Dietetics for Nurses

No. 6

No. 7. Milk and Starch Enema—Von Leube

Malted Milk Enema

Normal Saline Solution

Formulas Used in Diabetes[47]

* Bran Agar Wafers

Makes 30 wafers.

Mix agar-agar, saccharin, salt and water. Boil until dissolved. Pour over dry bran. Mix thoroughly and mold into muffin tins while hot. Bake in a slow oven about 20 minutes, or until wafer is dry and will whirl in the tin.

* Agar Jelly

Dissolve agar-agar in water. Add citric acid and saccharin. Put over flame and boil. Remove from fire—add flavoring and coloring. Put in cool place to harden. This jelly has no food value.

* Spinach and Egg Salad

Add:

Surround mold with slices of hard cooked egg, placing the spinach in the center. Pour over this the gelatin mixture; allow to mold and serve on lettuce.

* Mayonnaise Dressing

Beat egg yolks. Gradually add oil until all has been used (beating the mixture constantly). Then add the remainder of the ingredients. Put in a covered jar and keep in a cool place.

The percentage composition of this dressing is

Fat—83%. Protein—0.9%

Cellu Bran Crackers

Makes 12 crackers about 4 inches by 4 inches and ⅛ inch thick (resembling Graham crackers).

Mix all dry ingredients. Add mineral oil and saccharin dissolved in a small amount of water. Then add sufficient hot water to make a soft dough. Spread on a baking sheet or in flat baking pans and cut into twelve wafers. Bake in a slow oven until dry.

These crackers have practically no food value.

Soya Manna may be secured from Vitae Health Food Company, 364 Roy Street, Seattle, Washington.

Soya Manna muffins may be substituted for hepco cakes in any of the following recipes:

** Olmsted Brancakes

(Recipe 41)

Mix ingredients in order given and bake in a moderate oven. This recipe makes 18 muffins. Food value of 6 muffins, 1 gram carbohydrate, 5 grams protein, 23 grams fat.

** Soya Manna Muffins

(Recipe 42)

Beat eggs, add cream and then flour, beating all the time. Add water and melted butter. Mold into 12 cakes and bake. Each cake contains 6 grams protein, 6 grams fat: approximately 75 calories.

** Noodle Soup

(Recipe 43)

Beat eggs until stiff and bake in 5 grams of butter as an omelet; let cool, cut into strips as noodles. Heat broth and add noodles. If desired, add vegetables, cut in cubes, using such variety and quantity as give flavor to soup adding their food value to diet. Food value 6 grams protein, 10 grains fat.

** Chicken Supreme

(Recipe 44)

Beat egg slightly, add chicken, cut in small pieces, milk salt and pepper. Put in mold, set in pan of hot water and bake in moderate oven until firm. Food value 4 grams carbohydrate, 18 grams protein, 13 grams fat.

** Salisbury Steak

(Recipe 45)

Grind the meat, add seasoning and make into firm balls. Sear in hot mineral oil, then cook at a lower temperature. Food value, 2 grams carbohydrate, 17 grams protein, 22 grams fat.

** Veal Bird

(Recipe 46)

Have meat cut in one thin slice. Use the trimmings chopped fine in dressing of crumbs, celery and seasoning moistened with water. Spread dressing on meat, roll and tie or skewer with toothpicks. Put in casserole and bake in milk until done. Food value, 6 grams carbohydrate, 23 grams protein, 19 grams fat.

** Salmon Molded

(Recipe 47)

Remove the salmon from the can, weigh, separate in flakes. Add beaten yolks, melted butter, milk and vinegar and salt. Cook over boiling water, stirring constantly until mixture thickens. Soak gelatin, strain and add to salmon. Fill individual molds, chill, and serve with cucumber sauce. Food value, 3 grams carbohydrate, 26 grams protein, 23 grams fat.

** Cabbage Soufflé

(Recipe 48)

Chop cabbage fine, add meat, cream, beaten egg, salt and pepper. Put into mould and sprinkle grated cheese over top. Bake in a moderate oven until firm and brown. Food value, 5 grams carbohydrate, 15 grams protein, 17 grams fat.

** Celery Ramekins

Heat milk; add crumbed hepco cake, grated celery and seasonings, let come to a boil, add butter, remove from fire; add beaten egg yolk. Fold into beaten white. Put in ramekin and bake 20 or 30 minutes in slow oven until well browned. Food value, 3 grams carbohydrate, 11 grams protein, 15 grams fat.

** Baked Onion

Parboil the onion, scrape out the inside, leaving only shell. Weigh shell and scrapings to 50 grams. Add meat and return to shell. Put into casserole, add milk and bake until tender. Food value, 4 grams carbohydrate, 4 grams protein, 2 grams fat.

** Squash Pie

(Recipe 92)

Beat egg, add mashed squash, cream, spice, salt and saccharin dissolved in 1 teaspoonful of cold water. Bake until firm in center, using cellu flour recipe for pie crust. Food value, 12 grams carbohydrate, 10 grams protein, 14 grams fat.

** Spice Cookies

(Recipe 93)

Beat the yolks, add saccharin dissolved in cream, then spices and ground almonds. Add to the stiffly beaten whites. Drop from spoon on oiled pan and bake in hot oven. Food value, 4 grams carbohydrate, 16 grams protein, 25 grams fat.

Cream of Cauliflower

Add cauliflower to stock, and allow to come to a boil, season and add cream. Serve at once.

Tomato Bisque

Cook tomatoes with cloves, parsley, and water for 20 minutes. Press through sieve and return to fire. Add soda; when effervescence ceases, add cream, and serve at once.

Spinach Soup

Cook spinach until tender and press through a sieve; add the broth; allow to cook about 5 minutes and add the well-beaten yolk and cream. Place the saucepan over hot water and cook 10 minutes. Season and serve at once.

Other Cream Soups, except Tomato Bisque, are made by the same recipe.

Vegetables

The nurse must be governed in the selection of the vegetables by the physician, using those from the 5% group until otherwise ordered. These must be boiled in three separate waters to further reduce their carbohydrate content.

Cream or butter is added to them when diet permits; in the beginning (after starvation) only salt or (in case the vegetable is given in form of a salad) a little lemon juice with a little salt and pepper added.

Grated onion, a small quantity of celery seed, or a tiny bit of chopped green pepper may be added for additional seasoning. When some fats are allowed, butter, olive oil, and cocoanut cream may be used; the latter is prepared as follows:

1 small cocoanut grated; this is washed in cold water slightly acidulated with vinegar to remove the sugar, then washed to remove the vinegar. Over the washed cocoanut pour 1 pint of boiling water; allow to stand until cold enough to squeeze through a cloth; press as much of the water out as possible. Pour the water into a shallow dish and allow to stand until the cream rises; skim off and serve with lemon juice on salad as a dressing.

Boiled Corned Beef With Cabbage and Other Vegetables[48]

“A portion containing 50-75 grams meat and 100 grams of each vegetable makes an excellent meal.”

Horseradish (sauce) is recommended by Joslin as a seasoning, and some pickles made from group of 5% vegetables and without sweetening.

Curry powder, tarragon, bay leaves, capers may likewise be used in moderation to vary the monotony of the diet.

Parsley Butter

Cream butter, add lemon juice, salt, and pepper. Stir in parsley. Serve on meat or fish.

Neufchâtel Cheese Salad

Season with salt and paprika and dress with cream dressing.

Cheese Salad

Mash cream cheese with fork; add tablespoonful chopped pecan nuts to ⅓ Neufchâtel cheese. Season with salt and pepper and dress with French dressing.

Tuna Fish Salad

Dress with French Dressing.

Egg Salad

Cook 1 egg hard. Cut into rings; arrange on lettuce leaf; dress with cream dressing.

Tomato Aspic

Boil all ingredients (except gelatin and celery hearts) 20 minutes. Measure. Add hot water or tomato juice to make one cup; add gelatin; allow to cool; cut celery fine, place in mold; pour in the tomato aspic and allow to jelly in a cold place.

Bread Substitutes

Bran Biscuits, or Muffins

Tie bran in cheesecloth bag and attach to cold water faucet; allow water to pass through bran, removing starch by squeezing the water through; using dry. Beat egg separately; add cream; mix with bran, add melted butter, salt, and baking powder. Grease muffin rings and pour in the mixture. Bake in moderate oven.

Diabetes Muffins[49]

(The Equivalent of an Egg)

Recipe for Hepco Cakes, so arranged that one cake is equivalent to an egg:

Make twelve cakes; each cake contains 6 grams of protein, 6 grams of fat, and approximately 75 calories.

Lister Muffins

So arranged that each muffin is equivalent to one egg:

Make 17 muffins; each muffin contains 6 grams protein, 6 grams fat.

Bran Biscuits for Constipation

(By F. M. Allen)

Tie bran in cheesecloth and wash under tap until water is clear. Bring agar-agar and water (100 c.c.) to boiling point. Add washed bran and salt and agar-agar solution (hot). Mold into ten cakes; place on oiled paper and let stand ½ hour, then when firm and cool, bake in moderate oven 30 to 40 minutes. The bran muffins are more palatable if butter and eggs are added. This may be done, provided the patient allows for them in the diet.

Casoid Flour and Bran Muffins

Total food value: protein, 18 grams; fat, 24 grams; carbohydrates, 1 gram; calories, 300.

One muffin: protein, 3 grams; fat, 4 grams; carbohydrates, trace; and calories, 50.

The flours and meals used in this recipe are prepared by Cutlard, Stewart & Walt, Ltd., London (casoid flour). Theo. Metcalf & Co., Boston (soya bean meal). Lister Brothers, Andover, Mass. (Lister diabetic flour).

Lister Flour and Bran Muffins, or Biscuits

Squeeze all the water from the bran, then add flour and melted butter, salt, well-beaten egg yolk and cream. Whip egg white stiff and fold into mixture. Add baking powder and enough water to make thick batter. Use less water if biscuits instead of muffins are desired, and knead into a dough. Roll out into a sheet one-half inch thick and cut with biscuit cutter.

After making muffin batter, grease muffin ring with melted lard, and pour half full of above mixture. Bake in moderate oven about 20 or 30 minutes.

Soya Meal and Bran Muffins[50]

Mix soya meal, salt, and baking powder. Add to washed bran; add melted butter and cream. Beat egg white and fold into mixture; add enough water to make thick drop batter. Bake in six well-greased muffin tins until golden brown from 15 to 25 minutes.

Total food value: protein, 11 grams; fat, 27 grams; carbohydrates, 2 grams; calories, 304; one muffin, protein, 2 grams; fat, 4.5 grams; carbohydrates, trace; calories, 50.

Almond Biscuits

Beat egg yolk until light, add cream and saccharin; stir this into almond meal. Fold in the stiffly beaten white. Drop on a greased paper and bake until golden brown in a moderate oven.

Almond meal or flour is prepared as follows:

Blanch 1 pound of almonds; dry and pass through grinder, or pound in mortar until powdered. Place in a muslin bag and immerse in a pan of water acidulated with vinegar to remove sugar; allow to stand 15 minutes. Squeeze dry and place in a warm (not hot) oven to remove all moisture. Grind or pound once more. Almond flour does not keep well; it must be made in small quantities and kept in a glass jar in a cool place.

Cocoanut Flour

Grate cocoanut and treat as almonds to remove sugar; dry thoroughly and grind or pound to fine meal.

Cocoanut Biscuits

(A biscuit may be made without saccharin for bread substitute.)

Spanish Cream

Pour coffee, or cocoa infusion, into a double boiler, beat egg yolk and saccharin dissolved in 1 tsp. of water, and stir into hot coffee. Cook gently until mixture coats the spoon (raw flavor of egg has disappeared); add gelatin and mix thoroughly. Whip cream and egg white. Place on ice to set.

Lister Cream Puff

This is made by pouring 30 grams of soft custard (diabetic) over 1 Lister biscuit.

Custard

Beat egg until it is well broken up, but not light; stir into the cream; dissolve saccharin in teaspoonful of water and add to mixture. If custard is to be baked, pour into molds and place upon a rack, or on a folded cloth in a pan half filled with hot water; bake in moderate oven until firm in center.

If soft custard is desired, pour mixture into double boiler and cook gently until mixture coats the spoon and the raw egg flavor has disappeared.

Snow Pudding

Make ½ cup gelatin, as directed below.

Whip in 1 egg white.

When gelatin is half congealed, mold and set on ice.

When ready to serve, unmold and serve with custard, or 1 tbs. whipped cream.

Jellies

1 tbs. cold water to 2 tsp. granulated gelatin is used in making the following jellies:

Lemon

16.6 calories

Irish Moss Pudding

Carefully pick over and wash through several waters 1 tbs. Irish moss. Place in double boiler with ⅓ cup of water and 3 tbs. 40% cream and ¼ grain saccharin. Cook until mixture thickens when dropped upon a cold saucer. Pour over 1 stiffly beaten egg white; add 3-4 drops of vanilla extract. Mold and set on ice.

Irish moss may be used as a substitute for gelatin. The carbohydrates in this substance are not believed to be utilized for the manufacture of glucose in the human body.

Orange

54 calories

Wine

40.8 calories

Method for Fruit Jellies

Soak gelatin in cold water about 2 or 3 minutes, then pour over it the boiling liquid; add saccharin and fruit juice, strain through cloth into wet molds. Set in cold place to stiffen; when firm, unmold. Serve with whipped cream, or pour liquid into baskets made from orange or grapefruit, hollowed out and the edges scalloped, or pour into shallow pans, and cut in ½-inch blocks when firm and serve on a bed of whipped cream.

Wine Jelly

Put water, wine, lemon juice and peel, cinnamon, and saccharin into a saucepan, allow to boil 5 minutes, pour over gelatin (which has been soaked in cold water). If the jelly looks cloudy, return to saucepan, and add ½ egg white beaten stiff; allow to boil 1 minute, stirring constantly, and strain into mold. Serve with whipped cream.

Ices

Lemon

30 calories

Orange

75.5 calories

Sweeten fruit juice with saccharin instead of sugar. Clip egg white with scissors, or beat with Dover egg beater, add mixture and freeze.

Ice Cream

(1) Use recipe for soft custard, freezing after the custard has become thoroughly cold.

Whip cream, add saccharin and nuts. Pour into a small ¼-pound baking powder can, seal the edges of mold or can with a thin strip of buttered muslin. Pack in equal parts of salt and ice for two hours.

Sugar-free Milk.—A sugar-free milk has been advised by Williamson. It is made from washed cream as follows: 3 tablespoonfuls of cream are shaken in a pint of water and set aside until the cream rises, it is then skimmed off and mixed with the white of one egg and diluted with pure water. This furnishes a beverage not unlike milk in appearance and flavor.

Nut Charlotte

Whip cream stiff; add saccharin, nuts, and vanilla.

1 tbs. sherry wine and 1 tsp. gelatin soaked in 1 tbs. cold water and melted over hot water may be substituted for vanilla to vary the above recipe.

Orange Charlotte

Soak gelatin in cold water; dissolve over hot water, add to orange juice; add saccharin; set aside until it begins to jelly. Whip cream and add to partially jellied orange juice; fold in the stiffly beaten egg white; mold. Serve 30 grams.

SECTION III

THE HUMAN MACHINE

CHAPTER VII

THE HUMAN BODY

Chemical Composition of the Body.—It has been estimated by various writers that the human body has an approximate average chemical composition[51] of—