Part 39

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=Acute Nephritis.= In case of inflammation of the kidneys the excretions are interrupted. In this event the quantity of water should be limited to three to four glasses a day. In the event that the kidneys will not excrete the water, the pores of the skin must be kept freely open by sweat baths to assist in the elimination of waste.

Dr. Hall recommends a milk and cream diet of from three to seven pints a day, for a few days, according to the case,—two parts of milk to one of cream. If the urine is scanty, he reduces it to one and one half pints a day, taken in four or five installments. After the three to seven days of milk diet he gradually introduces starches and fats.

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=Brights Disease.= This term covers forms of diseases of the kidneys, associated with albumin in the urine.

Where for any reason the kidneys have difficulty in discharging the nitrogenous waste of the system, the work of the dietitian must be to eliminate protein from the diet as closely as may be consistent with the body necessities. Besides restricting the amount of nitrogenous foods, the kidneys must be assisted in eliminating the nitrogenous waste, and the products of the inflammation, by a copious drinking of water. Hot water and hot diluent drinks are best, such as toast water, barley water, cream of tartar, lemon and acid drinks. In acute cases the patient is put on a milk diet of from two to three pints of milk a day, given one-half pint every three or four hours, diluted with one-third as much hot water. If the case be a prolonged one, broths may be included.

Even in cases which are chronic and not acute, it is well to follow a milk diet for a number of weeks. The quantity of milk, for an exclusive milk diet, must depend upon the age and size of the patient as well as upon his ability to exercise. If he is confined to his room, from five to seven pints of milk a day are sufficient. If he is taking a great deal of exercise, he may take from eighteen to twenty glasses of milk a day. If he loses weight on the milk diet, bread and rice may be added.

It is unwise to begin a milk diet at once, by feeding from eighteen to twenty glasses of milk a day, but this amount may be approximated within a week’s time and the change in diet should be begun by cutting down all meats and legumes and gradually eliminating starches. In changing from a milk diet to a diet including more hearty foods, the transition should be gradual.

A. F. Pattee gives the following diet for Brights Disease.

=DIET: Soup.=—Vegetable or fish soup, broths with rice or barley.

=Fish.=—Raw oysters or clams, fresh fish broiled or boiled.

=Meats.=—Eat sparingly, chicken, game, fat bacon, fat ham.

=Farinaceous.=—Stale bread, whole wheat bread, toast, milk toast, biscuits, macaroni, rice, cereals of all kinds.

=Vegetables.=—Onion, cauliflower, mashed potatoes, mushrooms, lettuce, watercress, spinach, celery, cabbage.

=Desserts.=—Ripe raw fruits, stewed fruits, rice tapioca, bread and milk puddings, junkets, cocoa.

=Liquids.=—Toast water, weak tea, pure water, peptonized milk, malted milk, fresh buttermilk, milk with hot water, equal parts, whey, unfermented grape juice.

=AVOID.=—Fried fish, corned beef, hashes, stews, pork, veal, heavy bread, batter cakes, lamb, mutton, beef, gravies, beans, peas, malt or spirituous liquors, tobacco, coffee, ice cream, cake, pastry.

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The condition of the nerves depends upon the general condition of the system and upon general nutrition. There is no one food or set of foods which directly affect any nervous trouble, unless this trouble be localized by disturbance in some particular organ. Then the effort must be to correct the difficulty in that organ.

There is no disturbance in any part of the body requiring less medicine than a disturbance in the nerves. The correction must come through general hygienic treatment. Regular exercise, alternated with regular rest periods, the formation of the habit of complete nerve relaxation, the general regulation of an easily digested, nutritious diet, with deep breathing exercises, are the best remedies.

In many cases of nerve debility the nerves seem to be stronger in the latter part of the day. Where this is the case the hearty meal should be eaten at this time.

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=Neurasthenia.= In cases of Neurasthenia, or “Tired Nerves,” all vital organs are more or less affected, because the nerves do not properly direct digestion, absorption, assimilation or elimination and, for this reason, the diet should be light and of easily digested foods. A free, correct breathing of fresh air, day and night, is imperative. It is important also to thoroughly masticate all food and drink freely of water. A change of thought, induced by a change of scene or companions, is helpful.

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This difficulty is usually the result of high living. It most often attacks people past middle age, who have indulged in rich pastries, puddings, meat three times a day, or who have frequently indulged in alcohol.

Being supposedly caused by an excess of uric acid and other waste deposited in the joints, resulting from too much protein and an insufficient elimination of the waste of the system, the dietetic treatment must be a low protein diet. Alcohol is absolutely prohibited and the quantity of carbohydrates and fats must be cut down as well as the protein.

In acute cases a diet of bread and milk, or toast and milk, with light vegetable broths should be followed for one to three days.

In chronic cases the diet may consist of the following: