A Discussion on Foods for Invalids and Infants
Authors: B. Yeo
Journal: BMJ (1889)

IN accepting the invitation you were so good as to address to me, that 1 should open a discussion in this important Section on the subject of foods for invalids and infants, I felt that you had asked me to deal with an unusually wide and comprehensive, although undoubtedly a most interesting and practical, subject, and one which is very intimately associated with recent progress in therapeutics.The subject is, however, so large, and extends over such a very wide field, both of observation and experiment, that I must ask you to allow me to remain strictly within my role of "intro- ducer," and to content myself with pointing out a few topics which appear to me to be especiallv suitable for discussion in this Section, adding here and there a few observations of my own with the view of stimulating or provoking further expressions of opinion from those who may be able to throw more light on the questions involved than I anm.The connection between invalids and infants may not appear to some minds to be a very close one, and if I had had my own choice in this matter, I might perhaps have been disposed to " drop the infant," for my acquaintance with infancy is entirely uninterested and impartial, and is not complicated by claims of ownership.But if 1 cannot claim that direct and intimate asso- ciation with the state of infancy which so many of you are, no doubt, able to, I may, perhaps, for that very reason, be able to take a more calm and dispassionate view of its wants and its weaknesses.There is, however, this very important connection between invalids and infants-namely, that they ate commonly dependent on others for the provision or selection of their food, and it is for this reason, I presume, that we are invited to consider their food wants together.And, first, with regard to the feeding of invalids, I would suggest that we should consider chiefly the foods most suitable to be given in acute febrile diseases; for if we allow ourselves to wander into the question of the dietetics of chronic disease, in- cluding such questions as the diet most appropriate in diabetes, albuminuria, uriceamia, phthisis, scrofula, antemia, diseases of the digestive organs, of the heart, etc., we shall be overwhelmed with the magnitude of our subject.FOOD IN ACUTE DISEASE.We all remember the remarkable words of the late Dr. Graves, of Dublin; "Lest when I am gone you may be at a loss for an epitaph for me, let me give you one in three words, 'He fed fevers."'Since the time when these pregnant words were ut- tered there has been little inclination displayed by physicians in this country to go back to the starving methods of some of Graves's distinguished predecessors or contemporaries.Yet it can hardly be doubted that the conclusion arrived at by some of the older physicians that the free administration of food in fever occasionally intensified the febrile process, rested on some basis of practical observation; and we do not, in the present day, alto- gether lack oceasions of observing that the indiscreet administra- tion of food in acute diseases, food unsuitable either in quality or quantity, is distinctly injurious.No one can be more willing than I am to recognise the necessity and importance of administering a sufficiency of food to febrile patients, especially with the object of lessening or compensating for that tendency to destruction of tissue, which is one of the most serious consequences of fever; but I am at the same time convinced that, especially in large public institutions where patients are nursed en bloc, the free administration of food and alcoholic stimulants is far too much a matter of routine, and