accompanied by an elevation of
temperature, is more or less strained; this is particularly true in
tonsillitis, diphtheria, etc.

~The Kidneys~ are likewise taxed in certain diseases, even when the
fever is not great or lasting; this is found to be the case in scarlet
fever, tonsillitis, etc.

~Dietetic Treatment~ consists in giving no food for a period lasting
from twenty-four to forty-eight hours. This is followed by a liquid
diet, milk and broth particularly, which is continued as long as the
fever remains.

~Convalescent Diet~ is instituted as soon as the fever has disappeared
and acute symptoms subside.

~Thirst~ is apt to be great with any elevation of temperature. It is
relieved by water, crushed ice, and fruit beverages.

~The Mouth~ requires much care, even in fevers of short duration. A
simple antiseptic wash should be used several times each day.

~Nitrogen Equilibrium~ is not sufficiently disturbed in such cases to
require taking into account. Should the disease, however, develop
into one causing a material breaking down of the body tissues,
measures must be instituted to prevent the upsetting of the nitrogen
balance in the body.

PROBLEMS

(a) Outline the dietetic treatment for malarial fever.

(b) Outline a diet order, using liquids only. Show method of
reinforcing this diet.

(c) Show how the solids are added as convalescence progresses.

FOOTNOTE:

[95] In scarlet fever and other conditions in which the kidneys may be
involved the above diet is not given unless advised by physician in
charge.

CHAPTER XIV

TYPHOID FEVER

~Definition.~--Typhoid fever is an acute infectious disease excited by
specific bacteria (Eberth). The intestines become the seat of
ulcerations (Peyer's patches), which at times perforate. The chief
symptoms of the disease are fever, headache, abdominal distention and
tenderness, more or less diarrhea and a rose-colored abdominal rash.
The source of infection is found in the intestinal contents of a
typhoid fever patient, which in some way come in contact with and
infect drinking water, milk, etc.

~Energy Expenditure in Febrile Conditions.~--In febrile conditions the
energy expenditures increase as much as twenty-five per cent. In some
cases, and when bacterial activity is added to this, as is the case in
typhoid fever, the tissue waste becomes correspondingly greater; hence
the nutrition assumes the chief role in such cases, for in no other
way can