What to eat and when

The diet is of the greatest importance in this difficulty, as it is usually accompanied by anemia. Rest and a very nourishing and easily digested diet are essential. Sometimes a complete rest in bed and a milk diet, or a diet composed largely of milk, is the best means of treatment.

If possible the patient should be isolated and in the care of a trained nurse who is naturally cheerful and bright.

Children are especially liable to this malady. They are usually anemic and care should be exercised that they be not overworked in school and that they retire early and get from ten to twelve hours’ sleep.

Their eyes must be kept from strain and the nervous system not allowed to become tense from too much excitement, as teasing by playmates or the family, etc.

They should be given the diet for Anemia on page 249.

DIET IN SKIN DISEASES

An improper diet or a lowered nerve tone are often shown by the condition of the skin.

When the waste of the system is not being properly eliminated through the other excretory organs the skin is required to throw off more than its normal amount.

The muddy complexion in biliousness or the congestion of the facial capillaries in the alcoholic are familiar examples.

Overeating, especially of food too rich or too concentrated, causes fermentation from non-digestion, or imperfect oxidation, due to too large an amount of nutriment for the amount of oxygen furnished to the tissues.

An inactive skin results in an accumulation of fat in the sebaceous glands with clogging of the ducts; germ infection in these clogged glands often results in pimples and boils. An excess of acid in the secretion of the sweat glands irritates the skin and causes eruptions.[15]

Chronic skin troubles are always increased and made more troublesome when there are errors in the diet, and they are often benefited and in some cases cured when the dietetic errors are corrected.

Skin troubles often occur when for any reason the nervous system is run down, because the weakened nerves cause the tissues or organs they supply to become inactive. The skin thus becomes affected with the rest of the body and derangements of its function appear. Increasing nerve tone will result in a disappearance of the skin disorders. This takes time.

All rich food and highly seasoned preparations, veal, pork, tea, coffee, pastry, too much sweets and fats, and any fruits and vegetables that cause flatulence should be avoided.

A diet of fruit, water, and Graham bread for three or four days, every week or two, daily exercise and deep breathing of pure air will usually clear the skin.

The skin of the face is materially cleared by the use of facial exercises which promote its activity and the elimination of waste. Exercises for increasing the tone of the skin and the muscles are as essential for the face as for the body.

In all skin troubles alcohol must be prohibited.

This is characterized by distressing itching and may be caused by any article of food which disagrees. A more or less irritant food or one difficult of digestion, such as strawberries, shellfish, pork, cheese, and sausage, are the foods which most usually produce it, if taken into an inactive stomach. When the intestines are in a sluggish condition the stomach does not act well, and any food which does not digest promptly is liable to excite an attack.

It is remedied, by eating very lightly, by fasting for a day or two, by drinking much water, exercising, breathing deeply, and securing activity of the bowels. Care must be taken to avoid foods known to disagree.

The cause of this disorder is often difficult to ascertain, but it is aggravated or relapses occur when too much or too rich food is eaten. The skin is not able to dispose of all the material sent to it.

It often occurs in those who are excessive eaters of meat.

The diet may have to be confined to fruit, bread and milk, or crackers and milk for a few weeks.

Meat, if allowed, should be taken sparingly and not oftener than once a day—better only every other day. Beef and chicken are the preferable meats. If no improvement occurs, or if it be slight, meat should be omitted altogether. Eggs may be substituted for meat. A little fresh fruit, if thoroughly ripe, may be taken, but all made desserts must be avoided and very little sweets used. Cracked wheat, or other wheat cereal, with a little cream, may be eaten.

Oatmeal may provoke an attack because of the amount of fat in it. Foods may cause an attack in one case that have no detrimental action in another.

Skin eruptions, eczema-like, often occur if for any reason the diet has been too limited, as in the semi-starvation seen in poor children. In these cases a more nutritious diet will often cure.

Bananas, apples, cabbage, or fried foods, often cause a temporary attack or aggravate an existing condition.

The food must be thoroughly masticated, must be taken at regular times, and not in excess. As this condition sometimes accompanies other diseases, any underlying condition must be sought, but all diet should be as simple as the needs of the system will bear. The foods which are found to increase the irritation of the skin are the ones to be avoided in each case.

The all-prevalent American habit of eating fried food often produces an intense itching of the skin in various parts of the body. It occurs often in those who eat food highly seasoned with pepper or other condiments. The articles of food causing the overstimulation must be avoided, and all fried food, pastries, or food containing much fat, must be greatly lessened or omitted altogether.

Itching is sometimes caused during the change of seasons due to the effect of the changing temperature on the nerves of the skin. To rub the skin with oil for two or three days to soften the dead cells and to aid their removal from the surface will secure a better circulation in the skin and help to eliminate the cause of the itching. A free drinking of water, fresh air, and exercise will help the condition.

The rapidly changing system of the growing boy and girl is especially liable to disorders, due to improper eating, irregular habits, worry, lack of rest, or improper food. Eruptions, especially on the face, appear as a result. The sebaceous glands are especially active, and any alteration in the structure of the blood, due to deranged digestive processes and defective elimination by the skin, causes too great an amount of deposit in the fat glands. Their contents become hardened and infected by germs, with consequent irritation and reddening, and the condition known as acne is the result.

Once well established it is difficult to cure, but it often rapidly improves under a simple diet, rested nerves, cheerful, kind thoughts, and better digestion and elimination.

The food should be thoroughly masticated. Young people are prone to eat too hastily, and thus not thoroughly mix the food with saliva. If careful attention is paid to mastication of the food, water at meals is an aid to digestion. Water should be taken freely between meals, on rising and before retiring, for its diuretic and laxative effect.

All candy, and sweets, hot breads, corn bread, pastry, soups with much fat, rich hashes and sauces, fried food, pork, and veal should be eliminated from the diet.

A badly blotched face is an embarrassment, and no restriction in the diet should be deemed a hardship as a means to an improved digestion, increased mental vigor, and improved health.

A pimple on the face should be treated as antiseptically as a boil. The pus from a pimple which has “come to a head” should not be allowed to infect the surrounding skin. Infection may take place from towels or wash cloths used by one afflicted with acne. Care should be exercised to sterilize the surrounding skin by peroxide of hydrogen or alcohol before a pimple is opened and its contents should be taken up with absorbent cotton. A pimple should never be severely squeezed as the skin will be irritated and other pimples may result.

Often the infection from one pimple is spread by the hands or by the wash cloth. Care should be taken to avoid this.

Exercise directed to the facial muscles and to the liver and digestive organs, deep breathing, plenty of oxygen by night and day, wholesome thoughts, plenty of sleep, and simple food, will eliminate or improve most skin difficulties. Care should be taken, by frequent bathing and friction baths, to aid the eliminative work of the skin.

Since the medical profession is unable to determine just what rheumatism is, it is difficult to prescribe a diet. The theory so long believed that it is caused by an excess of uric acid in the system is no longer held by most of the advanced physicians. Uric acid, however, sometimes accompanies the disease.

Some authorities hold that it is a nerve difficulty; others that it is caused by an excess of lactic acid; others hold that it is caused by infection from the tonsils and the gums.

Assuming that it is due to the failure of the system to promptly eliminate its waste, whether this failure to eliminate be through a weakened condition of the nerves, and the consequent failure to properly direct the body activities, the correction of the difficulty must lie in building up the general vitality and in aiding the system in its elimination.

Hot sweat baths, a free use of water, and a free use of fruits and fruit juices, particularly the citrus fruits, such as lemons, oranges, limes, etc., are desirable in moderation, because they increase the alkalinity of the blood, and because of their diuretic effect. Lemonade, orangeade, and all fresh fruits and vegetables are diuretic.

The diet should be cut down in quantity. If an excess of uric acid exists, meat may be eliminated and the suggestions given in the diet for Gout may be followed.

The food must be plain and well cooked, not highly seasoned, and the amount must be confined to the needs of the system as shown by the general condition.

Regular exercise, until the body is thoroughly heated, deep breathing of pure air day and night, and a copious drinking of water are necessary.

No definite diet can be given here for flesh building, because a lack of sufficient fat to round out the figure is due to faulty digestion or assimilation.

It may be that the strength of the muscles and nerves of the stomach, liver, and intestines should be built up by exercises and deep breathing, and it may be that the habit of nerve relaxation must be established. When the nerves are tense much nourishment is consumed in nervous energy and the nerves to the digestive organs and muscles being disordered, they interfere with digestion and assimilation.

It is apparent that the cause of the lack of flesh must first be corrected. Merely to give a fat-building diet may overload deranged digestive organs with sugars, starches, and fats, further weakening them.

Often leanness is due to inability to digest the starches or sugars, and when this is the case the condition must be remedied by strengthening the digestive organs through exercises for the muscles of the stomach and intestines, exercises to create a free activity of the liver and to strengthen the nerves controlling digestion. Deep breathing habits to insure sufficient oxygen to put the waste in condition for elimination are necessary. Most often sufficient food is eaten, but due to nerve tension or to sluggish circulation, particularly through the vital organs, it is not assimilated.

Usually, however, bodily flesh may be increased by increasing the liquids and the carbohydrate consumption and also the fat if these are assimilated.

If habits of life, overwork, improper food, unhealthy thoughts, nerve exhaustion, excessive nerve tension, or disease are responsible, they must first be corrected. Often the nerve tension must be relaxed by change of habit of both body and mind before the flesh will accumulate.

There must be no mental strain, and plenty of sleep must be secured.

If they can be assimilated, the diet should contain soups, butter, milk, cream, cocoa, chocolate, well-cooked cereals, as oatmeal, bread, tapioca, or rice puddings with cream and sugar, bread, potatoes, leguminous foods, as peas and beans, cake, honey, especially sweet fruits, carrots, parsnips, and other vegetables; meat not oftener than once a day.

Vinegar and too much spice, pastry, coffee, and tea should be avoided.

The free drinking of liquid is most important.

Obesity is caused by a disturbed balance of nutrition occasioned, often, by more food being taken than the body requires. The resultant fat is deposited in and among the tissues.

It is most often seen in those in middle life of sedentary habit who continue to eat as heartily as ever without using a little thought to determine the actual body needs for food.

An excess of fat is often seen in light eaters, however. This is usually due to a weakness of nerve tissue, which does not direct the regular activities of the body—digestion assimilation, elimination, etc.—with sufficient force to burn up the normal amount of fat in automatic activities.

In all cases breathing is usually faulty, oxidation is incomplete, and little exercise for the vital organs is taken. Anemia may exist in such individuals.

The body fat is formed from various elements in foods, and a food which may cause obesity in one individual may not produce it in another. Fat meats, alcoholic drinks, or the excessive use of starches and sugars may cause it. The food at fault in each case must be determined and largely reduced or eliminated from the diet.

Many obesity cures are in existence, and have had considerable vogue from time to time. Anti-fat remedies are dangerous, as they lower the vitality of the system and render it liable to be attacked by disease. All such remedies act by decreasing the appetite and causing impairment of the digestion.

The rational method is to limit both the amount of food and the liquid to be taken, to increase oxidation by deep breathing and exercise. By restricting the carbohydrates and fats consumed the body calls on that stored in the tissues. In obesity, unless there is an underlying condition of disease, the amount of water should be limited while reducing and none should be drunk with the meals. Soup, milk, and all juicy fruits and all foods made from cereals should be taken sparingly; sugar must usually be forbidden and fat in the food limited to a little butter. One need not starve under this treatment for the diet may be varied enough to prevent monotony even though restricted.

Fresh green vegetables, fruit, and lean meat should form the main ingredients of the diet, but if gastric disturbances arise the diet must be varied to correct them. Meat should be eaten but once a day.

Extremes in diet should be strictly avoided; a sudden restriction of diet produces changes in the blood which may do harm. For this reason the amount of food taken should be gradually but steadily reduced and one article after another eliminated until the system becomes accustomed to the reduction.

Thorough elimination must be secured through exercise and deep breathing.

All alcoholic liquors must be omitted.

All diets for obesity must be prescribed for the individual condition. A diet suited to one person may be entirely unsuited to another. For this reason, and because of the danger of one following a diet which may be unsuited to the condition, diets for obesity are not given here.

Exercise and deep breathing must constitute an appreciable part of reduction methods to cause a combustion of the fat liberated. These are the natural, scientific means of reduction.

If one reduces by diet alone the excess of fat may not come from the part desired. One is likely to show the results first in the face and neck. One should exercise the parts desired to be reduced so as to oxidize the fat stored about these particular tissues.

A large number of the obese are afflicted with rheumatism, sluggish livers, sluggish action of the intestines, and weak nerves, and the diet must be governed accordingly.

The regulation of food for reduction of flesh must also be governed by age, sex, by the manner of breathing, and by the amount of daily exercise. The food must be regulated in accordance with the quantity of carbohydrates and fats daily consumed in heat and energy.

A rational study of the needs of the system and a persistent following of the indicated regimen will result in a steady reduction, renewed vitality, and a sense of “being fit.” The better elimination secured by exercise and increased oxygen will aid the muscles to release the fat which may have caused them to become flabby.

Reduction must not be accomplished too suddenly, but it can be gained by a little self-denial and determination.

One who carries too much fat is much more liable to gout, rheumatism, apoplexy, high blood pressure, asthma, and bronchial affections.

When an individual is recovering from an illness the appetite often becomes excessively active, and his demands for food, if yielded to by the family or attendant, may produce digestive derangements from which recovery is slow.

On the other hand, too much food is often urged on the convalescent from a mistaken idea that large quantities of food are necessary in order to rebuild the enfeebled system.

Care must be taken not to return too rapidly to a solid diet when a liquid diet has been followed for some time. The digestive system shares in the general weakness and must not be overloaded.

The more easily digested foods, as ice cream, milk, tapioca, crackers and cream or cream toast, cream soups and meat broths thickened with bread crumbs rolled from toasted bread, custards, stewed fruits, corn meal, mush, in some conditions, cornstarch blancmange, boiled rice, and poached eggs may be given.

Later, when meat is added to the diet it should be scraped or finely minced so as to give the stomach as little work as possible until it regains its tone.

Potatoes, if allowed, should be baked or mashed.

Sweetbreads in cream, sponge cake or lady fingers with light cream may also be allowed.

At least a week should be taken in returning to a solid diet and the orders of the physician must be strictly followed. Pickles, nuts, or solid meats should not be allowed. They will often occasion a return of fever and possibly a relapse.

After typhoid fever or other lingering illness, the appetite is usually much increased, but great care must be exercised not to allow solid food before the condition of the stomach and intestines shows that danger is past. It is usual not to allow solid food in typhoid fever for two weeks after the fever has disappeared.

It is possible to make great variety in the diet even if it be light and easily digested and common sense must govern in the kind as well as the quantity of food allowed the convalescent.

Scraped beef or scraped chicken may be seasoned, lightly pan broiled, and made into a sandwich. The first solid meat may be creamed sweetbread, a bit of broiled tenderloin steak, or breast of chicken.

It is better to give small amounts both because of the lessened work of digestion and because large amounts of food often destroy rather than aid the appetite.

If the appetite is capricious, or lacking, it needs to be stimulated by food appetizingly prepared and daintily served. A sloppy tray with half-cold tea or coffee will often cause complete loss of appetite.

The face and hands of an invalid should always be bathed before a meal; the fresh feeling induced is often an aid to the appetite. The mouth should be carefully cleansed after eating in order that no fermenting food particles may be carried into the stomach to cause disturbance there. Swabbing the mouth with cotton dipped in an alkaline wash or rinsing the mouth with listerine and water or peroxide of hydrogen and water will add greatly to the comfort of the sick, especially when the tongue is coated and the mouth bitter.

Great care should be taken not to allow bread crumbs to fall into or under the bedclothes, as a small bread crumb is often a source of great discomfort. The skin is especially sensitive and a small bread crumb may so disturb the mind as to cause a patient, otherwise doing well, to become restless and disturbed.

The invalid frequently forgets to ask for water and the attendant should see that a sufficient amount of water is taken. A glass of water should be placed where it is within easy reach and it should not be allowed to become warm. Cool water is one of the prime requisites in the invalid’s dietary.