€<J0KIN<5

BY TROOPS,
IN'

CAilfiP Al\l>

IIOSPITAI.,

WITH

TAKING FOOD & WHAT FOOD,
BY
i

FLORENCE NIGHTINGALE.
J.

W. BANDOLPH,

Bichmond, Va.

I--

THE LIBRARY OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES
GIFT OF
DR.

AND

MRS. ELMER BELT

DIRECTIONS
FOR

COOKl'iNG

BY TROOPS,
IN

CAMP AND HOSPITAL,
PREPAKED FOR THE ARMY OF VIRGINIA, AND PUBLISHED BY ORDER OF THE SURGEON GENERAL:

WITH ESSAYS ON

'TAKING FOOD," AND "WHAT FOOD/
BY FLORENCE NIGHTINGALE.

J.
121

W. RANDOLPH:
1861.

MAIN STREET, RICHMOND, VA,

Ac

I?

Directions for Cooking in Camp.

No.

1.

COFFEE FOR ONE HUNDRED MEN, ONE PINT EACH.
Put 12 gallons water into a suitable vessel (or divide necessary), on the fire when boiling, add 3 lbs. ground coffee mix well with a spoon leave on the fivt a few minutes longer; take it off, and pour in ^ a gallon cold water let it stand till the dregs subside, say from 5 to 10 minutes then pour off, and add 6 lbs. sugar. If milk is used, put in 12 pints, and diminish the water by that amount.
if
; .

;

;

:

No.

2.

FRESH BEEF SOUP FOR ONE HUNDRED MEN.
each
lbs. beef; cut into pieces of about ^ lb. 15 gallons water 8 lbs. mixed vegetables 10 ^mall tablespoonfuls salt 2 small tablespoonfuls gi-ound
;

Take 75

;

;

;

pepper
thicken

;

;

-immer

cold bread, ci'ackers, or 3 lbs. rice, to place on the fire let it come to aboil then for 3 hours. Skim off the fat and serve.
:
;

some

4

DIRECTIONS FOR
No.
3.

COOKING.

soter's stew for owe hundred men.

Cut 50 lbs. fresh beef in piece.s of about ^ lb. each, and with 18 quarts of water put into the boiler; add 10 tabiespoonfuls of salt, two of pepper, 7 lbs. onions, cut in slices, and 20 lbs. potatoes peeled and sliced stir well, and let it boil for 20 or 30 minutes then add 1| lbs. flour previously mixed with water; mix well together, and with a moderate heat simmer for about two hours. Mutton, veal or pork can be stewed in a similar n-anner, but will take half an hour less cooking. A pound of lice or plain dumplings may be added with
;
;

sreat advanta2:e.

No.

4.

suet dumplings.
15 teaspoonfuls of salt, 7 of ground pepper, 7 lbs. chopped fat pork or suet, 5 pints water mix v.ell together divide into about 150 pieces which roll in flour, and boil with meat for 20 or 30 minutes. Jf no fat or suet can be obtained, take the same ingredients, adding a little more water, and boil about 10 iTiinute.?. Serve with the meat.
lbs. flour,
;

Take 10

;

;

No.

5.

TO FRY MEAT.
clean

;

pan on the fire for a minute or so: wipe it when t!ie pan is hot, put in either fat or butter

DIRECTIONS FOR
(fat

COOKING.
;

5

from salt meat is preferable) then add the meat going to cook; turn it several times, to have it equally done season to each pound a small teaspoonful of salt and a quarter of pepper. A few onions in the remaining fat, with the addition of a little flour, a
yoLi are
;

quarter pint of water, two tablespoonfuls of vinegar, a few chopped pickles, will be very relishing.

o;-

No.

6.

TO COOK SALT BEEF OR PORK.
Put the meat, cut in pieces of from 3 to 4 lbs., to soak the night before in the morning wash in fresh water, and squeeze well with the hands to extract the salt; after which, put in your kettle with a pint of v.ater to each pound, and boil from 2 to 3 hours.
;

No.

7.

SALT BEEF OR PORK, WITH MASHED BEAXS. FOR HUNDRED MEN.
;

0:\E

Put in two vessels 37^ lbs. meat each divide 24 lb.-:, oeans in four pudding cloths, loosely tied putting to boil at the same time as your meat, in sufficient water let all boil gently for two hours take out the meat and beans put all the meat into one boiler, and remove the liquor from the other; into which turn out the beans; add to them two teaspoonfuls of pepper, a pound of fat, and with the wooden spatular mash the beans, and serve with the meat. Six sliced onions fried and added im.proves the dish.
;
:

;

;

6

DIRECTIONS FOR COOKINO.

[Note. -In cooking all kinds of meat, be careful to preserve the grease, which can be easily done by putting the liquor in which it is boiled, by till it cools It then skim off and place in a clean covered vessel. for butter; is useful for cookis an excellent substitute ing purposes, and will burn in a common lamp or tin plate with a piece of old cotton twisted up for a wick.1
;

Directions for Cooliing in Hospital.

No.

1.

MUTTON STEWED AND SOUP FOR ONE HUNDRED MEN.
lbs. meat, 12 lbs. plain

convenient sized vessel 16 gallons water, 60 mixed vegetables, 9 lbs. pearl barley or rice (or 4| lbs. each), 1| lbs. salt, 1^ lbs. Put all the ingiedients, except the flour, 1 oz. pepper. set it on the fire, and when beginflour, into the pan ning to boil, diminish the beat, and simmer gently for two hours and a half,-^ take the meat out and keep warm add to the soup your flour, which you have mixed with enough water to form a light batter; stir well together with a large spoon boil another half hour; skim off* the fat, and serve the meat and soup separate. The soup should be stirred occar:ionallv while making, to prevent burning or sticking.

Put

in a

;

;

;

No.

2.

BEEF SOUP.
Proceed the same as
in
till

The

for mutton, only leave the meat takes longer to cook than mutton. pieces are not to be above 4 or 5 lbs, weight each.

servino;, as

it

8

DIRECTIONS FOR COOKING.

No.

3.

BEEF TEA,

SIX PINTS.

Cut three pounds lean beef into pieces the size of walnuts, and break up the bones (if any) put it into a convenient sized kettle, with ^ lb. mixed vegetables (onions, celery, turnips, carrots, or one or two of these, if all are not to be obtained), 1 oz. salt, a little pepper, 2 oz. butter, | pint of water. Set it on a sharp fire for 15 minutes, stirring occasionally, till it forms a rather then add 7 thick gravy at the bottom, but not brown pints of hot water; simmer gently for'an hour. Skim off all the fat, strain through a sieve and serve.
; ;

No.

4.

THICK BEEF TEA.
Dissolve a teaspoonful of arrow-root in a gill of water, and pour it into the beef tea twenty minutes before passing through the seive, or add ^ oz. gelatine to the above quantity of beef tea, when cooking. Mutton and veal will make good tea, by proceeding the same as above.

No.

5.

ESSENCE OF BEEF.
lean beef, cut fine; put it into a porter bottle with a tea cup of water, ^ teaspoonful of salt, a tork loosely, and little pepper, and 6 grains allspice then with a gentle place in a saucepan of cold water heat let it simmer till sufficient quantity of the essence is obtained. Serve either warm or cold.
1 lb.
; ;

Take

DIRECTIONS FOR COOKING.
No.
6.

y

CHICKEN BROTH.
Put
in a

stew-pan a fowl,

.3

pints water, 2 teaspoon-

pepper and a small onion, or two ounces of mixed vegetables boil the whole gently for one hour (if an old fowl, simmer for two hours, Skim off the fat and adding one pint more water.)
fuls of rice, 1 of salt, a little
;

serve.
light mutton broth may be neck taking 1^ pounds mutton

A

made
if

in the same way, convenient.

No.

7.

PLAIN BOILED RICE.
pan with a teaspoonful add to it | pound rice, well washed boil for ten minutes; drain off the water and slightly grease the pan with butter; put the rice back, and let it swell slowly for about twenty minutes, near Each grain will then swell up, and be well the fire. separated. Flavor with nutmeg or cinnamon, and sweeten to taste.
Put 2 quarts water
salt
;

in a steW'

of

when

boiling,

;

No.

8.

SAGO JELLY.
a pan with 3 pints water, 3 oz. sago, 1^ oz. sugar, half a lemon peel, cut very thin, ^ teaspoonful of ground cinnamon, or a small stick of the same, and a little salt; boil about 15 minutes, stirring constantly, then add a little port, sherry or madeira wine, as the case will admit.
in

Put

10

DIRECTIONS FOR

COOKING.

No.

9.

ARROW-ROOT MILK.
Put
set
in a

pan 4
;

oz. arrow-root, 3 oz. sugar, the peel of

half a lemon, ^ teaspoonful of >salt, 2^ pints of milk; it on the fire stir gently boil for ten minutes, and serve.
;

If

no lemons

at

hand, a

little

essence of any kind

will do.

When
of butter

short of milk, use half water
is

-half

an ounce

an improvement.

No. 10.

ARROW-ROOT WATER.
Put in a pan 3 oz. arrow-root. 2 oz. white sugar, the peel of a lemon, ^ teaspoonful of salt, and 4 pints water; mix well, set on the fire, and boil for ten minutes.
Serve hot or cold.

No.

11.

RICE WATER.

Put 7 pints water
for three quarters of

to

boil

;

add 2 oz.

rice,

washed, 2
to

oz. sugar, the peel of two-thirds of a lemon, boil gently

Strain and serve

— use

an hour, or til! reduced as a beverage.

5 pints.

No.

i2.

BARLEY WATER.
Put
stir

saucepan 7 pints water, 2 oz. pearl barley now and then w^hen boiling: add 2 oz. white sugar,
in a

;

DIRECTIONS FOR COOKING.
the rind of half a lemon, thinly peeled
;

11
boil

gently for

two hours, and serve, either strained
left in.

or with the barley

No. 13.

CRIMEAN LEMONADE.
Put in a basin 2 tablespoon fu Is of white or brown sugar, ^ a tablespoonful of lime juice, nnix well together. and add one pint of water.

No.
CITRIC ACID

14.

LEMONADE,
;^

Dissolve 1 oz. citric acid in one pint of cold water add 1 lb. 9 oz. white sugar, mix well to form a thick syrup; then put in 19 pints cold water, slowly mixing
well.

No.

15.

TOAST AND WATER.
Cut a piece of crusty bread about ^ lb. toast gently and uniformly to a light yellow color; then place near the fire, and when of a good brown chocolate, put in a
;

pitcher; pour on
pitcher, and

it

3

pii.ts

when

cold, strain

boiling water; cover the
it is then ready for use. causes fermentation in a

Neverleave the

toast in, as

it

short time. piece of apple, slowly toasted

A

till it

gets quite black.
drink.

and added

to the above,

makes a very refreshing

ii

T^KliSra FOOD."

<i

TAKING FOOD."

Every careful observer of the sick will agree in this, that thousands of patients are annually starved in the midst of plenty, from want of attention to the ways which alone make it possible for them to take food.
This want of attention is as remarkable in those who urge upon the sick to do what is quite impossible to them, as in the sick themselves who will not make the effort to do what is perfectly possible to them. For instance, to the large majority of very weak pait is quite impossible to take any solid food before 11 A. M,, nor then, if their strength is still further exhausted hy fasting till that hour. For weak patients have generally feverish nights, and, in the morning, dr}' mouths and, if they could eat with those dry mouths, A spoonful of beef-tea, it would be the worse for them. of arrowroot and wine, of egg flip, every hour, will give

tients

;

them the
being too

requisite nourishment, and pievent

them from

take at a later hour the And solid food, which is necessary for their recovery. every patient who can swallow at all can swallow these But how often do we hear liquid things, if he chooses. a mutton-chop, an egg, a bit of bacon, ordered to a patient for breakfast, to whom (as a moment's consideration would show us) it must be quite impossible to masticate such things at that hour.
to

much exhausted

16
Again,
full

TAKING FOOD.
a

nurse

is

of

some

article of food
it.

ordered to give a patient a tea-cup every three hours. The paIf so, try a table-spoonfull

tient's storricich rejects

every hour; if this will not do, a tea-spoonfull every quarter of an hour.
I am bound to say, that I think more patients are lost by want of care and ingenuity in these momentous mi-

nursing than in public hospitals. And think there is more of the entente cordiah to assist one another's hands between the Doctor and his head Nurse in the latter institutions, than between the doctor and the patient's friends in the private house.
nutiae in private
I

the consequences which may enfrom ten minutes' fasting or repletion (I call it repletion when they are obliged to let too small an interval elapse between taking food and some other exertion, owing to the nurse's unpunctuality),
If

we

did but

know

sue, in

very weak

patients,

we should be more careful never to let this occur. In very \\e2tk patients there is often a nervous difficulty of swallowing, which is so much increased by any other call upon their strength that, unless they have their food punctually at the minute, which minute again must be arranged so as to fall in with no other minute's occupation, they can take nothing till the next respite occurs so that an unpunctuality or delay of ten minutes may very well turn out to be one of two or three hours. And why is it not as easy to be punctual to a minute ? Life often literally hangs upon the^e minutes.
In acute cases, where life or death is to be determined a few^ hours, these matters are very generally attended to, especiall3Mn Hospitals; and the number of cases is large where the patient is, as it were, brought back to life by exceeding care on the part of the Doctor
in

TAKING FOOD.
or Nurse, or both, in ordering and giving with minute selection and punctuality.

17
nourishment

But

in

chronic cases, lasting over months and years,

fatal issue is often determined at last by mere protracted starvation, I had rather not enumerate the instances which I have known where a little ingenuity, and a great deal of perseverance, might, in all probabilThe consulting the hours ity, have averted the result. when the patient can take food, the observation of the times, often varying, w'hen he is most faint, the altering seasons of taking food, in order to anticipate and prevent such times all this, which requires observation, ingenuity, and perseverance (and these really constitute the good Nurse), might save more lives than we wot of.* To leave the patient's untasted food by his side, Irom meal to meal, in hopes that he will eat it in the interval, I is simply to prevent him from taking any food at all. have known patients literally incapacitated from taking one article of food after another, by this piece of ignoLet the food come at the right time, and be taken rance. awa}^ eaten or uneaten, at the right time; but never let a patient have " something always standing" by him, if you dont wish to disgust him of everything. On the other hand, I have known a patient's life saved (he was sinking for want of food) by the-simple question, put to him by the doctor, " But is there no hour when you feel yoti could eat?" " Oh, yes," he said, o'clock and "I could always take something at o'clock." The thing was tried and succeeded. Patients very seldom, however, can tell this; it is for you to

where the

watch and
-•

find

it

out.

A

article of food;

any

patient should never be asked if he will have any particular let it be prepared, and broug-ht to him, without questioning on the part of the nurse.

18

TAKING FOOD.

patient should, if possible, not see or smell either fhe food of others, or a greater amount of food than he himself can consume at one time, or even hear food
I know of no talked about or see it in the raw state. The breaking of it always exception to the above rule. induces a greater or less incapacity of taking food. In hospital wards it is of course impossible to observe and in single wards, where a patient ,must be all this continuousl}' and closely watched, it is frequently impossible to relieve the attendant, so that his or her own But it is not the meals can be taken out of the ward. less true that, in such cases, even where the patient is not himself aware of it, his possibility of taking food is limited by seeing the attendant eating meals under his observation. In some cases the sick are aware of it, and case where the patient was supposed to complain. be insensible, but complained as soon as able to speak,
;

A

A

is

now present to my recollection. 'Remember, however, that the extreme punctuality

in

well-ordered hospitals, the rule that nothing shall be done in the ward while the patients are having their meals, go far to counterbalance what unavoidable evil I have often seen cliere is in having patients together. the private nurse go on dusting or fidgeting about in a sick room all the while the patient is eating or trying to
eat.

That the more alone an invalid can be when taking and, even if he inust is unquestionable be fed, the nurse should not allow him to talk, or talk to
food, the better,
;

him, especially about food, while eating. When a person is compelled, by the pressure of occupation, to continue his business while sick, it ought to be
a rule

without any exception whatever,

shall bring business to him. or talk to

that no one him while he is

TAKING FOOD.

19

faking food, nor go on talking to him on interesting submoment before his meals, nor make an engagement with him immediately after, so that there be an}' hurry of mind while taking thern. Upon the observance of these rules, especially the first, often depends the patient's capability of taking food at all, or, if he is amiable and forces himself to take food, of deriving any nourishment from it. nurse should never put before a patient milk that is sour meat or soup that is turned, an egg that is bad. or vegetables undone. Yet often I have seen these things brought in to the sick in a state perfectly perceptible to every nose or eye except the nurse's. It is here that the clever nurse appears she will not bring in the peccant article, but, not to disappoint the patient, she will whip up something else in a few minutes. Remember that sick cookery should half, do the work of your poor patient's weak digestion. But if you further impair it with your bad articles, I know not what is to become of him or of it. If the nurse is an intelligent being, and not a mere carrier of diets to and from the patient, let her exercise her intelligence in these things. How often we have known a patient eat nothing at all in ihe day, because one meal was left untasted (at that time he was incapable of eating), at another the milk was sour, the third was spoiled by some other accident. And it never occurred to the nurse to extemporize some expedient, it never occurred to her that as he had had no solid food that day he might eat a bit of toast (say) with his tea in the evening, or he might have some meal an hour earlier. patient who cannot to'.ich his dinner at two, will often accept it gladly, if brought to him at seven. But some how nurses never " think of these thinsrs."
jects up to the last

A

;

;

A

20

TAKING FOOD.

One would imagine they did not consider themselves bound to exercise their judgment; they leave it to the
patient.

Now

I

am

quite sure that

it is

better for a pa-

tient rather to suffer these neglects than to try to teach

nurse to nurse him, if she does not know how. him, and if he is ill he is in no condition to The above remarks apteach, especially upon himself. ply much more to private nursing than to hospitals. I would say to the nurse, have a rule of thought consider, remember how about your patient's diet much he has had, and how much he ought to have today. Generally, the only rule of the private patient's diet is what the nurse has to ^ive. It is true she cannot o-ive him what she has not got; but his stomach does not wait for her convenience, or even her necessity.* If it is used to having its stimulus at one hour to-day, and tomorrow it does not have it, because she has failed in getShe must be always exercising ting it, he will suffer. her ingenuity to supply defects, and to remedy accidents which will happen among the best contrivers, but from which the patient does not suffer the less, because "they cannot be helped." One very minute caution, take care not to spill into your patient's saucer, in other words, take care that the outside bottom rim of his cup shall be quite dry and clean
his
It ruffies
;

;

*Why, because the nurse has not got some food'to-day %vhicl. the patient takes, can the patient %vait four hours for food to-day, ^vho could not wait two hours yesterday ? Yet this is the only logic one generally hears. On the other hand, the other logic, viz of the nurse giving the patient a thing because she has got it, If she happens to have a fresh jelly, or fresh fruit, is equally fatal. she will frequently give it to the patient half an hour after his dinner, or at his dinner, when he cannot possibly eat that and the broth too or, worse still, leave it by his bed-side till he is so sickened with the sight of it, that he cannot eat it at alL
;

TAKING FOOD.
if,

21
he has
to

every time he

lifts

his

cup

to his lips,

carry

the saucer with it, or else to drop the liquid upon, and to soil his sheet, or his bed-gown, or pillow, or if he is siting up, his dress, you have no idea what a difference
this
fort

minute want of care on your part makes
and even
to his

to his

com-

willingness for food.

"^WH^T FOOD."

2S

''WHAT FOOD.''
among women in charge of sick respecting sick diet. — One is the belief that beef tea is the most nutritive of all articles. Now, just try and boil down a lb. of beef
into beef tea, evaporate
left of
i will

mention one or two of the most

common

errors

your beef tea and see what

is

your beef.
;

You

will find that there is barely a

teaspoonful of solid nourishment to half a pint of water nevertheless there is a certain reparative in beef tea quality in it, we do not know what, as there is in tea; but it may safely be given in almpst any inflammatory disease, and is as little to be depended upon with the healthy or convalescent where much nouri?-hment is required. Again, it is an ever ready saw that an egg is equivalent Also, it is to a lb. of meat, -^whereas it is not at all so. seldom noticed with how many patients, particularly of All nervous or bilious temperament, eggs disagree. puddings made with eggs, are distasteful to them in con^ sequence. An egg, whipped up with wine, is often the only form in which they can take this kind of nourishment. Again, if the patient has attained to eating nrieat, it is supposed that to give him meat is the only whereas scorbutic sores thing needful for his recovery have been actually known to appear among sick persons living in the mid.^t of plenty in England, which could that the be traced to no other source than this; viz. nurse, depending on meat alone, had allowed the patient
; :

26

WHAT FOOD?

to be without vegetables for a considerable time, these

being 80 badly cooked that he always left them untouched. Arrow-root is another grand dependence of the nurse. As a vehicle for wine, and as a restorative quickly prepared, it is all very well But it 'is nothing but starch and water. Flour is both more nutritive, and less liable to ferment, and is preferable wherever it can be used. Again, milk, and the preparations from milk, are a most important article of food for the vsick. Butter is the lightest kind of animal fat, and though it wants the sugar and some of the other elements which there are in milk, yet it is most valuable both in itself and in enalatter

bling the patient to eat more bread. Flour, oats, groats,* barley, and their kind, are, as we have already said; preferable in all their preparations to all the preparations of arrowroot, sago, tapioca, and their kind. Cream, in many
i> quite irreplaceable by any other whatevtT. It seems to act in the same manner as beef tea. and to most it is much easier of digestion than Cheese is not usumilk. In fact, it seldom disagrees. ally digestible by the sick, but it is pure nourishment for repairing waste and I have seen sick, and not a fevjr either, whose craving for cheese showed how much it was needed by them.f

long chronic diseases,
article

;

••'

" Groats," or grits, a coarse
sifted.
Tliis

hominy, fanned and

gronnd corn meal, or very small can be prepared at any country

corn mill, is a cheap and valuable article of diet for the sick. It can be boiled or baked. In the latter form, a sauce made with a little sugar, butter and lemon juice, or vinegar, renders it very palata ble. When boiled it is usually eaten with a little butter and salt,

tin the diseases produced by bad food, such as scorbutic dysentery and diarrhoea, the patient's stomach often craves for and digests things, some of which certainly would be laid down

WHAT FOOD

?

'.2t

But, if fre^h milk is so valuable a food for the sick, the least ch mge or sourness in it, makes it of all artidiarrhcea is a commoQ cles, perhaps, the most injurious The result of fresh milk allowed to become at all sour. nurse therefore ought to exercise her utmost care in this. In large institutions for the sick, even the poorest, the utmost care is exercised. Wenham Lake ice is used for this express purpose every summer, while the private patient, perhaps, never tastes a drop of iTiilk that is not sour, all through the hot weather, so little does the priYet, vate nurse understand the necessity of such care. if you consider that the only drop of real nourishment in your patient's tea is the drop of milk, and how much almost all En^^lish patients depend upon their tea, you will see the great importance of not depriving your paButtermilk, a totally differtient of this drop of milk. ent thing, is often very useful, especially in fevers. In laying down rules of diet, by the amounts of " solid nutriment " in different kinds of food, it is constantly lost sight of what the patient requires to repair You his waste, what he can take and what he can't. cannot diet a patient from a book, you cannot make up the human body as you would make up a prescription, so many parts "carboniferous," so many parts " nitro;

geneous" will constitute a perfect diet for the patient. The nurse's observation hei-e will materially assist the
in no dietary that ever was invented for sick, and especially not for such sick These are fruit, pickles, jams, gingerbread, fat of ham or bacon, suei, cheese, butter, milk. These cases I have seen not by ones, nor by tens, but by hundreds. And the patient's

stomach was right and the book was wrong. The articles craved for, in these cases, might have been principally*arranged under the two heads of fiit and vegetable acids. There is often a marked difference between im?n and women in
this matter ot sick feeling.

Women's

digestion

is

genei'aUy slower.

28
Doctor

WHAT FOOD?

the patient's "fancies " will nnaterially assist the nurse. For instance, sugar is one of the nnost nutritive of all articles, being pure carbon, and is particularly re-

commended
all

— and
well,

in some books. But the vast majority of patients in England, young and old, male and female, rich and poor, hospital and private, dislike sweet things,

wMiile I have never known a person take to sweets when he was ill who disliked them when he was
I

have known many fond of them when in health sickness would leave off anything sweet, even to sugar in tea, sweet puddings, sweet drinks, are their aversion the furred tongue almost always likes

who

in

;

sharp or pungent. Scorbutic patients are an exThey often crave for sweetmeats and jams. Jelly is another article of diet in great favor with nurses and friends of the sick even if it could be eaten solid, it would not nourish; but it is simpl}^ the heightof folly to take ^ oz. of gelatine and make it into a certain bulk by dissolving it in water and then to give it to the sick, as if the mere bulk represented nourishment. It is now known that jelly does not nourish, that it has a tendency to produce diarrhoea,— and to trust to it to repair the waste of a diseased constitution is simply to starve the sick under the guise of feeding them. If 100 spoonfuls of jelly were given in the course of the day, you would have given one spoonful of gelatine, which spoonful has no nutritive power whatever. And, nevertheless, gelatine contains a large quantity of nitrogen, which is one of the most powerful elements in nutrition on the other hand, beef tea may be chosen as an illustration of great nutrient power in sickness, coexisting with'a very small amount of solid nitrogenous
is

what

ception.

;

;

matter.

Dr. Christison says that

•'

every one will be struck

WHAT POOD?
tients will often take diluted

29

with the readiness with which" certain classes of " pameat juice or beef tea repeatedly, when they refuse all other kinds of food." This is particularly remarkable in " cases of gastric fever in which," he says, "little or nothing else besides beef tea or diluted meat juice" has been taken for weeks or even months, " and yet a pint of beef tea contains the result is so scarcely ^ oz. of anything but water," " Not striking that he asks what is its mode of action ? simply nutrient ^ oz. of the most nutritive material cannot nearly replace the daily wear and tear of the tisPossibly,'' he says, " it besues in any circumstances. longs to a new denomination of remedies."* It has been observed that a small quantity of beef tea added to other articles of nutrition augments their power out of all proportion to the additional amount of solid

matter.

The reason why

jellyt should be innutritious
is

and leef

too nutritious to the sick,
is

a secret yet undiscovered,

but it clearly shows that careful observation of the sick the only clue to the best dietary. Chemistry has as yet afforded little insight into the dieting of sick. All that chemistry can tell us is the
* Chicken broth, with the fat well skimme.d more palatable than beef tea.
off, is,

to

most pa-

tients,

t Another most excellent dietetic article is biscuit jelly, made according to the following formula Biscuit Jelly. cold water, 2 quarts; Biscuit^ crushed, 4 oz. soak for some hours boil to one ha!f strain evaporate to one pint then flavor with sugar, red wine and cinnamon. Parched Corn, powdered and sweetened to suit the taste, is recommended as a pleasant and nutritious diet for invalids.

:

;

;

;

;

In a Southern convalescent, one of the most desirable things that can be given them is thin corn meal,-ground, well boiled, seasoned with salt, and presented while hot.

30

WHAT FOOD

?

or " nitrogenous " elements discoverable in different dietetic articles. It has given us li?ts of dietetic substances, arranged in the order of their richness in one or other of these principles but In the great majority of cases, the stomach that is all. of the patient is guided by other principles of selection than merely the amount of carbon or nitrogen in the diet. No doubt, in this as in other things, nature has very definite rules for her guidance, but these rules can only be ascertained by the most careful observation at the She there teaches us that living chemistry, b?d-side. the chemistry of reparation, is something different from Organic chemistry is the chemistry of the laboratory. useful, as all knowledge is, when we cotne face to face with nature; but it by no meaiis follows that we should learn in the laboratory any one of the reparative processes going on in disease. Again, the nutritive power of milk and of the prepathere is rations fiom milk, is veiy much undervalued nearly as much nourishment in half a pint of milk as there is in a quarter of a lb. of meat. But this is not the whole question or nearly the whole. The main question is what the patient's stomach can assimilate or derive nourishment from, and of this the patient's stomach is the sole judge. Chemistry cannot tell this. The patients stomach must be its own chemist. The diet which will keep the healthy man healthy, will kill the sick one. The same beef which is the most nutritive of all meat and which nourishes the healthy man, is the least nourishing of all food to the sick man, whose half-dead stomach can assimilaie no part of it, that is, make no food out of it. On a diet of beef tea healthy men on the other hand speedily lose their strength. I have known patients live for many months without

amount of " carboniferous"

;

;

WHAT FOOD

?

31

touching bread, because they could not eat bakers' Theee were mostly country patients, but not all. Homemade bread or brown bread is a most imThe use of portant article of diet for many patients. Oat cake apeiients may be entirely superseded by it.
bread.
is

another.

To watch for the opinions, then, which the patient's stomach gives, rather than to read "analyses of foods," to settle what is the business of all those who have the patient is to eat perhaps the most important thing to be provided for him after the air he is to

breathe.

the medical man who sees the patient only even only once or twice a week, cantiot possibly tell this without the assistance of the patient himself, or of those who are in con>tant observation on the patient. The utmost the medical man can tell is whether the patient is weaker or stronger at this visit [ should, therefore, say than he was at the last visit. that incomparably the most important office of the nurse after she has taken care of the patient's air, is to take care to observe the effect of his food, and report it to the medical attendant. It is quite incalculable the good that would certainly come fiom such sound and close observation in this almost neglected branch of nursing, or the help it W'ould give to the medical man. A great deal too much against tea* is said b}' wise

Now

once

a day, or

* It is made a frequfcnt recommendation to persons about to incur great exhaustion, either from the nature of the service, or from their being not in a state fit for it, to eat a fjiece of Inead recommenders would themseFves try 1 wish the before they go. the experiment of substituting a piece of bread for a cup of tea They would find it a very or coffee, or beef tea, as a refresher.

32

WHAT FOOD?

people, and a great deal too much of tea is given to When you see the natural the sick by foolish people. and almost universal craving in English sick for their "tea," you cannot but feel that nature knows what she But a little tea or coffee restores them quite is about. as much as a gieat deal, and a great deal of tea, and especially of coffee, impairs the little power of digesYet a nurse, because she sees how tion they have. one or two cups of tea or coffee restores her patient, thinks that three or four cups will do twice as much. This is not the case at all; it is, however, certain that there is nothing yet discovered which is a substihe can tute to the English patient for his cup of tea take it when he can take nothing else, and he often I should be can't take anything else if he has it not. very glad if any of the abusers of tea would point out what to give to an English patient after a sleepless
;

poor comfort. Wheti soldiers have to set out fasting on fatiguing duty, when nurses have to go tasting in to their patients, it is a hot rest-orative they want, and ought to have, before they go, not a cold bit of bread. And dreadful have been the consequences If they can take a bit of bread tvith the hot of neglecting this. cup of tea, so much the better, but not inslead of it. The fact that their is more nourishment in bread than in almost anything -elSe has probably induced th« mistake. That it is a fatal mistake It seems, though very little is known on the there is no doubt.
subject, that

what ''assimilates" itself directly, and with the least trouble of digestion with the human body, is the best for the above circumstances. Bread requires two or three processes of assimilation, before it becomes like the human body. The almost universal testimony of English men and women who liave undergone great fatigue, such as riding long journeys without stopping or sitting up for several nights in succession, is that they and nothing could do it best upon an occasional cup of tea

else.

Let experience, not theory, decide upon this as upon
things.

all

other

WHAT FOOD?
night, instead of
in

33

tea. If you give it at 5 or 6 o'clock the morning, he may even sometimes fall asleep after it, and get perhaps his only two or three hours' At the same time you sleep during the twenty-four. never should give tea or coffee to the siok, as a rule, Sleeplessness in the after 5 o'clock in the afternoon. early night is from excitement generally, and is insleeplessness which contincreased by tea or coffee ues to the early morning is fiom exhaustion often, and The only English patients I have is relieved by tea. ever known refuse tea, have been typhus cases, and the first sigii of their getting better was their craving ao:ain for tea. In general, the dry and dirty tongue always prefers tea to coffee, and will quite decline milk, unless with tea. Coffee is a better restorative than tea, but a greater impairer of the digesLet the patient's taste decide. tion. You will say that, in cases of great thirst, the patient's craving decides that it will drink a great deal of tea, and that you cannot help it. But in these cases be sure that the patient require? diluents for quite other purposes than quenching the thirst he wants a great deal of some drink, not only of tea, and tiie doctor will order what he is to have, barley water or lemonade, or soda water and milk, as the case may be. Le;iman, quoted by Dr. Christison, says that, among the well and active, "the infusion of 1 oz. of roasted coffee daily will diminish the waste going on in the body by one-fourth," -and Dr. Christison adds that tea has the same property. Now this is actual experiment. Lehmaa weighs the man and finds the fact fiom his weight. It is not deduced from any "analy;

;

34
sis" of food.

WHAT FOOD?
All experience

among
to

the sick shows the
the sick in lieu of
fact that

same thing.* Cocoa is often reconimended
tea or coffee.
lish sick

But independently of the

Eng-

very generally dislike cocoa, it has quite a different effect from tea or coffee. It is an oily starchy nut, having no restoritive at all, but simply increasing fat. It is pure mockery of the sick, therefore, to call it a substitute for tea. For any renovating stimulus it has, you might just as well offer them chestnuts instead
of tea.

An almost universal error among nurses is in the bulk of the food, and especially the drinks they offer totheir patients. Suppose a patient ordered 4 oz. brandy during the day, how is he to take this if you make it into four pints with diluting it? The same with tea and beef tea, with arrowroot, milk, &c. You have not in.

*

111

making

coffee, it

is

absolulel y iiecessary to

buy

it

in the

berry and grind it at home. Otherwise you may reckon upon its containing a certain amount of chicory, at least. This is not a question of the taste, or of the wholesoraeness of chicory. It is that chicory has nothing at all of the properiies for which you give coffee. And therefore you may as well not give it. Again, all laundresses, mistresses of dairy-farms, head nurses, (I speak of the good old sort only women who unite a good deal of hard man-ual labor with the head-work necessary for arranging the day's business, so that none of it shall tread upon the heels of something else,) set great value, I have observed, upon liaving a high-priced tea. This is called extravagant. But these women are '^extravagant" in nothing else. And they ate right in this. Real tea-leaf tea alone contains'the restorative they want which is not to be found in sloe-leaf tea. The mistresses of houses, who cannot even go over their own house once a day, are incapable of judging for these women. For they are incapable themselves, to all appearance, of the spirit of arrangement (no small task) necessary for managing a large waro or dairv.

WHAT FOOD?

35

creased the nourishment, you have not increased the renovating power of these articles, by increasina: their bulk', you have very likely diminished both by giving
the patient's digestion more to do, and most likely of the patient will leave half of what he has been ordered to take, because he cannot swallow the bulk with which you have been pleased to invest it. It requires very nice observation and care (and meets with hardly any) to determine what will not be too thick or strong for the patient to take, while giving him no more than ^he bulk which he is able to swallow,all,

SCIENCE OF WAR!
TA.CTICS

OFFICERS
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ARRANGED AND COMPILED BY
I. V.

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J.

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