i grapefruit . .
legg . . . .
1 slice bread . .
Coffee or tea .
20 gm.
180 gm.
90 gm.
100 gm.
100 gm.
6.3
1.6
4.1
.2
5
10
20
59
48
Total for meal .
Dinner :
Tomato bouillon
Whitefish . .
Boiled onions . ,
Bran muffin (1)
Tea or coffee . .
6.9
2.2
2
1.5
5
4.3
.23
.8
7
15
2.6
6
7.5
45,
107
16
28
101
Total for meal .
Supper :
^egg
Tomato (baked)
Bran muffin (1) .
Tea or coffee . .
?5.7
5.2
.6
1
16.^
4.1
5
^0.5
2
7
328.
5a
10
101
Total for meal .
Total for day . .
6.8
38.4
9.1
29.6
9
44
170
513
Digitized by
Google
378
DIETETICS FOR NURSES
Fifth Day
Protein
Gm.
Fat
Gm.
Carbo-
hydrate
Gm.
Calories
Breakfast:
J grapefruit . . .
Broiled tomato . . 100 gm.
Tea or coffee . .
1.6
5
3
20
18
Total for meal . .
Dinner :
Broth .... 120 c.c.
Lettuce .... 50 gm.
Cauliflower . . . 90 gm.
Tea or coffee . .
1.5
3
.6
1.5
.4
8
1.6
3.9
38
12
8
25
Total for meal . .
Supper:
1 egg
String beans . . 100 gm.
Celery .... 50 gm.
Tea or coffee . .
5
6.36
2
.5
7.85
14.3
.4
4.16
6.4
5
1.5
45
59
28
8
Total for meal . .
Total for day . .
4.16
12.5
6.5
19.9
85
168
Sixth Day
Protein
Gm.
Fat
Gm.
Carbo-
hydrate
Gm.
Calories
Breakfast :
Asparagus tips . . 60 gm.
Spinach .... 60 gm.
Tea or coffee . .
1.5
1.1
1.8
3
1.8
18
32
Total for meal . .
Dinner :
Stewed celery . . 100 gm.
String beans . . 50 gm.
Tea or coffee . .
2.68
1
1.5
1.8
.10
5.8
2.1
2.5
50
15
16
Total for meal . .
Supper :
Beet tops . . . 75 gm.
Onions (boiled) . 75 gm.
Tea or coffee . .
2.5
1.5
1.5
.1
.3
5.6
2.6
7.5
31
16
44
Total for meal . .
Total for day . .
3
11.2
.3
2.2
10
21.4
60
141
Digitized by
Google
DIABETES MELLITUS 379
FAST
Method of Administering Treatment. — In many cases
the patient is first put to bed during the starvation treat-
ment, but recently Dr. Allen has emphasized the value of
exercise, claiming that it assists in utilizing the sugar. In
any case, the starvation regime remains the same. The
patient is given only coflfee or clear broth with or without
whisky (one ounce every two hours) and the treatment con-
tinued from one to four days, or until the urine becomes
sugar free.*
It has rarely been found necessary to continue the fast
longer than four days, since in most cases the sugar de-
creases rapidly upon the discontinuance of food.
Loss of Weight. — The slight loss of weight, which may
be noticeable as the result of starvation, is not undesirable,
especially in those cases where obesity is a prominent fea-
ture. In fact care must be exercised in the follow-up treat-
ment to prevent the taking on of weight by the diabetic
individual, since, according to Allen, it is often found that
even moderately obese patients (180 lb.) continue to ex-
crete a small amount of sugar so long as they hold this
weight, even upon a low carbohydrate diet, whereas those
same patients show no difficulty in becoming sugar free if
the weight is reduced by ten or fifteen pounds.
SCHEDULE FOR TREATMENT AND METHODS OF DETERMINING
FOOD TOLERANCES
A number of schedules have been devised to enable the
nurse successfully to carry out the Allen Treatment. In
following out this treatment and reeducating the organs
afterward to tolerate foods which they have been unable to
handle on account of the impairment of the sugar-making
*The giving of coffee or clear broth, with or without whisky, does not
materiallv affect the starvation and serves to make the patient more
comfortable during this trying period.
Digitized by CjOOQIC
380 DIETETICS FOR NURSES
organs, it is necessary to make a series of tests whereby the
diet is gradually increased in its various constituents until
the diabetic patient is able to handle a reasonable amount
of carbohydrates as well as other foods which have given
more or less trouble in the past.
The following schedule, after Joslin,' is included, and a
careful study of it is advised in order that the nurse may
intelligently carry out the Allen Treatment.
Schedule. — Fasting in many cases begins at once and
the patient experiences no ill eflfects from it. However, in
severe, long-standing cases many patients do better if the
fats are omitted at once and the rest of the diet left un-
changed for two days. Then the proteins in the diet are
omitted and the carbohydrates cut in half. This halving
of the carbohydrates is continued daily until only 10 grams
remain, after which they too are omitted. The fast is thus
made complete and remains so until the urine is entirely free
from sugar.
Carbohydrate Tolerance is determined by giving, as
soon as the urine has been sugar-free for twenty-four hours,
150 grams of 5% vegetables. This is equivalent to from 8
to 10 grams of carbohydrates. After this 5 grams of carbo-
hydrates, or 75 grams of 5% vegetables, are added daily to
the diet until the patient is taking 20 grams. Then the ad-
dition of 5 grams of carbohydrates is made every other day,
using the fruits and vegetables belonging to the 10% and
15% ciarbohydrate group, until potatoes and oatmeal and
finally bread can be tolerated unless sugar appears in the
urine before this or the tolerance reaches 3 grams to each
kilogram of body weight or, in other words, until a man
weighing 150 pounds is consuming 225 grams of carbohy-
drates per day.
•Dr. Joslin has given a very complete schedule in his "Treatment of
piabetes Mellitus^" from, whicb. the ^bove schedule is taken.
Digitized by VjOOQIC
DIABETES MELLITUS 381
Protein Tolerance. — In making the test for the protein
tolerance it is necessary to wait until the urine has been
sugar free for forty-eight hours; 20 grams of protein is then
given. This is equivalent to 3 eggs, and daily additions of
5 grams protein are made, usually in the form of meat, until
the patient is receiving 1 gram of protein to every kilogram
of his body weight per day unless his carbohydrate tolerance
is zero, in which case it is wise to add only three-fourths of a
gram of protein per day.
Fat Tolerance, — A determination of the fat tolerance
is made coincidently with that of the protein. No addi-
tional fat is allowed until the protein tolerance reaches 1
gram per kilogram of body weight, unless the patient's
tolerance for protein is less than that. After which 25 grams
of fat per day are added until there is no further loss of
wei^it, taking care never to allow more than 40 calories per
kilogram of body weight.
Reappearance of Sugar. — Should the urine again show
the presence of sugar, another period of fasting lasting for
twenty-four hours, or until the urine is again sugar free,
must be instituted. After the second fast the increase in the
diet may be twice as rapid as used after the first fast. How-
ever, it is not advisable to increase the amount of carbo-
hydrates to more than half of that determined by the former
tolerance for a period of two weeks, during which time the
urine has been entirely sugar free, then the increase is made
more slowly and the amount given should not exceed 5
grams a week.
Weekly Fast Days. — One day in seven should be set
aside by the diabetic patient for fasting, when the carbohy-
drate tolerance is less than 20 grams. When, however, the
tolerance is between 20 and 50 grams of carbohydrates, the
patient may take one-half of his daily allowance of protein
and fat and a certain amount of 59^? vegetables as well upon
Digitized by CjOOQIC
382 DIETETICS FOR NURSES
the weekly faBt day. When the tolerance reaches between
50 and 100 grams per day, vegetables of a hi^er carbo-
hydrate content may also be included. If the carbohydrate
tolerance should exceed 100 grams per day, the carbohy-
drates upon the fast day may be simply half of the amount
allowed upon other days.
The Giving of Alkalies. — If acidosis is evident, as may
be indicated by an excretion of diacetic acid, oxybutjric
acid, or acetone in the urine, alkalies may be given. Bicar-
bonate of soda may be given in doses of 2 grams every 3
hours, as suggested by Hill and Eckman,^ but this is not as a
rule necessary, for, as Jacobi aptly remarks: " Prevention is
the treatment of acidosis in children, and those susceptible
to acidosis should not have fat/' What he has said for chil-
dren holds good for adults. However, it is likewise true that
fat must constitute a large part of a diabetic diet and the
only way to prevent it poisoning, is to raise the fat in the
diet gradually until the tolerance is determined.
Determining the Extent of Acidosis. — It will be re-
membered that in an earlier chapter it was found that the
excretion of ammonia in the urine to a certain extent indi-
cated the extent of the acidosis in the body, that is, if the
ammonia output exceeds three or four grams a day (twenty-
four hours), the extent of the acidosis is considerable, while
if it falls below that amount it is not alarming. More exact
methods, however, for the determining of the severity of
the acidosis will be found in another part of this text, where
the test for sugar and the acetone bodies will be explained in
detail.
Dietetic Treatment. — The patient is placed upon a
vegetable diet consisting of vegetables containing not more
than five per cent, carbohydrate.® These vegetables have
their carbohydrate content still further reduced by changing
*Hill and Eckman's ''Starvation (Allen) Treatment of Diabetes."
■See 6% vegetable, p. 383.
Digitized by CjOOQIC
DIABETES MELLITUS
383
the water in which they are cooked three times. In many
cases this will reduce their content as much as one-half.
A small amount of fat usually in the form of butter is
allowed with these vegetables. The amount of 5% vege-
tables given must be carefully adjusted since the patient
might readily take too much if allowed to follow the dictates
of his appetite.
The carbohydrate intake during the first one or two days
must be limited to 15 grams. This allows about 10 grams
of protein, 7 grams of fat, and 15 grams of carbohydrates.
Tea or coffee, without sugar or cream, may be given at each
of the three meals.
The following table is included, showing the various
foods arranged according to their carbohydrate content:
TABLE*
Stwot Diet
Meats, fish, broths, gelatin, eggs, butter, olire oil, coffee, tea, and
cracked cocoa.
Foods arranged approximately according to per cent of carbohydrates
6%
10%
16%
Pumpkin
Greens
Turnip
Peas
Kohl-rabi
Ajrtichokes
Squash
Parsnips
Beets
Lima beans
Carrots
(canned)
Onions
Mushrooms
20%
'g Lettuce
g Cucumbers
e Spinach
Asparagus
^ Rhubarb
'^ Endive
t Marrow
^^ Sorrel
§ Sauerkraut
S Beet greens
<§ Dandelion
g> Swiss chard
t:^. Celery
Brussels sprouts
Water cress
Sea kale
Okra
Cauliflower
Eggplant
Cabbage
Radishes
Leeks
String beans
Broccoli
Tomatoes
Potatoes
Shell beans
Baked beans
Green corn
Boiled rice
Boiled maca-
roni
Prunes
•Table used by Dr. Joslin in his treatment of diabetes mellitus. It is
convenient, and many changes in the diet may be made by substituting
one food for another of like carbohydrate content. This table can be
purchased on cards from Thomas Groom & Co., Boston, Mass.
Digitized by
Google
384
DIETETICS FOR NURSES
TABLE— Continued
5%
10%
16%
20%
Ripe olives
(20% fat)
Lemons
Apples
Plums
Grapefruit
Oranges
Cranberries
Black-
Pears
Apricots
Blueberries
Bananas
13b,
berries
Cherries
Goose-
Currants
berries
Raspberries
Peaches
Huckle-
Pineapple
berries
Water-
melon
Butternuts
Brazil nuts
Almonds
Peanuts
Pignolias
Black
English
40%
^
walnuts
walnuts
Chestnuts
>.
Hickory
Pecans
Filberts
Beechnuts
Pistachios
Pine nuts
C Unsweetened and unspiced
'£ pickle, clams, oysters, scal-
^ lops, liver, fish roe.
Reckon available carbohydrates
in vegetables of 5% group as 3%,
of 10% group as 6%.
30 grams (1 oz.) contains approximately
Protein
FaJt
Carbo-
hydrate
Om.
5
2
20
6
3
8
5
0.7
1
6
5
15
1
12
1
1
6
1
1
1
1.5
8
18
25
6
6
5
20
2
10
0.5
lor2
6
1
4
Caloriea
Oatmeal, dry weight ....
Meat (uncooked ham) .
Meat (cooked ham) ....
Broth
Potato
Bacon
Cream, 40%
Cream, 20 /o
Milk
Bread
Butter
Egg (one)
Brazil nuts
Orange or grapefruit (one)
Vegetables, 5% and 10% groups
Oysters
110
50
75
3
25
155
120
60
20
90
240
75
210
40
6 or 10
50
Digitized by
Google
DIABETES MELLITUS
385
TABLE"
Caiboliydrate equivalent of 1 slice of white bread (1 oz. or 30 gm.)
containing approximately 16 gm. of starch
Vncoohed
Household
Gm,
Cooked
Household
Om.
Flours, etc.
Measure''
Vegetables
Measure
Barley
1 h. tbs.
21
Artichokes .
i medium
320
Buckwheat
1 h. tbs.
19
Beans (baked
Com meal
1 h. tbs.
20
canned) .
2h.tb8.
76
Farina .
1 h. tbs.
20
Beans, lima .
li tbs.
50
Hominy .
1 h. tbs.
18
Beets . .
6 tbs.
200
Macaroni
1 h. tbs.
20
Carrots . .
13 tbs.
446
Noodles .
l}4i.tbs.
20
Okra . .
4 tbs.
200
Oatmeal .
1 h. tbs.
22
Onions . .
3 tbs.
300
Rice . .
1 h. tbs.
18
Parsnips
4 slices
120
Rye flour
1 h. tbs.
18
Peas, green .
3h.tbs.
100
Spaghetti
li tbs.
20
Potatoes
Vermicelli
li tbs.
21
(baked) .
i medium
60
Wheat flour
Itbs.
20
Potatoes
(boiled) .
} medium
70
Potatoes
(mashed) .
li h. tbs.
80
Potatoes, sweet
(boiled) .
i medium
35
Squash . .
2 h. tbs.
100
Turnips . .
3
210
Bread and
Cooked Cereal
Crackers
Force . .
5h.tbs.
18
Bread .
1 slice
80
Farina . .
2i h. tbs.
125
Breakfast bis
-
Grape-Nuts .
li h. tbs.
20
cuit, Huntl,
y
Hominy . .
li h. tbs.
90
and Palme
r 3
18
Macaroni
2 h. tbs.
100
Com bread
1 slice
32
Oatmeal . .
2i h. tbs.
130
Roll, Vienni
i 3
18
Rice . . .
i h. tbs.
60
Zwieback
IJ
20
Shredded
Fruits
wheat
Apple
1 medium
120
biscuit
I .
22
Apricots .
2 large
120
Dried Fruit
Banana (wit
h-
Apples . .
3 small
22
out skin)
i medium
75
Apricots . .
3 large
24
Cherries .
90
Currants
li h. tbs.
20
Currants
6 h. tbs.
120
Dates . .
3
19
Grapefruit
\ small
150
Figs . . .
1 large
12
Huckleberrie
s H tbs.
90
Pmnes . .
2 large
24
Lemons .
2 medium
210
Raisins . .
10 large
23
'Table devised by H. O. Mosenthal showing accessory diets rich in
carbohydrates. ''Medical Clinics of North America," July, 1917.
^"h'' represents household measure
Digitized by
Google
386
DIETETICS FOR NURSES
TABLE —
Continued
Fruits
Household
Measure
Gm.
Milk and
Cream
Household
Measure
C.C.
Muskmelon .
i
300
Buttermilk .
li tumbler
300
Nectarine .
1
100
Cream, 16%
1 J tumbler
300
Olives (green)
20
180
Cream, 40%
li tumbler
300
Orange . .
i large
150
Koumiss . .
1 J tumbler
300
Peaches . .
IJ medium
150
Whole milk .
11 tumbler
300
Pear . . .
1 small
100
Nuts
Grams
Pineapple
3 slices
150
x\lmond8
60
90
Plums
3 medium
75
Brazil . .
30
180
Raspberries .
41 h. tbs.
120
Chestnuts
Strawberries
8 h. tbs.
200
(roasted) .
15
40
Watermelon
large slice
300
Cocoanut
1 slice
(3X2 in.)
50
Filberts . .
100
110
Peanuts . .
40
80
Pecans . .
35
110
Pistachios .
190
95
Walnuts . .
30
125
TABLE "
Caloric equivalent of 10 gm. steak in carbohydrate-free
meat
or fish
Food
Gm.
Fat
Gm,
Protein
Gm,
Calories
Steak
10
1.0
2.4
19
Roast beef
5
1.4
1.1
18
Tongue .
7
1.4
1.6
20
Lamb chop
5
1.5
1.1
18
Roast lamb
8
1.3
1.6
20
Sweetbreads
11
0.1
4.4
19
Boiled ham
7
1.4
1.5
19
Fried ham
5
1.7
1.1
20
Roast pork •
9
0.9
2.6
19
Bacon
9
1.7
0.9
20
Chicken . .
10
1.0
2.4
19
Duck . . .
9
1.3
1.8
19
Guinea hen
12
0.8
2.8
19 .
Squab
9
1.1
2.1
19
Turkey . .
7
1.3
2.0
20
Bluefish . .
13
0.6
3.5
20
Halibut .
16
0.7
3.3
20
Mackerel .
15
1.0
2.5
20
Sardines in oil
7
1.4
1.6
20
"Mosenthal: "Medical Clinics of North America," July, 1917.
Digitized by
Google
DIABETES MELLITUS 387
Approximate equivalent in 30 c.
containing 2 per cent
c. (1 oz.) of whisky in liquors
or less of carbohydrates
C.C.
Household
Measure
Gin, rum, brandy
Claret, Burgundy Hock, Rhine
and Moselle wines ....
30
130-160
2 tbs.
i tumbler
CARBOHYDRATE-FREE MENUS
The following menus are suggested as meeting the carbo-
hydrate-free diet requirements with a nutrient value of
from 200 to 500 calories:
Breakfast — Black coffee (cream, 20 c.c.) 1 qq gr^rns
Bacon, 2 slices (1 oz.) J '
Egg— 1
Dinner — Broth, 6 ounces 180 grams
Steak, 1 small piece, 1% oz. . . . 40 grams
Stewed tomatoes, 3% oz. . . . 100 grams
Lettuce (lemon juice and olive oil) 25 grams
Supper — Broth 180 grams
Whitefish 40 grams
Spinach 100 grams
Cabbage salad 100 grams
Coffee
Breakfast — i/^ grapefruit
legg
Bacon 40 grams
Coffee 50 grams
Cream 20 c.c.
Dinnw — Broth 180 c.c.
Kohl-rabi 100 grams
Lettuce 25 grams
Cheese salad 50 grams
Roast beef 40 grams
Coffee
Butter 5 grams
Digitized by CjOOQIC
38S
DIETETICS FOR NURSES
Supper — Cold chicken 25granis
Baked tomatoes 100 grams
Water cress 50 grains
Coffee
Cream 20c.c.
Butter 5 grams
TABLE
Material
Measure
Pro-
tein
Om.
Fat
Carbo-
hydrate
Om.
Calories
Apple
Almonds " . .
Apricots (dried)
Asparagus . .
Baoon (raw)" .
Bacon (cooked)^
Beef juice**
Beef roast"
Cheese " . .
(Neufchatel)
Cream, gravity
16% . . .
Cream, 40% .
Cracker (Uneeda
biscuit) .
Dry peptonoids'
Egg ....
Fowl . . .
Grapefruit . .
Ham (lean)
Lemon juice" .
Lemon Jelly " .
Milk (whole) .
1 medium
(150 gm.)
10 small (10 gm.)
1 oz. (30 gm.)
6 large stalks
(74 gm.)
4 slices, 6 in. long,
2 in. wide
4 slices, 6 in. long,
2 in. wide
100 gm.
IJ in. X i in.
1 cheese 2J in. X
IJ in. X IJ in.
1 glass (7 oz.)
30 c.c. (2 tbs.)
1 biscuit
Itbs.
1 medium (45 to
50 gm.)
3ioz. (lOOgm.)
i
50 gm.
3 tbs. (43 gm.)
3oz. (90 gm.)
1 glass (8 oz.)
240 c.c.
.5
2
1.5
1.3
10
10
4.9
6
16
.6
1
6
54
19.3
12.4
2.6
7.9
.28
.14
64
32 to 46
.6
7
23
32
12
16
17.5
2.5
.5
4.2
16.3
7.1
9.6
10
1
1
8
4.2
1.4
10
70
63
78
16
636
388 to 468
25
89
284
359
114
16
57
60
224
20
113
19
16
158
""Starvation Treatment of Diabetes," by Hill and Eckman.
""Practical Dietetics," by Alidia Pattee.
""Food for the Sick," p. 62, by Strouse and Perry.
"Sweetened with saccharin.
Digitized by
Google
DIABETES MELLITUS
TABLE— Continued
389
Pro-
Carbo-
Material
Measure
tein
Fat
hydrate
Gm.
Om,
Gm.
Calories
Oatmeal" . .
1 tbs. (50 gm.)
1
6
33
Oatmeal
i cup (3.6 oz.)
2.1
.1
8.2
50
Potato" (size
large egg)
KlOOgm.)
2
.8
83
6% vegetable "
uncooked
Itbs.
2.5
10
6% vegetable
(boiled once)
Itbs.
1.7
7
6% vegetable
(boiled thrice)
Itbs.
1
4
Orange . . .
1 large
1.7
.2
22.7
100
Orange" . .
1 medium
1
13
57
Increasing the Diet. — The following menus show the
manner in which the diet is increased after the starvation
treatment:
First Day
Approximately 150 grams of vegetables with tea or cof-
fee; value: protein 2, fat trace, carbohydrate 4.
Breakfast — String beans 20 grams
Celery hearts 20 grams
Lunch — Spinach . 25 grams
Lettuce 25 grams
Supper — Tomatoes 25 grams
Cucumbers 25 grams
Second Day
Three eggs, 150 grams of 5% vegetables, tea or coffee;
value approximately: protein 18, fat 12, carbohydrate, 4,
calories 198.
""Starvation Treatment of Diabetes," by Hill and Eckman,
Digitized by
Google
390 DIETETICS FOR NURSES
Breakfast — 1 poached egg
Spinach or beet tops 50 grains
Coffee or tea
Dinner — 1 hard-cooked egg
String beans 25 grams
Lettuce 25 grams
Tea
Supper — 1 soft-cooked egg
Asparagus tips 25 grams
Tomatoes 25 grams
Third Day
Approximately 19 grams protein, 15 grams fat, 5 grams
carbohydrate, 230 calories.
Breakfast — 1 egg
String beans 50 grams
Tomatoes 25 grams
Coffee
Dinner — Cauliflower 50 grams
Celery 50 grams
Tea
Supper — Asparagus 75 grams
Lettuce 50 grams
Fourth Day
Approximately 26 grams protein, 15 grams fat, 10 grams
carbohydrate, 279 calories.
Breakfast — 1 egg
String beans .... 75 grams
Coffee with cream ... 15 c.c.
Dinner — Tomato bouillon . . . . 6 oz. (180 c.c.)
legg
Asparagus . .... 75 grams
Lettuce 25 grams
Tea
Digitized by VjOOQIC
DIABETES MELLITUS 391
Supper — 1 egg
Celery 50 grams
Cauliflower 100 grams
Fifth Day
Approximately 20 grams protein, 46 grams fat, 15 grains
carbohydrate.
Breakfast — Egg omelet (1 egg)
Butter 10 grams
Vegetable hash 100 grams
Coffee or tea
Cream 15 grams
Dinner — Chicken broth 180 c.c.
1 poached egg
Tomatoes 100 grams
Tea
Supper — 1 soft-cooked egg
Spinach 100 grams
Cucumbers 50 grams
Tea or Coffee
Cream 15 grams
Sixth Day
Breakfast — y^ grapefruit
legg
Butter 5 grams
Spinach 50 grams
Coffee
Cream 15 grams
Dinner — Broth 180 grams
Fish 50 grams
String beans 100 grams
Lettuce 50 grams
Asparagus 50 grams
Digitized by CjOOQIC
392 DIETETICS FOR NURSES
Supper — 2 eggs
Tomato, baked (1 medium) . . 75 grams
Cabbage salad 75 grams
Tea
Cream 15 grams
Approximately 33 grams protein, 35 grams fat, 12 grams
carbohydrate, 495 calories.
Seventh Day
Breakfast — ^ grapefruit
2 ^gs
Butter 10 grams
Cofifee
Cream 15 grams
Dinner — Beef broth 180 grams
1 lamb chop 50 grams
Cauliflower 100 grams
Tomato 150 grams
Lettuce 50 grams
Butter 10 grams
Supper— 1 egg
Tuna salad 50 grams
String beans 100 grams
Butter 5 grams
Tea
Approximately 38 grams protein, 45 grams fat, 17 grams
carbohydrate, 625 calories.
Eighth Day
Approximately 32 grams protein, 16 grams fat, 20 grams
carbohydrate, 625 calories.
Breakfast — 1 egg
String beans 100 grams
Raw tomatoes 100 grams
Coffee
Cream 15 grams
Digitized by CjOOQIC
DIABETES MELLITUS 393
Dinner — Chicken 50 grams
Cabbage 100 grams
Asparagus 100 grams
Water-cress salad 50 grams
Tea
Supper — 1 egg
Greens 100 grams
Celery salad 50 grams
Tea
Cream 15 grams
The following menus are used after the diet has been
more or less increased :
First Day
Breakfast — 1 soft-cooked egg
2 slices of bacon
1 bran muffin, 5 gm. butter
Coffee with 15 c.c. of 40% cream
Lunch — 6 oz. tomato bouillon
2 oz. (60 gm.) roast lamb
60 gm. string beans
50 gm. lettuce and celery salad
25 gm. lemon jelly with 15 gm. cream
Dinner — 60 ^m. chicken
75 gm. asparagus
4 olives
50 gm. cauliflower
30 gm. ice cream
1 Lister roll, 5 gm. butter
Black coffee
Second Day
Breakfast — i/^ grapefruit
1 scrambled egg
1 Lister roll, 8 gm. butter