The milk may be peptonised when the digestive organs are weak, but as a rule it cannot be tolerated in large amount when so treated. Ren netted milk is much preferable, and cream can be used along with it to great advantage.
A raw-meat dietary is recommended by Richet, and in some Continental sanatoria this system is carried out under the name of Zomo-therapy. The uncooked muscle fibre is held to possess a distinct immunising or protective power which disappears on cooking; in other words, large doses of raw meat in some way increase the defensive mechanism of the body. The juice may be expressed from fresh meat by a press, and may be swallowed from a ruby-coloured drinking vessel by fastidious patients. The meat is passed through a mincing machine, scraped with a knife, pounded in a mortar, or rubbed through a sieve, or rolled into pellets and covered with chocolate.
Fish, poultry, game, raw or cooked eggs, and oysters in abundance, and, in fact, every food which is considered easy of digestion and highly nutritious maybe allowed without stint, always provided that farinaceous, fatty, and fat-forming stuffs are allowed a good place. Weber objects to potatoes and all foods which contain potash salts, which, he argues, encourage the growth of the tubercle bacilli.
Four staple meals in the day is the best division of time for the phthisical patient when his digestive organs are in good condition, and the meals should be served up and consumed when possible in the open air. Some patients do best on three meals, and others who cannot take solid food or raw meat can get along on the milk or koumiss swallowed every two hours.
Debove's sztr alimentation method consists, as its name implies, of " overfeeding "; he recommends that this should be commenced by forced feeding, the food in a liquid form as milk, strong soups or broth, dried raw muscle fibre mixed with milk, raw eggs, &c., being introduced into the stomach by a soft rubber oesophageal tube. It is claimed for this forced feeding plan that the food is retained when everything swal lowed in the ordinary way is constantly rejected by the patient. Soon
the tube can be dispensed with and the equivalent of 3 lbs. of meat can be swallowed daily without inconvenience. Beef tea is of little value in any form in the treatment of phthisis, and is better replaced by broths or by strong clear soup in all cases. Many phthisical patients may be advan tageously sent to a good farmhouse in the country or near to the sea, where their diet consists of poultry, fresh milk in abundance, butter, cream and fresh new-laid eggs consumed in the raw or lightly boiled state, the meals being all partaken of in the open air, which usually powerfully increases the appetite of the city dweller.
As a rule it may be said that alcoholic stimulants are not advisable in the early stages, except where experiment proves that they increase appetite and assist digestion. They should always be administered along with the food, and any good, sound, light wine may be permitted; but the best form for the administration of alcohol is a little good brandy or whiskey largely diluted with fresh cow's milk. Claret, Burgundy, hock, stout and beer should he avoided; these liquids often set up acid fermen tation when mixed food is being administered in large quantities, and Champagne should be reserved for very occasional use when the stomach becomes irritable.
Whiskey may be allowed in the later stages of the disease in fair quantity, and if mixed with the patient's milk any reasonable amount may be allowed without danger of doing harm. By giving it in this way cough may be eased, diarrhoea checked, sleep produced, fever diminished and waste retarded. It is obvious that in the class of case referred to a fatal issue is most likely to be the outcome of the disease, and therefore the moral objection to creating an alcohol habit is not serious.
Cod-Liver Oil still holds a place in the treatment of phthisis, though no t so frequently employed as formerly. Its use will be referred to later on under the head of Drugs, though the substance must be regarded in the light of a food. It is best given in combination with Malt Extract.