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The Feeding of Invalids
It is a truism to say that the proper feeding of the invalid is one of the most important means of restoring him to health.
There are one or two preliminary points to be noticed in regard to the diet of the sick room. First of all, scrupulous cleanliness must be preserved; secondly, no cooking must be done in the room itself, and no food or utensils must be left there after the patient has finished; thirdly, nothing must be given but what the doctor orders; and fourthly, the meals must be served at regular intervals. It should be remembered that, in the case of invalids, the smallest details are as important as general principles. The best nurse is she who not only knows these details, but takes a pleasure in carrying them out. It is important, as far as possible, to humour the patient's likes and dislikes. It is thus useful to have at one's command more ways than one of preparing a dish. If beef tea, for instance, is repugnant in one form, it may be acceptable in another. If the invalid who is ordered a milk diet cannot take milk pure and simple, he may be induced to take it under some tempting disguise. A patient should never be forced to take anything he does not like. Beef tea may be considered the staple article of invalid dietary. There are many methods of making it, but the following is the best for the sick room. Take a pound of the best rump steak, free it from fat, chop or cut it into very small pieces, place these in an earthenware jar to which there is a lid, pour half a pint of cold water over them. Put the lid on the jar, and let it stand for three hours. By this time all the parts of the meat that are soluble in cold water will be extracted. Pour off the fluid into a jug, cover it, and place it on one side. Then pour another half-pint of water over the cubes of meat, and heat it up to 160 deg. Fahr., and keep it at that temperature for three more hours. Then pour off this fluid into the jug in which the cold extract is, and you have all the nourishing material that can be drawn from the meat by warm water. Next, pour another half-pint of water over the meat, bring it gradually to boiling point, and keep it simmering at that point for three hours, then add it to the previous solutions. You have now all that can be extracted from the meat by cold, warm, and boiling water. Heat it up as required, unless it is ordered to be taken cold.
That is the most perfect way of preparing beef tea, but, as will be noticed, it takes nine hours to accomplish. Often it is necessary to make it in a much shorter time. Here is a recipe which will give a good beef tea in about half an hour. Take half a pound of rump steak, free it from fat, chop it up or scrape it into very fine pieces, and place them in a jar. Pour half a pint of cold water over them, and let them stand five minutes, stirring meanwhile, and adding a little salt. Tie a paper cover over the top, place the jar in a saucepan of warm water, put it over a very slow fire, bring it gently to boiling point, and keep it simmering for half an hour. Strain it, and use immediately.
From beef tea to broths is but a step. Those chiefly used are made from mutton, veal, or chicken, the last being generally preferred. One of the best ways of making chicken broth is to put the half of a young tender fowl into a saucepan, with salt and pepper to taste. Pour over it a pint of cold water, and simmer gently for an hour and a half, skim carefully while simmering, strain it, and put it away into a cool place until wanted. Heat up the quantity required, and before serving remove all fat. For mutton broth the scrag end of the mutton is generally used, while for veal the knuckle is the best part to employ. To make about a quart of broth put into a saucepan one pound of meat with three pints of water. Add pepper and salt, a turnip, an onion, a bunch of herbs, and some barley, and bring the whole gently to boiling point, skimming carefully all the time. Then put the lid upon the saucepan, and allow the contents to simmer for an hour. Strain, and put aside to cool. When required to be served, heat a sufficient quantity and remove all fat. When allowed by the doctor, a quarter of a pound of mashed potatoes may be added to each pint of broth.
Calf's-foot broth is a very nutritious article of diet for an invalid. A foot should be well cleaned, and allowed to stew very gently in a pan with three pints of water and a slice of lemon, until the bulk of the mixture is reduced to one-half. The liquor is then skimmed and put aside in a jug until it cools. About a pint of the liquor is next warmed up gently and gradually, with a lump of sugar, a small piece of butter, and a little grated nutmeg. Take it off the fire, add to it the yolk of an egg well beaten up, place the pan back on the fire, and warm until the whole begins to thicken. Be careful that the heat does not get to boiling point after the egg has been added. A very nutritious broth may be made from eels in the following manner. Skin and clean an eel, about half a pound in weight; cut it into small pieces and place them in a pan with three pints of water, a small onion, some chopped parsley, and seasoning. Warm it gently until the bulk is reduced one half, carefully skimming all the time. Strain through a hair sieve, and cool. Warm up when wanted, and serve with pieces of toast.
Milk is an indispensable sick-room food, but it sometimes disagrees with delicate stomachs, causing nausea and vomiting, owing to the formation of curd. This may sometimes be overcome by getting the patient to drink it slowly and in small quantities. In other cases it may be necessary to dilute the milk with soda water, lime water, or barley water, in order to ensure its digestion.
When milk in any form is refused by the patient, recourse may be had to one of those malted foods, of which Mellin's may be taken as a type. Arrowroot, too, is a most useful food, which can be prepared simply with boiling water, although it is much more nutritious with milk. The secret of making arrowroot is to see that it is rendered completely smooth and free from lumps by first mixing the required quantity thoroughly with a little cold water. The boiling milk or water is then to be poured over it very slowly, and the whole is to be constantly stirred during the process.
A good gruel should be made from the finest oatmeal procurable, in preference to groats. Mix two table-spoonfuls of the meal with a little cold water, till a perfectly smooth mass is the result. Then pour over it half a pint of cold water, and boil gently. To ensure perfection, about three-quarters of an hour should be allowed to the process. It should then be strained, and sugar or salt added according to taste. Oatmeal may also be usefully combined with beef tea to furnish a most nutritious diet.
Bread and milk forms another pleasant change in the routine of milk diet. Some stale bread should be cut into dice-shaped pieces of uniform size. Scald out a basin with boiling water, and place the pieces in it. Boil the milk, and the moment it boils add it to the bread. A saucer or plate should be placed as a cover over the basin for about ten minutes.
Eggs, as a highly concentrated form of nutriment, may be considered an adjunct to milk diet. They may be taken raw, or beaten up with milk, tea, or coffee, or added to some of the broths already described. The best of all ways of cooking eggs for an invalid, when he is able to take them, is in the form of an omelette.
Cooling drinks form an important item in invalid dietary. In many cases a sick person suffers more from thirst than from the pains of his disease, and it is therefore necessary to have a relay of refreshing drinks at hand. It is a popular idea--for which it is difficult to account--that cold water is harmful to invalids. This is an entirely erroneous belief, and is often the cause of unnecessary suffering. The patient may, in the great majority of cases, be allowed to drink water freely. The water should, of course, be filtered, and freshly drawn from the filter, and it should be slowly sipped, or drunk out of an invalid feeding-cup.
Next to water comes ice, which should be the best and purest obtainable. To keep it properly, wrap the block of ice in flannel, and place it on a piece of wood in a basin. When wanted for use, remove the flannel, and chip off some small pieces. Tie a piece of muslin round the top of a tumbler, so that it may form a pouch, and put the chips of ice in it. Leave the tumbler within easy reach of the patient, so that he may help himself as often as he feels inclined. The water that drips from the muslin bag may also be drunk. Effervescing or aerated waters will often be taken by an invalid in preference to plain water, as being more refreshing. These should always be from a manufacturer of high repute, such as Schweppe--the cheap are never to be depended upon. When a syphon is used, a little of the first water that comes should be thrown away, in case any impurities may lurk in the spout. A very refreshing cooling drink may be made by dissolving half a teaspoonful of cream of tartar in a pint of boiling water, and adding sugar and lemon peel according to taste. When quite cold it is fit for use, either alone or with aerated waters or ice. Another excellent drink is made as follows. Take the juice of six lemons and the thinly-pared rind of two. Add three pounds of loaf sugar, and pour over the whole two quarts of boiling water. After standing an hour or more, strain it, and let it get thoroughly cold before using. Barley water is often prescribed for invalids. Take an ounce of the best pearl barley, and wash it well in several waters. Pour a pint and a half of water over the barley, add the rind of half a lemon thinly pared, and a little sugar. Let it simmer gently over the fire, stirring constantly, until reduced to one pint, then strain it off.
Toast and water is another drink that is frequently ordered by medical men. This is prepared by toasting a slice of stale bread until it is browned all over without being burnt. Pour a quart of boiling water over it, and let it stand till cold; then strain it off into a jug. The flavour of this somewhat insipid drink may be vastly improved by the addition of a roast apple and a little lemon rind and sugar.
Such are the leading principles of invalid dietary, and by bearing them in mind the nurse will be able to vary the preparations of many different dishes so as always to have something tempting and appetising to put before her charge. The recipes of many dishes suitable for invalids will be found in the body of this work under the heading of "SICK, COOKING FOR THE," and the names of others are given in the Classified Index.