In selecting a diet, the following must be avoided: Vegetables which do not contain chlorophyl in quantity, as Potatoes, Turnips, Cauliflower, Carrots, Parnsips, Sea Kale, as well as Peas, Beans and Lentils.
Fruits—especially all sweet fruits—Grapes, Oranges, Apples, Pears, Gooseberries, Currants, Plums and Peaches, must be forbidden. Lepine thinks Apricots are admissible in most cases, as their sugar is chiefly lmvulose.
Farinaceous food must be avoided—thus Corn Flour, Baker's White Bread, Biscuits, Rice, Sago, Macaroni and Vermicelli, Tapioca, Sweets, Pastry, Puddings, &c.
Of the articles allowable, nearly every animal substance may be freely partaken of—any kind of Meat. Ham. Bacon, Tongue, Game, Fish, or Poultry,• indeed, the only animal products which are injurious and must be avoided are Liver, Honey, and Molluscs, especially oysters, though the flesh of the lobster may be safely permitted. In the cooking of animal substances, strict attention must be paid to the avoidance of any starchy or saccharine flavouring ingredients to the meat.
Cabbage (when quite green), Lettuce, Cress, Spinach, Watercress, Celery tops, Endive, young Brussels Sprouts, Spring Onions, Rhubarb, Cucumbers, and French Beans (when quite young), and green Artichokes may be allowed in moderate quantities. Almonds and all nuts save Chestnuts may be freely used, and Mushrooms are permissible.
Suet, Fat and Oils, Cream Cheese, Cream, Butter and Eggs may be used in quantity. The question of Milk will be considered after wards. If cream be mixed with a large quantity of water and the mixture allowed to stand, the perfectly pure cream devoid of all lactose can be skimmed off; this added to water, with which the white of an egg has been blended, will form a mixture almost identical with good cow's milk.
The exclusion of baker's bread is the great dietetic problem, as most patients find it impossible to use a meat diet without its assistance. It is therefore necessary to provide a substitute which will contain neither starch nor sugar, and which will at the same time be palatable.
Bran cakes made by Camplin's method, with eggs, butter, and a little milk, are used, and may be obtained from various makers. 6 oz.
finely ground bran, 1- doz. eggs, 3 oz. butter and a teaspoonful of baking powder make a good batter, which should be baked in an oven for 3o minutes.
Bread, made from thoroughly washed Gluten, in which as little starch as possible is left, is, if made carefully, a tolerable substitute, but its toughness and absence of taste are disgusting to most patients. The writer has had several poor diabetics kept alive upon home-made bread, prepared by themselves from the crude gluten obtained from the starch works. This compound is far from being a proper diabetic food, but, amongst the poor (kinetics discharged from hospital as incurables, it is the best that can he done for them. l le directs them to take 4 breakfast cupfuls of the finest bran, and a small teacupful of the best white Indian flour or meal, and rub these up with 6 oz. butter and a teaspoonful of bicarbonate of soda. This mass is then made into dough with the thick part of the washed gluten, which has been left to settle in a pail of water over night. This mass is to he rolled into cakes, and baked in a slow oven for two hours. Gluten flour, as sold, often contains large amounts of starch. Dr. V. Fielden has found as much as 68 per cent. in samples obtained from manufacturers. Many of the samples of gluten bread contain as much starch or more than ordinary wheaten or brown bread, and the latter, when cut in thin slices and thoroughly toasted through and through, is undoubtedly much less objectionable than many of the gluten breads, buns, and cakes freely advertised as safe diabetic food.
Bread made with Almonds offers upon the whole the most palatable substitute for white bread, and almond flour is procurable which, when freshly prepared and rubbed up with beaten eggs, and a little baking powder added, may be baked in small tins in any good oven without difficulty. Saundby recommends for almond cakes---I lb. ground almonds, 4 eggs, and two tablespoonfuls of milk, and a pinch of salt (or saccharin); the eggs to be beaten up, and the almond flour stirred in, divided into cakes, and baked in a moderate oven for 45 minutes.