~The Advantages of High Calorie Diet~ over other diets are distinctly noticeable in typhoid fever patients. Those treated by this method are more comfortable during the course of the disease and are saved a long, tedious convalescence which has made the starvation treatment a thing of horror in the past. The return to health is attended by a much better physical condition when the patients are well nourished than is possible when they are kept on practically a starvation ration. The mortality from the disease has been materially lessened by the administration of the high calorie diet. ~Acidosis~ may develop in typhoid fever patients and must be guarded against. The behavior of the fat in the body should be carefully watched and the amount reduced at the first evidence of acidosis. At the same time an increase in the carbohydrates may assist in overcoming the condition. This adjusting of the diet, however, is entirely in the hands of the physician. ~The Kidneys~ in typhoid fever patients are under a great strain, chiefly on account of the increased rate of metabolism. Great care must be exercised in the dietetic treatment to prevent these organs from being overworked with a consequent development of nephritic conditions. ~Care of the Mouth~ in any febrile condition is important, but especially so in typhoid fever, where the disease itself causes a most unpleasant taste in the mouth. This prevents the taking of nourishment with any degree of comfort, hence the mouth should be cleansed before and after each feeding. Any of the aseptic mouth washes may be used. ~Thirst~ may be relieved by plain or carbonated waters, fruit beverages, and crushed ice. When in certain complications the fluids in the diet are in a measure restricted, ice is used and water is given in spoonful doses. This, however, is the exceptional, rather than the ordinary state of affairs. ~Increasing the Diet~ after a fluid diet must be made with great care in order to prevent a relapse. Following the high calorie diet the increase is simple. The patient passes from the prescribed foods to meat with apparently no effort. The increase should not be made, however, until convalescence is firmly established. ~Reenforcing the Diet.~--On account of the great increase in the rate of metabolism and because of the difficulty of furnishing the requisite number of calories in the diet, reenforcing agents such as lactose, eggs, some forms of casein, or beef preparations are used. ~Idiosyncrasies~ against certain foods are, at times, manifested by patients. Efforts must be made to determine whether they are real or imaginary before eliminating any food which may be of importance to their future welfare. PROBLEMS (a) Give a sample diet order, using liquids only. Raise the fuel value of the diet from 2000 to 3000 calories. (b) Formulate a diet order, using the high calorie diet, fuel value 3500 calories. FOOTNOTES: