Chapter V: Food Materials and Their Preparation (1)

~Dairy Products.~--Milk, cream, and other dairy products form such an important part of the invalid dietary that they require especial care in their selection. "Certified Milk" is the safest. This is protected by special inspection. The methods and standards governing the production and distribution of certified milk were adopted by the American Association of Medical Milk Commissions, May 1, 1912. The sanitary condition of the dairy, the cleanliness of the vessels into which the milk is placed, the health of the milkers, and a surety that no member of their family with whom they come in contact has any kind of contagious disease, are all obligatory. The feed for the cows and the purity of the water given them to drink must be inspected and made to conform to the standard laid down for certified milk. The milk of sick cows and those having tuberculosis is absolutely condemned. The composition of certified milk is standardized as follows: the fat standard shall be 4%, with a permissible range varying from 3.5% to 4.5%. The proteins shall be 3.5%, with a permissible range varying from 3% to 4%. Certified milk shall not contain more than 10,000 bacteria to the cubic centimeter when it is delivered. This inspection and standardizing necessarily raises the price of certified milk above that of milk not so rigidly cared for, and when the additional expense makes it impossible for the patient to afford certified milk, the only thing to do is to be sure of the reliability of the dealer from whom the milk is purchased and the cleanliness of the dairy from which it is procured. Buttermilk and butter are the milk products which require some attention as to selection. The former grows sour with age and the odor of advanced fermentation and decomposition is readily recognized. Sweet butter, butter without salt, is less apt to be old when purchased than the salted variety, as the flavor of rancid fat is unmistakable in butter which has not been especially treated.

~Milk.~--Milk is without a doubt the most valuable food in the invalid dietary, furnishing not only a highly nutritious beverage, but likewise acting as a carrier of additional nourishment when such is necessary. Its form, its lack of definite flavor and odor, all add to its value as a food in sickness. Milk is one of the few foods which includes in its composition all of the chemical combinations known as foodstuffs. The carbohydrates, comprising 4.88% to 5% of the solids in milk, occur as lactose or milk sugar. This sugar belongs to the disaccharide group, and is, in the majority of cases, readily digested by even the most delicate digestive apparatus. This form of sugar lends itself particularly well as a reinforcing agent, and is generally used in such cases as typhoid fever, etc. The fat in milk, comprising 4% of the solids and occurring as butter fat (cream), is made up chiefly of olein and of palmitin, with smaller amounts of stearin and from 5% to 6% of its composition in the form of butyric acid (the fatty acid to which butter owes its name and flavor) and traces of other fatty acids, as well as small quantities of cholesterin, lecithin, and a yellow coloring matter.

The proteins of milk, which form the curd or larger part of the solids, according to Van Slyke[29] are in the form of casein and albumen. There are 3.6 parts casein to 1 part soluble proteins, but these figures vary somewhat at times. Casein is insoluble in pure water, but dissolves readily in water to which an alkali or calcium carbonate is added. The soluble protein in the form of lactalbumen is one of the constituents of whey. This substance contains more sulphur than does casein, but no phosphorus.

~Whey~ is the opalescent fluid which remains when the casein is precipitated, and is composed of water 93.8%, total ash 0.44% (Koenig).

~Mineral salts~, 0.7% of milk, are made up of calcium, potassium, sodium, magnesium, iron, sulphur, phosphorus, and chlorine. Milk is so rich in calcium that it requires only 400 c.c. (or about 2-1/2 cups) to furnish 1 gram of calcium. This is the amount believed to be necessary for the welfare of man each day and this must be derived from food.[30]

~Water.~--The fluid part of milk is composed chiefly of water, constituting 87% of whole milk.

Milk as a food for infants will be discussed in another chapter.

As has already been said, no food has so far been discovered which could be effectually substituted for milk. There is no food, however, which requires more attention in its selection and care. It is very susceptible to both odors and flavors, absorbing them both readily, as will be found if milk be placed in the same compartment with foods of strong odor and flavor, without being properly covered and protected. This is particularly noticeable with cucumbers, melons, etc.

Milk also furnishes a splendid medium for bacterial growth, and if left exposed to the air, put into unclean receptacles, or kept in a warm place, will immediately become more or less contaminated, after which it is unwise to use it. Sterilization and pasteurization will in a measure overcome the bacterial contamination, but milk purchased from a dairy which is not clean or milked under unsanitary conditions will remain dirty, hence unfit for human consumption. When the morning's milk supply is brought to the house it should be in clean, well-stoppered bottles, but before placing it in the ice-box the tops of the bottles should be carefully wiped off with a wet cloth to remove any superficial dust which may be adhering to them. Every time a portion of the milk is removed thereafter the tops should be again cleansed before the milk is poured out. This is a wise precaution, and often prevents contamination from the hands, etc.

The amount of water in milk prevents its being an adequate food for adults except in certain pathological conditions. However, it furnishes a supplementary food unequaled by any other beverage known. There are fortunately only a few individuals who are unable to drink milk. There are many who fancy they cannot do so, but if the nurse has the ingenuity to utilize some of the various methods whereby milk is made more digestible, it will generally be found that the patient can take it without trouble. In cases of personal dislike, if the milk is flavored or colored or made up into soup, cocoa, chocolate, junket, custards, blanc-mange, etc., it will usually prove acceptable.

~Application of Heat.~--A word as to the changes which are brought about as the result of heat as applied to milk. These changes are demonstrated in the two methods commonly used in the preparation of milk known as "pasteurization" and "sterilization." Pasteurization is rather an indefinite term to use, unless the time and the temperature to which the milk is subjected are given. According to Morse and Talbot "the term sterilization should never be applied to the processes used in the preparation of milk for the feeding of infants, because the milk is never rendered bacteriologically sterile by them."[31]

As a rule the flavor and odor of milk are not changed by heat until the temperature reaches nearly to the boiling point. A scum then forms on boiling milk, composed of casein 50.86%, fatty matter 45.42%, ash 4.72% (Rosenau). Prolonged boiling changes the color of milk from a creamy white to a yellowish brown which deepens with boiling. This is due to the caramelization of the milk sugar. Cream will not rise (or its rise will be very slow) on milk which has been subjected to a temperature of 150 deg. F. for thirty minutes or more because the fat droplets are broken down so that they cannot hold together at that temperature and become more completely distributed throughout the fluid.[32]

~Pasteurization~ is acknowledged to be preferable to sterilization in milk used for infant feeding because the higher the temperature the greater the change in the chemical composition of the fluid. According to Morse and Talbot[33] the temperature of the pasteurization should be as low as possible. Pasteurization at 140 deg. F. for 20 minutes is sufficient; lower temperatures are not. "At this temperature there is no change in the taste, odor, or color of the milk, no noteworthy changes in the chemical composition are produced, the ferments and bactericidal action are unaffected and bacterial toxins and non-spore-bearing microorganisms are destroyed."[34]

Rosenau[35] states that the bacillus of typhoid, diphtheria, and dysentery, as well as the cholera vibrio and other pathogenic non-spore-bearing bacteria which are often found in milk, are destroyed at a temperature of 140 deg. F. for twenty minutes, and at higher temperatures for shorter lengths of time.

Sommerfield's[36] investigations prove that butyric acid bacilli are destroyed at a temperature of 212 deg. F. for from 1 to 2 minutes.

It must be understood that no matter what method is used to insure purity in milk, nothing does away with the necessity for keeping the milk both clean and cold. The receptacles in which the milk is allowed to stand, the vessels in which it is measured, and the person who handles it must be absolutely clean, and the nurse must keep in mind the fact that pasteurization does not completely destroy the bacterial growth in milk, that it merely diminishes it, and she must see that the milk which has undergone the pasteurizing process is kept cold, otherwise the microoerganisms which are present, even if to a less extent than in raw milk, will undoubtedly multiply.

~Adulteration of Milk.~--There is not nearly so much adulteration of milk to-day as there was a few years ago. The stringent laws governing the care and composition of the milk make it unprofitable for the dairymen to practise it. However, there are times when such things are done and care must be taken to prevent it. Milk is, as has already been stated, very susceptible to contamination, and that which is infected with putrefactive bacteria is not fit for food even if the dealer has doctored it with formaldehyde. However, the danger to-day is not so much from drugs as from lack of care in the handling of the milk. It is well to remember, however, that water is an adulteration just the same as formaldehyde and perhaps more pernicious, since the quantities of the latter are so small in an ordinary quantity of milk as not to make a great deal of difference except in the feeding of invalids and children, while watered milk is a swindle not only to the pocketbook but to the body also, since the requisite nutritive value is lacking.

~Selection and Care of Milk.~--There are a few essential facts to keep in mind in regard to milk: (1) Be sure of the source of the milk supply, especially in the feeding of the sick and of infants. Milk for such cases should always be purchased from inspected dairies when it is possible. (2) Keep the milk cold; the best milk in the world will spoil if left in a warm place. (3) Always keep the milk bottle well covered, thus eliminating the danger of contamination, flies, etc.

ALBUMINIZED MILK

_135-152 calories_

6 ounces (3/4 glass) fresh whole milk.
1-2 eggs (whites only).

Have the milk thoroughly chilled.

Clip egg whites with scissors and strain through cheesecloth to remove stringy parts. Now stir into the milk with a fork.

If patient does not object to foam, the mixture may be placed in a milk shaker with pieces of ice and shaken until creamy, then poured over cracked ice.

ALBUMINIZED MILK SHAKE

_135 calories_

6 oz. (3/4 glassful) fresh whole milk
1 egg white

Place the milk on ice to become thoroughly chilled. Clip the egg white with scissors and strain through cheesecloth to free it from strings; stir into cold milk. If patient does not object to foam, the milk and egg whites may be placed in a milk shaker, and agitated for 4 or 5 minutes, then poured over cracked ice. This beverage may be flavored to suit the taste of patient. Vanilla, caramel, or coffee may be used to give variety.

To add additional nourishment 1 teaspoonful of Sanatogen, or Plasmon may be added, or 1 tablespoonful of Panopepton or liquid peptonoids used instead of the casein products.

MILK AND GINGER ALE (OR SARSAPARILLA)

_59 calories_

3 oz. milk
3 oz. ginger ale or sarsaparilla

Pour into a milk shaker and shake with cracked ice until foamy.

MILK PUNCH

_298 calories_

4 oz. rich milk
2 oz. cream
1 tbs. whisky (or sherry)
1 tbs. sugar (or less)
1 egg white (if additional nourishment is desired)

A grating of nutmeg on top. Place ingredients in shaker as directed above, and shake a few minutes to thoroughly mix ingredients. Pour over cracked ice, grate nutmeg or cinnamon over the top. The milk may be peptonized if necessary, using 1/2 tube of Fairchild's peptonizing powder.

PEPTONIZED MILK

_314 calories_

1 pt. of milk
1 tube of (Fairchild's) peptonizing powder

Dissolve the powder in 1 gill of cold water, and place in a clean quart jar (glass).

Pour in 1 pint of cold milk and stop the bottle with cotton, shake well and place the bottle in a saucepan containing water just warm enough to allow of the hand being immersed without being burned (115 deg. F.).

Keep the water at this temperature for 5 to 10 minutes or longer according to the degree of peptonization desired. Lift out of the warm water and plunge into cold, then place at once on ice.

The milk may be poured from bottle into a clean saucepan and brought quickly to a boil to prevent further peptonization; this process, however, is apt to make the milk very bitter and should not be used unless it is to be flavored with fruit juice.

PEPTONIZED MILK PUNCH

_212 calories_

Take a goblet about one-third full of finely crushed ice, add a tablespoonful of St. Croix rum, a dash of curacao or any liquor that is agreeable to the taste; fill the glass with "specially peptonized milk," stir well, and grate a little nutmeg on top. Add 1 tablespoon sugar.

BUTTERMILK (BULGARIAN)

_627 calories_

1 qt. fresh whole milk (or skimmed if desired)
1-1/2 to 2 oz. (Bulgarian) starter, or 1 buttermilk tablet[37]

If latter is used dissolve tablet in 1 gill of cold water.

Stir the buttermilk starter into the cold milk and place in a one-half gallon glass jar, place the cover on loosely and allow the jar to stand for 12 hours or until the milk is well clabbered. (Insert a thin-bladed knife close to the jar so that the rest of the milk is not disturbed to see if the coagulation is complete.) When this is accomplished place the jar in the ice-box. After the milk has become thoroughly cold, beat thoroughly. The mixture is like any well-made buttermilk. If the cream is removed before adding the culture the milk will be lower nutrient value, but in many cases this is necessary since it is often the fats which cause a disturbance.

COCOA

_147-166 calories_

2 tsp. cocoa
1-2 tsp. sugar
1/2 cup boiling water
2/3 cup milk

Mix cocoa and sugar together and add boiling water slowly. Boil 3 to 5 minutes; heat milk in double boiler and add cocoa mixture. Beat with Dover egg beater to distribute cocoa and prevent scum forming. Serve with or without whipped cream. Cocoa may be reinforced as directed in "broths" with albumen or the whole or yolk of one egg well beaten. If the white alone is used, care must be observed that the liquid is not hot enough to coagulate the albumen. Proprietary foods and casein preparations are used in like manner.

PLAIN JUNKET

_161 calories_

2/3 cup milk
1/2 junket tablet
1/4 tsp. vanilla extract or a grating of nutmeg
1 tbs. sugar

Heat milk to 100 deg. F. Add junket tablet dissolved in 1 tbs. cold water. Mix in sugar and flavoring, and pour into molds to jelly. When junket becomes firm, place in ice until needed.

JUNKET ICE CREAM

_428 calories_

1/2 cup each cream and rich milk
1 junket tablet
2 tbs. sugar
1/2 tsp. vanilla

Heat cream and milk to 100 deg. F. and proceed as in junket. When mixture is jellied turn into freezer, as any ice cream. This is the most wholesome of ice creams and especially suited for children and patients who have tuberculosis complicated with gastric disturbances.[38]

PLAIN VANILLA, LEMON, OR ALMOND ICE CREAM WITH OR WITHOUT EGG WHITE[39]

_585-602 calories_

1 cup thin cream
2 tbs. sugar (more if desired)
1/2 tsp. vanilla, lemon extract, or almond extract

Method I. Whip cream, add sugar and flavoring, and freeze.

Method II. Scald half the cream and cool. Whip the remaining half, add sugar and flavor and freeze.

Method III. Make "boiled custard," as directed, add one-half the amount of cream and freeze.

To reenforce ice cream:--Add 1 or 2 egg whites, beaten or unbeaten; these may be added in the beginning, or after the mixture begins to freeze. A tablespoonful of maple sirup, caramel sirup (1 tbs. sugar melted and browned and dissolved in 1 tbs. boiling water), or chocolate sirup may be poured over the ice cream to vary the flavor. Make chocolate sirup by boiling 2 tbs. water, 1 tbs. sugar, and 1 tbs. chocolate to a sirup. 143.3 calories.

FROZEN CUSTARD

_289-329 calories_

1 egg (or 2 yolks)
1 tbs. sugar
1/8 tsp. salt
1 cup of milk
Few drops of vanilla

Prepare as soft custard, freeze.

LACTONE BUTTERMILK

_627 calories_

1 qt. fresh milk
1 gill cold water
1 lactone tablet (or 1-1/2 oz. buttermilk starter)

(Parke, Davis & Co.'s and Hanson & Co.'s buttermilk tablets are practically the same.)

Dissolve tablet in cold water and stir into fresh milk (which may or may not be skimmed, according to the directions of the physician, but the finished product is more palatable using whole milk). Pour into a clean jar or wide-mouthed bottle; plug with cotton or close not tightly, allow to stand in room temperature 70 deg.-75 deg. F. 24 hours, shaking the bottle occasionally to keep the cream from rising. At the end of this time pour the milk out (if sufficiently fermented), and beat briskly for 5 to 6 minutes with egg beater or with churn; place on ice until ready to serve.

MALTED MILK (1)

_77-96 calories_

1 tbs. malted milk
1-2 tsp. sugar
6 oz. boiling water
1/4 tsp. salt
3 to 5 drops vanilla

Heat water to boiling and mix malted milk (Horlick's) with a little cold water. Stir into the boiling water, add sugar and salt, and serve with or without cream.

MALTED MILK (2)

_107-155 calories_

1/2 to 1 tbs. malted milk
3 oz. each milk and water
1-2 tsp. sugar
1/4 tsp. salt

Proceed as above.

MALTED MILK CHOCOLATE OR COCOA

_230-300 calories_

1 tbs. malted milk
1 tbs. cocoa or grated chocolate
6 oz. milk
2 oz. water
1-2 tsp. sugar
4-5 drops vanilla extract

Mix cocoa or chocolate with water and boil 2-3 minutes. Pour milk into a double boiler and heat, mix malted milk with a little water and stir into the hot milk, add the cocoa paste, sugar, and vanilla, mix thoroughly, beat the mixture briskly to mix ingredients thoroughly, and serve with or without cream.

~Milk or Cream Soups~

MILK OR CREAM SAUCE FOR SOUPS

_599-1229 calories_

2 tbs. flour
2 tbs. butter
1 pt. milk or thin cream
1/2 tsp. salt

Cream butter and flour to a smooth paste, heat milk in double boiler on an asbestos mat over the flame; when it is scalding hot, stir in the butter and flour paste, stir until smooth and the mixture begins to thicken, cover and allow to cook without boiling for 15 minutes; strain. The sauce may be used at once or put into a glass jar in the ice-box until needed.

CREAM OF ASPARAGUS (1)

_213 calories_

2/3 cup cream sauce
1/3 cup asparagus puree

Heat sauce and puree in separate saucepans, and when about ready to serve, stir them together, strain carefully, season with salt, and serve with or without croutons of toast or whipped cream. If the sauce is made from the cream instead of milk, the fuel value will be much higher (302.7 calories).

CREAM OF ASPARAGUS (2)

_216 calories_

8 medium stalks of asparagus
1 qt. water
1 tsp. salt
1 tbs. flour
1/2 cup cream sauce

Cut off the tips of the asparagus in 1-inch pieces, and place with the rest in a saucepan, and cover with water; add salt and cook until the tips are tender; lift out and put aside to be used instead of the toast croutons. After the water in which the asparagus is cooked is of sufficiently strong flavor, strain and add the extra spoonful of flour, mixed in a tablespoonful of water; cook 15 minutes, measure 1/2 cupful, and proceed as directed above.

CREAM OF POTATO

_259 calories_

Boil and cream the potato. Make sauce and add potato puree; stir until well blended and serve with toast croutons.

When boiling potato if a sprig of parsley is added and strained out, and a little of the potato water is used to make the puree smooth, the soup will have more character.

CREAM OF SPINACH, CELERY, PEAS OR CARROTS

_224-461 calories_

3/4 cup cream sauce
1/3 cup vegetable puree

Proceed as in making other cream soups.

OYSTER SOUP

_179 calories_

6 oysters
1 cracker (soda) or 8 oyster crackers
3/4 cup milk
1/4 tsp. salt
A dash of pepper

Put oysters (and their liquor) into a saucepan, and heat gently; skim thoroughly. Heat milk in separate pan; when very hot add to oysters. Roll the cracker and add to soup just before it is served. Add salt and pepper at the same time.

~Eggs~

~Eggs.~--The table shows eggs to have a chemical composition of water 73.7%, protein 14.8%, fat 10.5%, and mineral salts (ash) 1.0%. Fuel value per pound, 672 calories. The white of the egg, constituting 57% of the entire weight, is composed chiefly of albumen and water with a small percentage of mineral salts in the form of calcium, potassium, magnesium, sodium, phosphorus, chlorin, sulphur, and iron. Typical albumens are always rich in sulphur, and in eggs the sulphur content is much greater in the egg white than it is in the yolk. The yolk of eggs contains more protein and fat than the white, and less water. The protein of the yolk is chiefly in the form of ovovitellin, while the fats occur as palmitin, olein, and stearin. There is also 5% of coloring matter in the yolk of eggs besides lecithin, nuclein, salts of iron, potassium, magnesium, and phosphorus. The latter mineral salt comprises 1.0% in yolk, while in the white there is only .03%. Eggs have a position in the invalid dietary second only to that of milk. They are nutritious, easy of digestion, and exceedingly palatable if properly selected and correctly prepared. The albumen in the white is very susceptible to the effect of heat. At a temperature of about 135 deg. F. the clear, pale yellowish white begins to change to an opalescent tint, and, as the temperature is gradually increased, the texture changes from a viscid, sticky substance to an opaque, jelly-like mass which solidifies with an ever increasing temperature. Hard cooked white of egg, unless it is very finely divided, is considered difficult of digestion, but if the heat is applied gradually and is not raised to the boiling point (212 deg. F.) there is no reason why the hard cooked white of the egg should not be digested. However, it is unwise to cook eggs in this manner for invalids or children. Any of the other methods, with the exception of frying, which should never be used, is decidedly preferable. Egg albumen is soluble in water and fresh fruit juices, so that it may be used with great success as a reinforcing agent. In fact, the whole egg may be so used, but it is more difficult to disguise the yolk in a beverage than it is the white, and for this reason it is not so adaptable in many cases. Eggs may be cooked by the following methods in the invalid dietary: coddled, soft-cooked, poached, creamed, omelet, scrambled, or in custard. Uncooked eggs may be given in water, milk, wine, or fruit juices.

The selection of eggs is equally as important as the selection of other foods. There are "new-laid eggs," "fresh eggs," and just "eggs." The latter are generally storage and should not be used for the sick or for infants. As a rule old eggs will not stand poaching, the whites and yolks mingle and form an unappetizing mass. It does not make any difference whether the color of the shell is white or brown; if the egg is absolutely fresh the white and yolk should be distinct and easily separated, and when they are not it is safer to discard the egg entirely.

~Fruit Beverages~

ORANGEADE

_118 calories_

Juice of 1 orange
1 tbs. sugar
Juice of 1/2 lemon
Enough water to fill the glass

Sweeten the juice of orange and lemon and pour into a glass filled with crushed ice. Fill glass with plain or carbonated water.

ALBUMINIZED ORANGEADE

_152 calories_

Make orangeade as directed in above recipe, without the addition of water. Break the whites of 2 eggs into a saucer and with scissors cut the albumen until free from membrane and strain, stir this into the orange juice and add several pieces of cracked ice. This is both nourishing and palatable, and the taste of the egg cannot be detected.

ALBUMINIZED LEMONADE

_107 calories_

Juice of 1 lemon
1 tbs. sugar
Whites of 2 eggs

Cut as directed for Albuminized Orangeade. Mix until sugar is dissolved. Pour over a glassful of cracked ice. Fill glass with plain or carbonated water.

PINEAPPLEADE

_151 calories_

2 oz. (1/4 cup) grated pineapple
8 oz. (1 cup) cold water, or sufficient quantity carbonated water
to fill glass
Juice of 1 lemon
1 drop of lemon extract or a little of the peel, grated
1 tbs. sugar

Mix lemon juice, water, and pineapple together; add sugar, if not sweet enough, but the less used the better, in all beverages. Add extract and pour into a shaker with a few lumps of ice. Shake well to mix ingredients and pour the pineapple over crushed ice. If this proves too much at a time, make half the recipe. Serve in tall thin glasses holding from 4 to 6 ounces after the ice is put in, or serve in punch glasses with small spoons.

ALBUMINIZED GRAPE JUICE

Albuminized Grape Juice is made without the addition of lemon juice unless the white grape juice is substituted for the black, in which case add one or two teaspoonfuls to relieve the flat taste and proceed as in Albuminized Orangeade, using 3 oz. of grape juice.

EGG WHITE AND MINT

_57 calories_

1 egg
2 tsp. sugar
1 tsp. lemon juice
Several sprigs of fresh spearmint

Whip white of egg; add sugar and lemon juice. Crush lower parts of mint leaves slightly and place in glass. Pour mixture over ice in glass; stir well and serve at once.

Fill glass with carbonated water, Vichy, White Rock, Apollinaris, etc. This is especially good when patient suffers from nausea.

CREAM, EGG AND VICHY

_232 calories_

1 egg white
2 tsp. sugar
3 oz. (6 tbs.) cream
A few drops of vanilla extract
Celestine (French) Vichy to fill glass

Whip egg white to stiff froth; whip cream stiff and sweeten, add vanilla; lastly, the egg. Pour over cracked ice and fill up the glass with Vichy.

COFFEE

2 tbs. ground coffee
2 tsp. white of egg
1 cup boiling water
1/4 cup cold (boiled) water

Mix coffee with 1 tablespoonful of cold water and egg white in small pot (after scalding pot), add boiling water; allow to boil 3 minutes; stir down and add cold water; set pot where coffee will stay hot, but not boil, for 10 to 15 minutes, serve with cream and sugar or use to flavor hot milk.

PLAIN EGGNOG

_267 calories_

1 egg
2 tbs. cream
1 tbs. rum
1 tbs. whisky
1 tbs. sugar

Beat yolk of egg and sugar together; add cream, rum, and whisky. Beat egg white stiff and stir into the mixture; pour into glass with or without cracked ice.

Nutmeg may be grated over top for those who like it.

COFFEE EGGNOG

Follow recipe for plain eggnog, substituting 2 tablespoonfuls of strong coffee for the rum.

PANOPEPTON OR LIQUID PEPTONOID EGGNOG

_233-257 calories_

Is made as directed for plain eggnog, panopepton being substituted for the rum, using 1 ounce instead of 1 tablespoonful. This will probably more than fill a glass, but the whole amount must be made to keep the proportions correct. The whisky may be left in, if desired, or sherry wine may be substituted in its place to give flavor and additional stimulation.

MALTED MILK EGGNOG

_264-316 calories_

1 egg
1 tbs. malted milk
4 oz. milk
1 tbs. sherry wine or whisky
1/2-1 tbs. sugar
1 tsp. cream

Mix milk as directed above and chill thoroughly. Beat egg yolk with sugar and whisky or wine and add to the mixture. Beat egg white stiff and stir into the rest of the ingredients. Pour into shaker and shake with cracked ice until thoroughly chilled. The cream may be served on top, or beaten into the eggnog.

FOAMY OMELET

_130 calories_

1 egg
1 tbs. water
1/2 tbs. butter
1/8 tsp. salt and dash of pepper

Beat yolk until light colored and thick; add water, salt, and pepper. Beat white until stiff and dry. Turn the yolk over the beaten white and cut and fold the white into the yolk mixture.

Have pan hot and buttered, turn in the mixture, spread evenly in pan and allow to stand about two minutes on the top of the stove at a moderate heat; then remove the pan, place in a moderate oven and cook until a knife thrust into the center comes out nearly clean. Remove from oven, cut across center at right angles with handle of pan and turn over on a hot platter. Omelets may be varied by the use of different garnishes and flavors.

CODDLED EGGS

_75 calories_

1 pt. water
1 egg

Allow water to boil; wash egg; drop into boiling water and place saucepan where water will keep hot, but not boil; allow to stand 7 to 8 minutes. Serve with salt.

SOFT-COOKED EGGS

_75 calories_

Proceed as for coddled eggs, but allow egg to remain from 10 to 15 minutes or even longer, if very soft eggs are not desired.

POACHED EGGS

_75 calories_

Have small, shallow saucepan half filled with boiling water or milk--if an egg poacher is at hand, use that; otherwise, lower a flat perforated spoon into water and place where the water cannot boil. Break the egg carefully into the spoon, taking care not to break the yolk; allow to stand in hot water until the white is of the consistency of jelly; lift out--slide egg on to hot toast, taking care not to break. (A broken poached egg is very unappetizing, as well as untidy in appearance.)

CREAMED EGG ON TOAST

_With milk 131 calories_ _With cream 170 calories_

Cut the crust from one slice of bread and cut bread in one-inch cubes; toast while preparing egg. Beat egg with egg beater until light colored; stir into it 2 tablespoonfuls of rich milk; pour into a double boiler, over hot water; add 1 teaspoonful butter, a little salt and pepper; stir until like thick boiled custard. Pour over toasted cubes of bread and serve at once.

EGG NEST

_204 calories_

1 egg
1/2 tbs. butter
1 slice of bread (3/4 in. thick)
Salt and pepper to taste

Toast the bread on one side, butter and place on a plate (one which will not break in the oven).

Beat egg white stiff, and pile roughly upon the toast, leaving a slight depression in the center. Slip the unbroken yolk into the depression (take care not to break the egg yolk or the appearance and significance of the dish will be ruined). Set plate in oven to brown the white (the oven must not be too hot or the white will brown before the yolk is sufficiently cooked to be palatable). Place the remaining butter on the yolk, dust with salt and pepper and serve at once.

SOFT CUSTARD

_289 to 329 calories_

1 egg (or 2 yolks)
1 tbs. sugar
1 cup milk
A few drops of vanilla

Heat milk in double boiler. Beat egg and sugar together. When milk has reached the scalding point (small bubbles form around the edge of the saucepan), stir in the egg. Care must be taken not to allow the water under the saucepan to become too hot, as the custard will curdle if the egg is cooked at too high a degree of temperature. The custard must be stirred constantly in the beginning until it begins to thicken, then several times a minute until it is of the desired consistency and the raw taste is cooked out of the egg. This mixture is done when it will form a coating upon the spoon. Serve with whipped cream on top (57 calories extra with cream).

BAKED CUSTARD

_249 calories_

1 egg
1 tbs. sugar
3/4 cup milk
A few drops of vanilla

Beat egg and sugar together, stir into the milk, grease custard cup with butter, pour in the mixture. Set cup on several layers of paper in a deep pan, surround with hot water (to about half its depth). Set pan in moderate oven and allow to cook slowly until custard is firm in the center. It may be served hot or chilled and turned out, with a tablespoonful of whipped cream on top.

Care must be taken not to allow the oven to get hot, or the egg will coagulate, making a watery, unpalatable, and indigestible mixture.

CARAMEL CUSTARD

_306 calories_

Caramel custard is made exactly the same as baked custard, except that the cup is lined with a caramel made as follows: In a small frying pan, place 1 tablespoonful of sugar, place on the stove and stir constantly until it melts and turns a golden brown (do not allow to burn). Fold a cloth about the custard cup and pour in the caramel, moving the cup about until the sides and bottom are well coated. Pour in the custard mixture and proceed as in baked custard.

FLOATING ISLAND

_381 calories_

1 egg and 1 extra yolk
1 cup milk
2 lady fingers
Few drops vanilla
1 tbs. sugar

Make soft custard, using the two yolks (no white). Chill custard thoroughly. Line individual ice cream cup with the lady fingers; pour the custard over. Beat the white of egg and place on top. Serve at once. The lady fingers may be dipped in sherry wine if desired, using about 2 tablespoonfuls of wine. (26 calories extra.)

~Cereals and Breadstuffs~

CORN MEAL GRUEL

_101 calories_

2 tbs. corn meal
1 cup water
1/2 tsp. salt

Allow water to boil, mix corn meal with 3 or 4 teaspoonfuls of cold water. As soon as water begins to boil, stir briskly until gruel begins to thicken. Then place on a cooler part of the stove, and cook gently for 2 hours, replacing water as it evaporates. Strain through a coarse sieve if it lumps.

FARINA

_183 calories_

3 tbs. (1 oz.) farina
1/2 cup rich milk
1/2 cup boiling water
1/4 cup cold water
1/4 tsp. salt

Mix farina into a paste with cold water. Stir into boiling water, allow to cook for half an hour (if water boils out, add boiling water). Add milk, and place the saucepan in a hot water bath (double boiler); allow to cook half an hour longer, stirring occasionally.

RICE (1)

_99 calories_

2 tbs. (1 oz.) rice
1 pt. boiling water
1/2 tsp. salt

Soak rice for 1 hour in cold water. Sprinkle into the briskly boiling water, taking care not to stop the boil. Allow to cook until tender; test by pressing a grain between thumb and finger; there should be no hard center. When the rice is done, turn it into a colander and allow water from cold faucet to run over it to wash off surplus starch. Return to saucepan place on stove where moisture can be dried out of the rice without burning it.

RICE (2)

_2-3 servings, 316 calories_

4 tbs. rice
1/4 tsp. salt
3/4 cup water
3/4 cup milk

Wash rice and soak it in cold water for 1 hour (or overnight). Place in an earthenware baking dish, cover with the milk, water and salt. Cover and set in the oven; allow to cook until all of the moisture is absorbed (if the rice is not done by the time the moisture has evaporated, add more milk, or milk and water, and continue until the grains are tender). If the given amount of moisture is not absorbed by the time the rice is tender, drain off the surplus and return the dish to the oven for a few moments. Each grain should be separate, when the dish is prepared correctly.

MILK TOAST

_149 calories_

1 slice bread, toasted
1 tsp. butter
1/4 cup milk, heated
1/6 tsp. salt

Toast the bread on both sides and butter; place in a deep plate and pour over it the hot milk.

CREAM TOAST

_240 calories_

1 slice bread
1/4 cup thin cream
1 tsp. flour
1 tsp. butter
1/4 tsp. salt

Cream butter and flour together cold, and stir into hot milk. Stir until the mixture begins to thicken, cover the boiler and allow to cook for 15 minutes. Slice the bread and cut into cubes; toast a delicate brown, and pour over it the cream sauce. Strain the sauce if there are any lumps.

WINE PANADA

_185 calories_

2 water crackers
2 tbs. sherry wine
1/2 cup hot or cold milk
1/4 tsp. grated nutmeg

Sugar may be sprinkled over crackers if desired, but it is not ordinarily done.

Place the crackers in a deep plate and pour over each cracker 1 tablespoonful of wine, dust with nutmeg and pour over the hot or cold milk.

OATMEAL COOKIES

_3333 (about) calories_

2 cups flour
1/4 cup sugar
1/2 cup milk
1/2 cup oatmeal
2 tsp. butter, lard, or Crisco
1 cup seeded raisins
1 egg
1/2 cup shelled peanuts

Mix shortening and sugar together. Mix oatmeal and peanuts (broken into small pieces) into the flour. Add milk and well-beaten eggs, then the raisins; mix into a dough, roll into a thin sheet, and cut into small cakes. Bake in quick oven.

BAKED TAPIOCA

_550 calories_

1 cup milk (scalded)
2 egg yolks
3 tbs. sugar
6 dates
2 tbs. minute tapioca

Beat sugar and egg together, stir in the tapioca and dates, cut into small pieces. (The dates may be omitted, if desired.) Pour mixture into custard cups and bake slowly (as rice custard) until the tapioca is clear and the custard is fairly firm in center.

ORANGE TAPIOCA

_570 calories_

1/2 cup milk
1/2 cup orange juice
1/4 cup sugar
2 tbs. minute tapioca
2 egg yolks
6 drops orange extract

Mix and bake as directed in plain baked tapioca custard. Any other fruit juice may be substituted for the orange, raspberry, pineapple, or grape juice.

APPLE TAPIOCA

_475 calories_

1 apple (pared and cored)
1 egg
3/4 cup milk
2 tbs. sugar
1-1/2 tbs. tapioca
1/8 tsp. nutmeg

Beat egg and sugar together. Heat milk in double boiler and add egg when milk is scalding hot. Stir in tapioca. Cook 20 minutes. Place apple in cup a little larger than the apple and pour the tapioca custard over the apple. Cover the cup and bake 30 minutes in a moderate oven.

BROWN BETTY

_470 calories_

2 slices bread
1 large tart apple (or 1/2 cup blueberries may be substituted for
the apple)
2 tbs. sugar
1 tbs. butter
1/2 tsp. nutmeg or cinnamon

Toast bread and break into small pieces, line the bottom of the individual baking dish with toast bits, cover with a layer of apple or berries, sprinkle with sugar and nutmeg or cinnamon, add butter in bits over this, continue the process until the dish is filled, place bits of butter on top of the last layer of toast and set dish in oven; bake about 20 minutes in a slow oven; serve with whipped cream or hard sauce.

~Starchy Desserts~

RICE CUSTARD

_309 calories_

1 tbs. raw rice, broiled
1 egg
1 tbs. whipped cream
1/2 cup milk
1 tbs. sugar
1 doz. raisins if desired
A few drops of vanilla

Beat sugar and egg together. Stir into the milk, stir in the rice and flavor (add raisins if desired--29 calories). Grease custard cup and fill with the mixture. Bake slowly (in a pan of hot water) until custard is firm in center. Serve with whipped cream.

ORANGE RICE CUSTARD

_532 calories_

2 oz. orange juice
2 tbs. sugar
1/2 cup milk
2 egg yolks
1/2 cup boiled rice (or 1/4 cup uncooked)

Beat egg, sugar, and orange juice together. Mix milk with rice and stir the two mixtures together. Bake as directed in plain rice custard.

SNOW-BALLS

_356 calories_

1/4 cup rice
1 cup milk
1/4 tsp. salt

Place in a double boiler and cook without stirring until milk is absorbed and rice is tender. Then either pack in egg cups (wet first so that rice will slip out without breaking), or take a square of cheesecloth 8 inches square, dust with flour and place about 4 tablespoons of the cooked rice in center, draw the corners together and tie firmly into a ball. Set the ball in a steamer and steam 1 hour. Remove the cloth gently to prevent breaking the balls. They may be served with custard as a dessert, or as a vegetable with tomato dressing.

TAPIOCA CUSTARD

_503 calories_

1 cup milk
2 tbs. tapioca (minute tapioca)
1 egg
3 tbs. sugar

Flavor with vanilla or nutmeg, or 1/4 square chocolate grated. Scald milk. Boil tapioca in hot water until transparent like jelly, using one cupful of boiling water. (If tapioca does not absorb all of the water, pour off the surplus.) Beat egg and sugar together and add with the milk to the tapioca. Pour into a double boiler, and cook until the raw egg flavor has disappeared. Flavor as desired. 43 calories extra with chocolate.

SPONGE PUDDING

_772 calories_

2 tbs. sugar
1/4 cup flour
2 eggs
2 tbs. butter
1 cup milk
1/4 tsp. vanilla

Sift flour and sugar together and make into a thin paste with part of the milk, heat the remainder of the milk and stir in the flour paste. When the mixture is thick and smooth, stir in the butter, then the beaten yolks and last, the whites (well beaten) are folded in. The mixture is now turned into a baking dish and baked (in a pan of hot water as any other custard) until it is firm in the center and well puffed up and brown. Serve with foamy sauce.

SUNSHINE CAKE

_1716 calories_

7 egg whites
5 egg yolks
1 cup flour (sifted 3 or 4 times)
1 cup sugar
1/3 tsp. cream of tartar
1/4 tsp. salt

Beat whites of eggs until foamy and add cream of tartar; beat until dry and stiff, add the sugar gradually and fold in the well-beaten yolks. Sift the flour and gradually fold into the rest of the ingredients; pour into ungreased sponge cake pans and bake in a moderate oven for 30 to 40 minutes.

ANGEL FOOD CAKE

_721.5 calories_

4 egg whites
1/2 cup sugar
1/2 cup flour (pastry)
1/4 tsp. cream of tartar

Whip eggs until foamy and add cream of tartar, whip until stiff and dry, add sugar gradually, then fold in the flour (the flour must be sifted 4 or 5 times).

Pour batter into an ungreased angel food cake pan and bake in a slow oven for 25 or 30 minutes. Care must be taken not to disturb the cake during the baking, or it will fall.

CEREAL PUDDING

_1470 calories_

1/2 cup fine cereal
1 cup milk (scalded)
1/4 cup molasses
1 egg
1 tbs. butter
1/2 tsp. salt
1/2 tsp. soda
1/2 cup dates or other dried fruit

Stir cereal into scalded milk and cook until mixture thickens, remove from fire, add rest of the ingredients except eggs. When mixture has cooled somewhat, add the lightly beaten eggs, turn into a buttered baking dish and steam 3 hours. This pudding may be made without steaming by cooking the cereal and milk in double boiler for 1 hour, then add rest of ingredients and bake 30 minutes.

~Sauces for Puddings~

FOAMY SAUCE

_494-497 calories_

1/2 cup powdered sugar
1/4 cup butter
1/2 one egg yolk and 1 whole egg white
1 tbs. sherry wine or 1 tbs. hot milk
1/4 tsp. vanilla

Cream butter and sugar (powdered sugar must be used in this recipe). Stir in the well-beaten yolk, add sherry and pour into saucepan over hot water; stir until thick and creamy, lift from hot water and cool as quickly as possible, fold in the stiffly beaten white of egg and serve over pudding at once.

WINE OR FRUIT SAUCE

_381-434 calories_

1 egg
1/2 cup powdered sugar
1 wineglass sherry wine or whisky, or 1/2 glass orange juice
1 tbs. lemon juice
1 tsp. hot milk

Beat yolk and white of egg separately, add sugar to yolk and beat until creamy, add wine or fruit juice, fold in the egg white and add the hot milk last; serve at once.

HARD SAUCE

_231 calories_

1 tbs. butter
2 tbs. sugar
1/2 egg white may be added if desired
1/2 tsp. vanilla, or 1/2 tsp. nutmeg

Cream butter and sugar together until there are no lumps or grains in mixture. Beat the egg white stiff and fold into the sugar and butter mixture. Flavor.

FOAMY SAUCE

_794-797 calories_

1/2 cup powdered sugar
1/4 cup butter
1/2 one egg yolk and 1 whole egg white
1 tbs. sherry wine or 1 tbs. hot milk
1/4 tsp. vanilla

Cream butter and sugar (powdered sugar must be used in this recipe). Stir in the well-beaten yolk, add sherry and pour into saucepan over hot water; stir until thick and creamy, lift from hot water and cool as quickly as possible, fold in the stiffly beaten white of egg and serve over pudding at once.

SAUCE FOR PUDDINGS

_758.4 calories_

1 egg
1/2 cup powdered sugar
1 wineglass sherry wine or whisky, or 1/2 glass orange
1 tbs. lemon juice
1 tsp. hot milk

Beat yolk and white of egg separately, add sugar to yolk and beat until creamy, add wine or fruit juice, fold in the egg white and add the hot milk last; serve at once.

~Meats~

BEEF, LAMB, VEAL, POULTRY, FISH AND SHELLFISH

~Meats.~--The flesh of animals, poultry, and fish comes under the head of meat. These food materials form one of the most important sources of protein in the diet, the foodstuff being in concentrated form easily handled by the digestive apparatus and absorbed almost completely, leaving little residue in the intestinal tract. The chemical composition of different meats is very much alike, as will be seen in the table, the bulk of the weight being water, while the proteins range from 18.3% (E.P.)[40] in beef to 9.9% in bacon. The fats range from 17.9% in beef to 64.8% in smoked bacon.

The mineral salts or ash, as they are found in meat: "Sodium occurs in the animal body chiefly as chlorid in the fluids and blood, and to a less extent in the other tissues." "Potassium, on the other hand, is much more abundant in the soft solid tissues, in the corpuscles of the blood and the protoplasm of the muscles and other organs." "Potassium sulphate in the blood reacts to some extent with sodium chlorid, forming potassium chlorid and sodium sulphate, both of which are rapidly eliminated by the kidneys." The greater part of the sulphur with which we are concerned in nutrition enters the body by way of the protein, the percentage in lean beef being from 0.95% to 1.00%.[41] Phosphorus in meat occurs as phosphoprotein in the nucleoproteins of cell nuclei, and lecithoproteins in the brain and to a less extent in other tissues as phosphorized fats. Meat is poor in calcium, containing only about 0.01 gram per hundred grams of substance. Meat with eggs yields a considerable amount of what is known as acids in the body.

~Quality of Meats.~--The quality of meat depends upon several factors: _age_, _sex_, care, feeding, and the length of time it is hung. Cold storage beef is much more apt to be tender than that cut from a freshly killed animal. Animals that are not allowed to run over a large area, but are kept in a small inclosure and fed on fattening foods, produce meat of a high quality. This is because the muscular tissue has not been hardened with exercise. The worked muscle is always tougher than the quiet one. For this reason the tenderloin of beef is more tender than the flank. It is situated in the part of the animal that is exercised the least. The tough parts, however, are not lacking in flavor or nourishment, but the manner in which they must be cooked to assure them of being tender deprives them of much of their original flavor. This is demonstrated in broths and soups made from the tough cuts of meat. The extractives from which meat derives its flavor and the soluble albumens are drawn out by the water, and if it is to be used as hash, croquettes, etc., needs to be seasoned, since the broth, while it has taken very little of the actual nourishment from the meat, has deprived it of practically all of its flavor. In making broth or soup, if the meat is covered with cold water instead of hot, more of the extractives will be drawn out and the broth will be more highly flavored and much more stimulating. The color, odor, and freshness of the muscular and fatty tissues of meat are all indicative of their quality. Fresh meat is firm in texture and free from offensive odor. Stale beef and that cut from an old steer exhales a pungent odor of butyric acid. The color of beef should be dark purplish when fresh cut but this changes quickly to a bright red; it should contain preservatives of no kind and must be cut from animals free from all disease. The fat should be of a yellowish white and be crumbly, and should be distributed throughout the muscular tissue and around the organs.

~Veal~, being the flesh of an immature creature, is not so highly flavored as the flesh of older animals, but the bones and cartilages are softer, and when this meat is used for broth, more of the gelatin (collagen and elastin from the bones and connective tissue) is dissolved out, giving a slightly higher percentage of nutriment in the broth.

~Selecting of Chicken and Turkey.~--In selecting chicken for the diet of invalids, use only the young birds for broiling, those a few months older for baking and roasting, and the fowls for soup and broth. To test a chicken for broiling and roasting, select one in which the cartilage at the end of the breastbone is soft and pliable; the pinions (lower part of the wings) and the feet should be soft and readily bent. The breastbone of a fowl is firmer and the wings and feet harder than those of the younger chicken. The young chicken has an abundance of pin feathers while the old fowl has not. In fact, one of the means of differentiating between the old chicken and the young, even if they are practically of the same weight, is the presence of the long hairs instead of pin feathers. The fowl selected for broth should not be very fat, as this fat will melt into the broth, causing it to be greasy and unpalatable. Turkey, even when it is young, is not quite so digestible as young chicken; the fibers are longer and the connective tissue more abundant. Goose and duck are richer in fat and not so desirable as chicken in the invalid dietary. Squab, quail, and young squirrel are all palatable and readily digested. The squirrel must, however, be young, or the flesh will be tough and more difficult of digestion.

~Fish.~--Fish should be given consideration in the dietary of the invalid since it is a valuable source of protein and readily digested in the majority of cases. As a rule fish is not so well liked as meat, but since it contains a smaller percentage of ~extractives~ and ~purin~ bases it is exceedingly valuable in certain pathological conditions. The lean varieties of fish, halibut, flounder, trout, perch, haddock, turbot, whitefish, are more readily digested than the dark fish, which contain a higher percentage of fat. To this latter class belong the bluefish, mackerel, salmon, shad, and herring.