The following recipe of home-made artificial milk prepared from cream can be taken in unlimited quantity by diabetics, and is a most useful article of food: -

Sugar-free Milk.

Place 4 tablespoonfuls of cream in 1 pint of water. Mix well. Allow to stand for twelve hours. Then skim off the fat and place in a second Foods.

May Eat

Butcher meat of all kinds except liver.

Tongue, ham, bacon, or other smoked, salted, dried, or cured meats.

Poultry, game.

Fish of all kinds, fresh, salted, or cured; shellfish, except the bodies of lobsters and crabs; mussels.

Animal soups, not thickened with any starchy materials; beef-teas and broths.

Eggs, dressed in any way.

Cheese, cream cheeses, butter, cream.

Greens, spinach, turnip-tops» French beans,1 brussels sprouts,1 cauliflower.1

Broccoli,1 cabbage1, asparagus,1 seakale,1 vegetable marrow, lettuce, cucumber, tomatoes, mushrooms, mustard and cress, watercress, endive, spring onions, leeks, celery, rhubarb, pickles.

Oil, vinegar.

Savoury jelly; jellies and custards, sweetened with saccharin; blancmanges made with isinglass or gelatine.

All nuts, except chestnuts; olives.

May Not Eat

Sugar in any form.

Wheaten bread, and ordinary biscuits of all kinds.

Toast, rice, arrowroot, cornflour, oatmeal, sago, tapioca, macaroni, vermicelli.

Potatoes, carrots, parsnips, beetroot, peas, Spanish onions.

Pastry and puddings of all kinds, and honey.

All fruit, fresh and preserved, except lemons and unripe fruit.

Liver.

Oysters.

Cockles and mussels, and crabs.

Beverages.

May Take

Tea, coffee, cocoa from nibs; dry sherry, claret, dry Sauterne, Burgundy, Chablis, hock, brandy, whisky, and other unsweetened spirits; unsweetened aerated waters; milk (limited to 1 or 11/2 pints daily); Kephir,sugar-free milk.

May Not Take

Milk, except in limited quantities; sweet ales, porter, stout, cider; all sweet wines, port, Tokay, champagne; liqueurs; fruit juices and syrups; cocoa and ordinary chocolate.

1 These should be boiled in a large amount of water.

Vessel; to this add water (cautiously), a pinch of salt, a trace of saccharin, and a little white of egg, until the fluid has the consistence and colour of ordinary milk.

A second form of milk, containing only a little sugar, may be made by dissolving cream, and especially Devonshire clotted cream, in water.

A third artificial milk, practically free from sugar, can be made from Biogene powder and Milk albumin (Bonthron, 50 Glasshouse Street, London), as follows: -

To a glass of water a teaspoonful of cream and one or two table-spoonfuls of Biogene powder is added, and well mixed.

The supply of abundance of fat is often a difficulty, but fish and vegetables should be cooked and served with a liberal amount of butter. The fat of beef and mutton and bacon is very suitable. Many patients can readily take the fat of cold roasted beef, and ham, or bath chaps (pig's cheek); and large quantities of fatty food can be taken in this way. Bone-marrow, which consists almost entirely of fatty material, may be used in the following ways: -

Potted Meat

4 ounces of marrow-bone, 4 ounces shin of beef. Cut up the beef and marrow into small pieces; place in a jar, with a little onion and pepper and salt; just cover with water. Stew gently in a slow oven for three to four hours, until the meat is quite soft.

Take out the meat and marrow, leaving the fluid in the jar. Pound the meat and marrow, or pass twice through the mincer until they are quite smooth. Add a little fluid from the jar in which they were cooked; add pepper, salt, and spice, and mix all together into a paste. Place in small pots, and cover with clarified butter, to preserve it.

Grilled Marrow-Bones

Saw the bones into short lengths. Cover the ends with a paste made of flour and water, tie them in a floured cloth, and boil one and three-quarters to two hours. Remove the cloth and crust, set the bones upright on a dish covered with a hot napkin, and serve with dry, crisp toast. Serve very hot.

Salmon, herrings, mackerel, sardines in oil, pate de foie gras, cream cheeses, rich sauces made with eggs, oil, and cream (e.g. mayonnaise), are all useful. If the excess of fat in the food gives rise to dyspepsia, a small quantity of brandy and water after meals aids digestion.

The want of sugar in the diet is greatly felt by most patients; - of the sugars, milk sugar (lactose), as in milk, is the least injurious; but the sweet flavour can be replaced by saccharin and Saxin (coal-tar products), these being intensely sweet only require to be used in very small quantities; prepared glycerine is also available as a sweetening agent.

Starch being quite unsuitable for diabetics, means that all the breadstuff's are cut off, and this is a very great deprivation. Bread ordinarily contains about 50 per cent, carbohydrate and 2 per cent, sugar. Various bread substitutes, known as diabetic bread and biscuits, and claiming to contain only a small quantity of the starch, are to be obtained; but it should be noted that all reliable diabetic foodstuffs are expensive. The presence or absence of starch can easily be proved by the application of iodine and potassium iodide solution; if the breadstuff turns deep blue-black it contains a large amount of starch, and is little better than ordinary bread. The diabetic breads are made from bran, gluten, casein; and in recent years the oily nuts such as almond, cocoa-nut, hazel nut, and the soya bean have been largely used. The made-up breads, cakes, and biscuits can be procured direct from the makers (Blatchley, London; and Callard & Co., London); or the ground nuts, etc., in the form of flour can be purchased and made up in the patient's own house.

Almond flour or desiccated cocoa-nut powder made into biscuits is very satisfactory, and they contain a very considerable quantity of fat. These both contain a little sugar, which is destroyed by the action of yeast in the preparation of the foods. Cocoa-nut, hazel nut, and pine seeds can also be procured in powder form, and made into biscuits and flavoured in various ways. Bran flour is another product which, if carefully prepared, is entirely free from starch; this can be bought by the pound, and made at home into bran cakes or bread.