oysters alive, rice, venison, and tripe.

No. 2, the _savory_ quality, depends largely upon preparation, and is under the control of the nurse. A baked potato done in a _hot_ oven, just to the point, and served immediately, is a delicious dish; overdone, or done in an oven of low temperature, and served lukewarm, it is very far from appetizing. A steak, if cut thin, salted, and broiled slowly, will be hard, dry, and lacking in flavor, but if it is cut thick, at least an inch and a half, better two inches, broiled for the first minute over very hot coals, and then slowly, that the heat may have time to penetrate to the center, and raise the whole to a temperature sufficiently high to cook it (about 160° Fahr.) without charring the outside, it will make a dish both wholesome and savory.

No. 3, the next consideration, is that of _variety_, and here the resources and judgment of the person in charge must come to the front. Only general hints can be given. Endeavor to supply some protein, some fat, some of the carbohydrates, and some mineral matter in each meal. Bread, grains, or potatoes will give the necessary starch. Sugar is usually supplied with drinks. Milk, eggs, meat, fish, and oysters will give protein; cream, butter, bacon, and the fat of other meats will furnish fat, and fruits and green salads give acids and mineral salts. For the latter, grapes, apples, carrots, onions, dandelions, and lettuce are very valuable. Grapes are composed of water with salts in solution, and glucose; both are absorbed with very little outlay from the system. The others are every-day foods, but science has taught that their instinctive use in the past has been a wise one.

No. 4, the _quantity_ of food to offer to a sick person, will depend upon the individual. Give enough, but rather give to an invalid _too little_ than too much, especially in the first days of using solid food; for after some forms of sickness there is great hunger, and one may injure himself by overeating at such a time. Furnish a little of each kind of food, but let that little be of _good quality_ and _perfectly prepared_, so that every morsel is eatable. It is discouraging to any one to have set before him food such that much of it must be rejected uneaten. It is very encouraging, especially to an invalid, to be able to eat all that is brought him, and for this end cooking and serving are of great importance. It is necessary to adjust the _proportions_ of the different kinds of foods to the needs of the consumer, otherwise all unnecessary material will be rejected from the body as waste, or will be accumulated in it to interfere with the workings of the different organs.

In general it may be said that the needs of no two individuals can be satisfied with exactly the same diet. In sickness it is the province of the physician to adjust the food to the condition of the patient. In convalescence the taste of the individual and the judgment of the nurse or attendant combined will usually not fail of good results. If an individual craves a certain dish, and there is no good reason why he should not have it, by all means procure it. Let only your judgment act. It may be something that you personally do not like. That should not influence a decision, provided, of course, that the food is not unwholesome.

We should bear in mind that a sick person is not in the same condition as ourselves, and that no matter how absurd his cravings may seem, they may be but perfectly natural longings for those substances which his depleted and exhausted system needs in order to be restored to health.

PART II

RECIPES