Sunday, 13 November 2016

16 April 1881 - 'Cookery for Invalids' by Phillis Browne

I remember once hearing of an old gentleman who went to visit at a house where there were three young ladies in the family. While he was there the cook was taken ill, and it was thought advisable for her to have a little gruel. It turned out,  however, that there was no one who could make it. The young ladies looked at each other with blank countenances. The housemaid prudently withdrew from the kitchen, and busied herself with brushes and brooms, but the gruel was not to be had, and the sick woman was obliged to put up with a cup of tea in its stead. The feelings of the old gentleman on the occasion are more easily imagined than described. He never forgot the occurrence. As long as he lived those unfortunate girls were associated in his mind with ignorance concerning gruel. When, after a time one of them married, he regarded her husband with feelings of the deepest and most heartfelt pity.

The recovery of a patient very often largely depends upon the food which he takes, and as his power of taking food is affected very considerably by the way in which it is served and cooked, it is well worth while trying to learn how an invalid's food should be prepared.

Cookery for invalids is usually very plain and simple. All rich, highly spiced, and fatty foods are entirely out of the question, and small delicate dishes, light foods, and cooling or nourishing drinks are needed more than anything else. Variety, too, is a great thing in invalid cookery. We all enjoy frequent change of food, and would grow weary of a dish that was set before us day after day. How much more is this likely to be the case with invalids, whose appetite at the best is poor, and who have been rendered fastidious and fanciful through disease. The skill of a cook is shown quite as much in the readiness with which she can provide pleasant little surprises as in the delicacy of the food prepared.

Take, for example, the food which is perhaps more valuable and more frequently prepared for invalids than any other - beef-tea. When first supplied in cases of weakness beef-tea is usually taken with great relish. It seems to give strength and to supply just what is wanted, and a patient will look for it and enjoy it heartily. In a very short time, however, the appetite for it will fail, and the very name of beef-tea appears to excite loathing. In cases of this kind a nurse who is a clever cook will introduce a change of flavour; present the beef-tea under another form, and avoid the name altogether.

A very agreeable variety may be made by using half beef and half mutton or veal in making the tea, or by stewing an inch or two of celery, or even an onion and one or two cloves with the beef. The addition of a little sago also, or crushed tapioca, and a small quantity of cream to the beef-tea will alter its taste, whilst the addition will increase rather than diminish the nourishing wholesome qualities of the tea. When making this, soak a tablespoonful of sago or tapioca in a little cold water for an hour. This will take away the earthy taste.  Strain it and put it into a saucepan with a gill of fresh water and boil gently till tender. Add a pint of good beef-tea, hot; simmer this with the sago for a minute or two, then add a quarter of a pint of cream. Stir thoroughly, and serve. If liked, an egg or a couple of eggs may be added to the beef-tea, as well as the cream. The eggs must be broken into a basin, and the specks must be carefully removed. The hot tea, with the cream or without it, should now be poured on gradually, *off the fire, and stirred well that the eggs may be thoroughly broken up and separated. Beef-tea may also be used in savoury custard such as is sometimes made for putting into clear soup. For this, take the yolks of two eggs and the white of one, beat them well, put with them a quarter of a pint of strong beef-tea, and season with a little salt. Butter a small jar or basin, and pour in the custard. Tie some paper, slightly buttered, over the top, and set the basin in a saucepan containing boiling water which will reach half way up the basin, but which must on no account touch the edge of the paper. Set the saucepan by the side of the fire, and simmer very gently till the custard is set. It will take about twenty minutes. If the water is allowed to boil fast round the basin the custard inside will be full of holes, instead of being smooth and even. This custard may be served hot or cold.

Sometimes invalids who have a great distaste for ordinary beef-tea served hot, will enjoy it served cold, or offered as a jelly. Now, the best beef-tea, made from juicy meat, such as the roll of the blade bone, and which has not been allowed to reach the boiling point, will not jelly when cold; but beef-tea made by thoroughly stewing the shin of beef will jelly. Beef-tea jellies because of the gelatine which it contains. Gelatine is the least valuable part of butcher's meat, and it is obtained chiefly from bone and gristle. I do not recommend, therefore, that beef-tea should be made into a jelly because it will be more nourishing, but because it may prove more appetising. I have known invalids enjoy jelly beef-tea who turned away with loathing from liquid beef-tea.

Jelly (I do not mean now beef-tea jelly, but calf's-foot jelly, and isinglass, or gelatine jelly) has fallen very much in the estimation of doctors and nurses of late years. I can remember that when I was a girl calf's-foot jelly was the one article of nourishment that was supplied before all others in cases of weakness. If any member of a family was taken ill the cousins and the aunts, but especially the aunts, used to come round at once with superlative moulds of jelly, as furnishing undoubted proof of sympathy and affection. We children used to regard it as one of the compensations attending indisposition that we were allowed to have an unlimited supply of the same.

Of course calf's-foot jelly is a very different thing to gelatine jelly, but it is possible to estimate even calf's-foot jelly too highly. Jelly is very good when mixed with other substances, which are nourishing, but, taken alone, it serves too often to satisfy the appetite without doing much good. Gelatine jelly made from the gelatine sold in packets is of no use. Hear what Miss Nightingale says about it: "Jelly is an 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 folly to take one-eighth of an ounce 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 one hundred 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 whatsoever."

We must return, however, to our beef-tea, for I want to write a word or two about the best way of making it. I said a little while ago that the roll of the blade-bone of beef was the best part that could be chosen for making beef-tea. I must not forget to add that the butcher should be asked to supply freshly-killed meat, because that will be more full of gravy than well-kept beef. To make good beef-tea, take one pound of meat, trim away all fat and skin, cut the lean into very small pieces; place these in a jar, pour over them one point of cold water, and cover the jar closely; leave the meat to soak for one hour, stirring and pressing it now and then to draw out the juice. At the end of this time put the jar, still closely covered, into a saucepan with boiling water, which will come half way up, but which cannot touch the paper, if paper has been tied over as a cover. Keep the water boiling round the jar for two or even three hours, then pour the tea from the meat, add a little salt, and it is ready for use. Put it in a cool place till wanted and warm a little as required, but do not keep the tea hot till wanted or it will spoil.

Mutton-tea or veal-tea may be made exactly in the same way as beef-tea.

Perhaps girls feel inclined to say, Why should we not put the beef at once into the saucepan, and never mind the trouble of putting it into a jar first? Because by taking this extra trouble we make the beef-tea more digestible. People who are in a weakly condition need to have food that can be very easily digested. If the tea were to reach the boiling point, 212 deg., for even a second, the albumen contained in it would harden, and the tea would not be nearly so wholesome. Therefore we give great care to keep the tea from boiling, and we know that if we thus place it in a jar set in a saucepan of boiling water it never will boil, even if it remains on the fire all day, and so we are safe on that point. All we have to do is to keep putting more water into the saucepan, for fear it should boil away and leave the pan dry, for if this mischance should occur our beef-tea would be burnt.

Perhaps some economical person feels inclined to ask, "Could we not make more beef tea by putting in a quart instead of a pint of water?" Of course, you could put in a gallon of water if you liked, but, after all, it would only be so much more water, and it is the beef-juice that does good, not the water. If I wanted very strong beef-tea for very weak people, I should put less water even than this; and in cases of exhaustion, when the patient could take very little food at a time, no water at all should be put with the meat. The simple gravy of the beef should be drawn out by steaming the meat in the way already described, but without water in the jar, and the juice thus drawn out would be the strongest beef-tea that could be made. The beef-juice or beef-essence, as it is called, is sometimes poured over a slice of crumbs of bread freshly toasted, then seasoned with pepper and salt, and served on a hot dish; and this is an excellent dish for an invalid.

A good many poets have occupied themselves in singing the praises of sparkling wine. I wish some very clever one would take it into his head to sing in praise of good beef-tea. I am sure it deserves far more than wine to have its virtues told. Properly made, of fresh meat (not of somebody's extract), and taken, not instead of food, but in addition to food, I know of no more valuable restorative. It is particularly useful for bringing sleep to people who are overworked and overwrought as so many are nowadays. Let such a one have a cup of beef-tea by the side of his bed, and take it, not the last thing at night, but in the night when he wakes up, and finds Black Care sitting by the side of his pillow, and hears her say, "Now I have you in my power, sleep if you can." Beef-tea will chase away the demon. Let the victim drink it and he will be very different from most people, if he does not lay his head on his pillow, and in less than half an hour fall asleep as quickly as when he was a baby and his head lay on his mother's breast.

In cases of typhoid fever and some other diseases, doctors frequently give orders that raw beef-tea should be administered to the patient. This is made by drawing the juice of the meat out in cold water as already described, then straining it off at once and serving it uncooked. This tea must be made in small quantities, as it will not keep.

In making broth or beef-tea for sick people, great care should be taken to remove every particle of fat from the liquid, for fat will not only be likely to upset the stomach of the invalid, but it will prove most objectionable to him. If there is time  for the tea to go cold, the fat will cake on the surface, and can be easily taken off. If, however, the tea is wanted at once, a sheet of clean blotting-paper should be passed lightly over the top of the liquid. The fat, being the lightest, will rise to the surface, and will be taken up first by the paper. The fat will rise more quickly if the jar containing the hot tea is set in a bowl of cold water.

Care, too, must be taken about seasoning the broth or tea. People who like highly-seasoned food in a general way frequently object to it strongly when they are ill. It is wise, therefore, to season beef-tea or broth very slightly, and to place pepper and salt on the tray, and let the invalid season his food for himself, if he is able to do so.

We must not think that we have done everything that is wanted when we have made the tea or broth, seasoned it lightly, and removed the fat. A very great point in catering for sick folks is to make food look inviting. Every article used should of course be perfectly clean and bright, the tray should be covered with a spotless napkin, and if we can put on it a glass containing a few flowers as well as the food, all the better. Also we must remember, not to take over much food up at one time, for this will be likely to set the invalid against it altogether.

Another point is worth remembering. As soon as the patient has eaten as much as he can, take the food quite out of the room, and when it is time for food again bring it in afresh, in a fresh basin with a clean spoon, having made a change in some way. Nothing is more likely to disgust an invalid than to have the food which he had left brought to him again and again, as if we were a naughty child and must finish one portion before any more were given him. We should anticipate and consider the fancies of sick people. We want them to take nourishment and grow strong, and we know that a great deal is accomplished when food is enjoyed; therefore, anything we can do to this end is well worth the trouble.

Chicken broth used to be very highly thought of a few years ago, but it is not worth very much when all is said and done. It is strongest when the whole fowl is cut up, covered with cold water, boiled up, then drawn back and allowed to simmer gently for three hours, and strained for use. A little boiled rice, boiled barley, or chopped parsley can be added with the seasoning. This, however, is a painful way of making broth, because it is giving so much to produce so little. It is better to take the flesh from the bones, stew the latter for broth, then cook the meat separately turning it either into panada or mince. Panada is very nourishing and very good, but the meat must be well pounded after it is cooked, or it will not be made the most of. The meat is cut up and stewed gently with a little good broth, not being allowed to reach the boiling point. It is then pounded to a pulp, pressed patiently through a sieve, seasoned with pepper and salt, and mixed with a spoonful or two of cream, and served. For variety's sake veal may be substituted  for the chicken and cooked in the same way. In either case a spoonful of barley may be soaked and boiled, pounded and pressed through the sieve with the meat. It will be a great improvement, but will be difficult to get through the sieve. Chicken mince is made by mincing the meat when raw, heating it gently in milk or good broth for a few minutes without allowing it to boil, then serving it immediately.

Cooling, refreshing and soothing drinks are so much wanted by invalids that I must mention one or two before closing.

Gruel - The world-renowned gruel may be made either with oatmeal or patent "grits." "Grits" are the best. Mix a tablespoonful of grits or oatmeal to a paste with a little cold water; add a point of boiling water, boil the whole, gently stirring well for ten minutes. Sweeten with sugar or treacle, or season with salt and pepper, and serve. The gruel will be much better made with milk instead of water.

Barley Water - Wash two ounces of pearl barley, boil it for five minutes in clear water, then throw the water away. Pour on two quarts of boiling water, and boil gently till the liquid is reduced to half, or for about two hours. Flavour with sugar and lemon juice, strain (or not, as preferred), and serve. If liked, a little lemon rind can be boiled with the barley. Stir the barley water before using. Apple Barley Water - Cut a good large apple wiped, but not peeled, into slices, and boil this with a little lemon-juice till soft. Rub it through a sieve, and add it to a quart of barley-water.

Toast Water - Take a thin slice of bread, and toast it thoroughly on both sides. Put it into a jug, pour a point of boiling water over it, and let it stand till cold. Strain before using.

Lemonade - Roll two lemons on the table to make them soft. Cut the rind off very thinly, and be careful to reject the white pith, as that would make the lemonade bitter. Cut the lemons into slices, and put these, free from pips, into a jug with half the lemon rind and a pint and a half of boiling water. Cover till cold, strain, and serve. A very pleasant drink may be made by substituting oranges  for the lemons. A raw fresh egg beaten up with two tablespoonfuls of warm milk and a little sugar is a very nourishing and agreeable drink for invalids. Sometimes wine is used instead of the milk; in this case a little water may be added, or a little soda-water may be taken instead.

When a doctor is attending a case it is always well to consult him before offering any food to an invalid. It is a good plan, however, to think over beforehand two or three dishes which can be obtained and prepared without difficulty, then to suggest these to the medical man. Every good doctor knows that "kitchen physic" will frequently do more good than drugs, and he will rejoice when he sees that this part of the medical treatment is not neglected.

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