But, if fresh milk is so valuable a food for the sick, the least change or sourness in it, makes it of all articles, perhaps, the most injurious; diarrhoea is a common result of fresh milk allowed to become at all sour.  The nurse therefore ought to exercise her utmost care in this.  In large institutions for the sick, even the poorest, the utmost care is exercised.  Wenham Lake ice is used for this express purpose every summer, while the private patient, perhaps, never tastes a drop of milk that is not sour, all through the hot weather, so little does the private nurse understand the necessity of such care.  Yet, if you consider that the only drop of real nourishment in your patient’s tea is the drop of milk, and how much almost all English patients depend upon their tea, you will see the great importance of not depriving your patient of this drop of milk.  Buttermilk, a totally different thing, is often very useful, especially in fevers.

[Sidenote:  Sweet things.]

In laying down rules of diet, by the amounts of “solid nutriment” in different kinds of food, it is constantly lost sight of what the patient requires to repair his waste, what he can take and what he can’t.  You cannot diet a patient from a book, you cannot make up the human body as you would make up a prescription,—­so many parts “carboniferous,” so many parts “nitrogenous” will constitute a perfect diet for the patient.  The nurse’s observation here will materially assist the doctor—­the patient’s “fancies” will materially assist the nurse.  For instance, sugar is one of the most nutritive of all articles, being pure carbon, and is particularly recommended in some books.  But the vast majority of all patients in England, young and old, male and female, rich and poor, hospital and private, dislike sweet things,—­and while I have never known a person take to sweets when he was ill who disliked them when he was well, I have known many fond of them when in health, who in sickness would leave off anything sweet, even to sugar in tea,—­sweet puddings, sweet drinks, are their aversion; the furred tongue almost always likes what is sharp or pungent.  Scorbutic patients are an exception, they often crave for sweetmeats and jams.

[Sidenote:  Jelly.]

Jelly is another article of diet in great favour with nurses and friends of the sick; even if it could be eaten solid, it would not nourish, but it is simply the height of folly to take 1/8 oz. of gelatine and make it into a certain bulk by dissolving it in water and then to give it to the sick, as if the mere bulk represented nourishment.  It is now known that jelly does not nourish, that it has a tendency to produce diarrhoea,—­and to trust to it to repair the waste of a diseased constitution is simply to starve the sick under the guise of feeding them.  If 100 spoonfuls of jelly were given in the course of the day, you would have given one spoonful of gelatine, which spoonful has no nutritive power whatever.