Medicosnext
Every time I fell ill when I was a child, my aunt fed me only boiled parwal, toast, and milk. That was her standard diet for the sick and the convalescent. It must have worked, since I always recuperated quickly. And, being a firm believer in wisdom of the ages, today I was thrilled to come across an authoritative article titled, “Diet for Convalescent and The Aged”, by Cecil Bull, M.R.C.P. (Physician and Hon. Radiologist, Royal Waterloo Hospital; Physician, Ear, Nose and Throat Hospital, Golden Square; Hon, Radiologist, New General Hospital, Southend), which was published in the Post Graduate Medical Journal in February, 1935!
In it, the good doctor writes, “”Convalescent” is a wide term with a different significance to the lay and the medical minds…It is not possible to say that there is any diet, any treatment or any prognosis for a convalescent patient except in terms of the disease from which he has been suffering,” and he mentions three types of convalescence: 1. Convalescence from accidents and general febrile illnesses (exanthemata, common colds, influenza, tonsillitis, etc.) 2. Convalescence from illness and disease affecting the alimentary tract, and 3.Convalescence from diseases affecting other systems.
For the first, he recommends milk in the early stages. Proteins (eggs, fish, meat) are to be introduced gradually and in small quantities, and simple cereals (flour, oatmeal, rice) should be the main carbohydrate element. Any vegetable, as long as it is well cooked, is fine, and grapes are allowed, as is orange juice. And (surely because it wasn’t a taboo subject then), “Smoking is so closely associated with meals as almost to belong to a dietary. Smoking satisfies a desire to be restless and therefore has a psychological value which offsets any theoretical harm it may do to the gastric juices.” What about liquor? Well, “Alcohol is the promise for when he is cured,” he declares.
The second type, that is, “Convalescence from diseases of the alimentary tract”, he divides into two groups—non-specific diseases and specific infections, the principal members of the first being gastric and duodenal ulcer, cholecystitis and jaundice, appendicitis, and diverticulitis, for whom he recommends the same diet. Here, too, milk forms the basis in the early stage (at least a pint daily, up to the end of convalescence), to be given as coffee and milk, cereals and milk, and milk puddings. As for protein, eggs and fish in the early stage of convalescence, with poultry and meat coming in towards the end. While butter, cream, cheese, and olive oil are allowed, no large quantities of animal fat should be added (no fried meat). Well-cooked starch of wheat, rice, and oatmeal are the simple cereals he recommends, and well-cooked vegetables are okay (so, no salads). As for fruit, it is to be given sparingly, because, “The giving of fruit in quantity with the intention of promoting action of the bowels is as unprofitable as it is, in my view, unwise.”
As for diet for convalescence after specific infections of the alimentary tract, he says that the commoner specific infections—gastro-enteritis, typhoid fever, ulcerative colitis, and dysentery—are all due to bacterial poison introduced with the food. (“The exception being ulcerative colitis for which no definite organism has been isolated, but since it behaves like these diseases and the dietary treatment is similar it is included in the list.”).
The doctor writes, “In the dietary treatment of these diseases animal protein is excluded, and in the diet of convalescence our chief concern is to re-introduce protein with such care and watchfulness that we do not start a relapse,” which is why the diet for this group consists mainly of carbohydrates of all forms (cereals, vegetables and salads, fruits and fruit-juices), and “Sugar is good for them; alcohol in any form may be taken.” As far as protein is concerned, he writes, “We must be guided by the patient’s reactions…Begin with an egg; add two eggs and then three…add fish, and so on, gradually to meat…”. For convalescence from diseases affecting other systems (e.g. diabetes mellitus and diseases of the blood, renal, and cardiovascular systems), he writes that since it is a large and diverse group, where classification under one heading is not possible, the diet will be a continuance of whatever had been prescribed during the acute stage of the disease.
The doctor’s worldly wisdom is evident from the following excerpt: “Sufferers from cardiovascular diseases are frequently fond of and connoisseurs of alcohol, and to deprive them forever of alcohol removes something essential to their physical and psychical well-being; they no longer have the same interest in life or the same community of interest with or for their own particular friends…Harsh measures and alarming words make their joyful spirits miserable and our commendable efforts may actually shorten the life we are trying to prolong. “Uplift” is all very well, if you catch your victim young, but in these cases we are about 40 years late and dealing with the battered wreck of heart and arteries supporting the frame of established habits. Take care lest in our solicitude for the arteries we destroy the frame. It is better to insist on moderation than to force a fellow creature to embrace the fiery cross of abstinence.”
Reference: https://pmj.bmj.com/content/postgradmedj/11/112/77.full.pdf
