When swallowing is impossible we have to resort to the stomach tube, introduced either through the mouth or the nose, through which we slowly pour the food-mixture (milk, cream, egg) and perhaps occa sionally one of the preparations like sanatogen, malt tropon, somatose, etc.
b. Diseases of the stomach demand, as a rule, that food should be given by mouth as sparingly and as rarely as possible. It should be liquid and mostly cool or cold, principally thick soups, gruel and tea. During convalescence the appropriate food should be given at first strained and later, as healing progresses, minced. Liquids are not borne well and we should therefore give the water by rectum or hypodermically as physiological salt solution (NaCl 7.5 Gin., KCI 1 Gm., CaCI .2 to 1 litre of water). Frequent moistening of the mouth and tongue with a soft cloth or a swab (with water or lemonade) or melting small pieces of ice in the mouth (the liquid must be ejected) often quiets the torturing thirst. In disturbances of the secretions of the stomach (hyperacidity, hypoacidity) the diet must conform to the pathological condition, and likewise in ulcer of the stomach.
c. After operations and sometimes after severe diseases of the stomach, after operations on or diseases of the intestine (principally ulcers) and the peritoneum, direct feeding is at times entirely stopped and we feed per rectum. We first cleanse the rectum with water, then introduce, an elastic tube for about 10 to 1.5 cm. and let the food run in through a funnel attached to the tube or, as some prefer, inject it with a syringe. The nutritive enema should be lukewarm and should consist of 50 to 100 or 150 c.c. of egg in milk or cream with from 5 to 10 per cent. of sugar and 1 per cent. of salt. Otherwise the diet for these troubles should be identical with that for diseases of the stomach: we must feed as little and as rarely as possible; everything which might irritate (spices, cellulose, seeds and skins) mast be absolutely avoided and everything should be given as finely divided as possible (either strained or minced).
(1. Diseases of the kidneys demand a diet free from all irritating spices; at times the salt in the food must be reduced or avoided altogether. We will discuss particulars later, but here we will only state that a diet of plain milk cannot be regarded as a diet of rest, owing to the unfavor able proportions of the proteids to the nitrogen-free substances, and we therefore recommend the addition of cream and carbohydrates.
3. Stimulating frequently need a diet, which increases the action of a sluggish intestine, especially in chronic constipation which is mostly found in the petted children of the rich: according to A. Schmidt it is due to a lack of stimulation of the intestine. The scybala are hard and not sufficiently voluminous to excite energetic peristalsis. In some cases of anemia and chlorosis and of lack of appetite a system of harden ing the intestine by demanding more labor from it proves beneficial. We give a diet rich in cellulose by increasing the amount of green vege tables and especially green salads, we give the legumes with the shells, the different kinds of berries, and instead of zwiebach, toast and white bread, we give rye bread and bread made of the whole grain with the bran. We must then usually reduce the amount of milk or we replace it by giving buttermilk, sour cream, koumiss, kefyr and other like prepara tions.
1. The Dietetic Regulation of the amount and condi tion of the stools depend upon the quantity and quality of the food, how it is disposed of in the intestinal tract, and upon the condition of the latter. The diet we have given so far should neither increase nor decrease the number of stools and if this should happen we are neverthe less easily able to regulate it in dither direction by our dietetic orders. We have mentioned above how we overcome constipation. The fat in the food can be increased (butter, olive oil in salad, cream, etc.) but we must naturally guard against overfeeding. We give considerable fruit (inclusive of nuts, filberts and almonds) and vegetables rich in cellulose, even an increase in the amount of potatoes may 11(.11) rapidly. On the contrary, or prohibiting these things will reduce the number of stools and may even allay diarrhea : for this we also make use of the inhibitory action on the of tannic acid. is for instance, in the strained juice of black-berries (the shells awl seeds accelerate the stools, (see recipe 17, p. Milk has often a constipating action.