n the third, and
solid food of the simplest character and prepared in the simplest way
may be given on the fifth and sixth days. When, however, the operation
has been of a more serious character, for example, when there was pus
formation or a gangrenous appendix, the feeding by mouth must not be
instituted for five days or more, nutrient enemas being used instead.
Patients have been known to die from exhaustion after operations upon
the stomach and intestines, not on account of the operation but on
account of the lack of reserve power and endurance to carry them
through the ordeal without a sustaining diet to overcome it. Under the
circumstances Dr. F. Ehrlich[109] advises the following routine
method: "So soon as the nausea from the anesthetic has worn off the
patient gets tea, red wine, and gruel; on the day after the operation
he is given sweetbreads in bouillon even if it nauseates him; if the
nausea is persistent, his stomach is washed. On the second day finely
chopped cooked squab, chicken, or veal, is added; on the third day,
beef, potato puree and cakes; on the fourth, chopped (raw) ham, soft
zwieback, and soft-boiled eggs. On the fifth, white bread and
spinach. After the seventh day the meat is not chopped, and the
patient returns gradually to normal diet. The bowels are regulated by
oil enemas."

~Diet After Operation upon Gall Bladder or Liver.~--The dietetic
treatment in these cases is like that of any other abdominal operation
except for the character of the food. Fats are not well handled by the
body of such individuals and should be eliminated as far as possible
from the diet. Broths must be skimmed carefully to remove fat, and
milk when given should be skimmed or given in the form of buttermilk
or koumiss.

~Diet After Operations upon the Kidneys.~--The diet administered after
operations upon these organs is logically one in which those foods
which are entirely dependent upon the kidneys for their elimination
are restricted. In a former chapter the fate of the foods in
metabolism was explained; the protein foods were seen to be the ones
leaving the body chiefly by way of the kidneys and for this reason in
the diet after operations upon these organs, as well as in that
administered in disturbances affecting their functioning powers, this
food constituent, the protein of meat in particular, must necessarily
be restricted. The upsetting of the nitrogen equilibrium is for so
short a period after kidney op