Parenteral hyperalimentation, when used free of associated morbidity, usually produces a dramatic reversal in the deteriorating clinical course of the patient. Most patients who need nutritional support have a partially functional gastrointestinal tract. By using a continuous enteral gavage of a chemically defined diet through a 4F tube, the same positive N balance, weight gain and accelerated wound healing can be achieved. As with parenteral hyperalimentation, there are avoidable iatrogenic morbidities. A policy and procedure for safe and effective enteral hyperalimentation, results of clinical experience and a simplified method for assessing achievement of a therapeutic goal are presented.