Part 38

There is often a distaste for fat, but its use is imperative and in large quantities, because the weight and general vitality must be maintained. The effort of the physician is to get the system in condition to use carbohydrates.

Fats may be supplied in the yolk of egg, cream, butter, cheese, bacon, nuts, particularly pecans, butternuts, walnuts and Brazil nuts.

In beginning a diet, the change must not be too sudden. At least a week’s time should be allowed for the elimination of all sugar and starch. Begin by eliminating sugars and next bread and potatoes.

Van Noorden gives the following diet, free from carbohydrates, which has been in general use in Europe and America.

BREAKFAST.

Tea or coffee, 6 ounces. Lean meat (beefsteak, mutton chop, or ham), 4 ounces. Eggs one or two.

LUNCH.

Cold roast beef, 6 ounces. Celery, or cucumbers, or tomatoes with salad dressing. Coffee, without milk or sugar, 2 ounces. Whisky, drams, diluted with 13 ounces of water.

DINNER.

Bouillon, 6 ounces. Roast beef, 7½ ounces. Green salad, 2 ounces. Vinegar, 2½ drams. Butter, 2½ drams. Olive oil, 5 drams, or spinach with mayonnaise, large portion. Whisky, 5 drams, diluted with 13 ounces water.

SUPPER, 9 P. M.

Two eggs, raw or cooked.

Van Noorden includes alcohol, in whisky, in his diet and most physicians follow the theory that whisky or brandy aids in the digestion and absorption of fats; the need is recognized since fats must be supplied in so large quantities, yet the sweet wines and beers contain sugar while the sour wines contain acids, which disturb digestion.

There is a grave question in regard to the advisability of including alcohol in the diet of a young person afflicted with diabetes and the greater activity of the young patient will insure more perfect digestion, so that the physician may not consider alcohol necessary.

Dr. Hall gives the following as a reasonable diet for a diabetic case, after the first week or two, allowing potatoes.

BREAKFAST.

Tea or coffee, 6 ounces. Cream, 2 ounces. Meat, (beefsteak, mutton chops, or ham), 4 ounces. Bread and butter, 2 slices. Baked potato, with butter.

LUNCH.

Cold roast beef or cold boiled ham, 6 ounces. Bread and butter, two slices. Salad with mayonnaise dressing, egg garniture. Tea or coffee with cream.

4 P. M.

Egg lemonade or egg orangeade.

DINNER.

Clear soup of any kind. Roast beef or mutton, or pork. Potatoes, baked or boiled. Olives, celery, or radishes. Side dish of green vegetables. Bread and butter. Dessert, milk-egg custard, sweetened with saccharin.

After a week on either of the above diets, in mild cases, sugar will disappear from the urine. In extreme cases, it may be necessary to follow this strict regime for two weeks. When the patient begins to eat a little starch, potatoes and bread are re-instated first. Sugar is kept out of the diet, except the little in fruit and vegetables, until the urine shows no trace of it.

The following is a list of foods allowable:

Fresh meat, fish, oysters, clams, lobster, turtle, meat extracts, fats of all kinds, eggs, such fresh vegetables as peas, beans, lentils, lettuce, celery, asparagus, cabbage, pickles, clear soups (all kinds), cheese (all kinds), coffee, tea (without sugar), cream, butter, fruit, acid drinks and carbonated waters.

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In the dietetic treatment of any diseased organ, the object must be to give that organ as much rest as consistent with keeping up the general nutrition of the system. The stomach and intestines are so closely allied that, where one is affected, the other is liable to affection also, and the dietetic treatment is regulated accordingly. Yet generally speaking, in stomach disorders the quantity of protein is limited; in intestinal disorders the starches, sugar and fats are limited. Since the office of the kidneys is to pass from the system the soluble salts and the nitrogenous waste, which dissolve in water, the work of the kidneys in most conditions is aided by a copious drinking of water. Since uric acid is stimulated by the kidneys, the proteins should be restricted in the diet, particularly those formed from the glands of animals,—as liver, sweetbreads, kidneys, also brains. Potatoes, green vegetables, stone fruits and cranberries aggravate an acute condition.