diet.

[105] See "High Calorie Diet for Typhoid Fever," Chapter XIV.

CHAPTER XVI

DIETETIC TREATMENT BEFORE AND AFTER OPERATION

PREOPERATIVE FEEDING

The dietetic treatment which is essential before and after operations
is deserving of attention here, since it constitutes one of the points
so frequently overlooked or slighted. As a rule the treatment depends
(1) upon the character of the disease for which surgical intervention
is necessary, and (2) upon the general health and physical condition
of the patient in question.

~Preparatory Treatment.~--In many cases it is found to be advisable to
build up the patient before subjecting her to the shock of an
operation, and the more serious the operation the more necessary this
"building-up" process.

The character of the disease also has much to do with the preliminary
diet. In certain pathological conditions involving the gastro-intestinal
tract, for example, the patient comes to the surgeon after medical
treatment has failed to give relief and surgical intervention is
necessary to save life. The body is found to be in a condition bordering
on starvation, anemic and exhausted from insufficient nourishment. The
functions of the blood-making organs have become out of gear, as it
were, and the blood consequently is deficient in one or more of its
essential elements. For such patients it is wise to attempt to reenforce
and strengthen their bodies before operation, that they may have more
endurance to withstand the shock which is more or less unavoidable.

~Adjusting the Diet.~--In any case where preliminary diet is
prescribed the condition for which the operation is necessary
determines the nature of the diet; for example, if the operation is to
be upon the kidney, the diet beforehand would naturally be in the
nature of a nephritic one to save the diseased organ unnecessary work.
If the stomach or intestinal tract required surgical care, the diet
would necessarily be formulated to meet the particular needs of the
organ in question, an analysis of the stomach content furnishing the
keynote of the diet. In any case the food must be simple in character
and well prepared. All food in any way liable to bring about
indigestion should be studiously avoided.

~Habits.~--The habits of the patient must be regulated so that she may
not "overdo"; at the same time, gentle exercise may be the very thing
needed to give an impetus to the appetite and thus assist in the
a