Vol. XVII.

[132] The outside parts of roast meat must be avoided, even when meat
is allowed once a day. Meat is only added after the condition
materially improves.

[133] Coleman, in Forchheimer's "Therapeusis of Internal Diseases,"
Vol. I, p. 642.

CHAPTER XIX

DISEASES OF THE HEART

The dietetic treatment in diseases of the heart has been the subject
of much study, especially during the past few years.

~The Diet.~--In this pathological condition, as in many other diseases
in which one or more of the functions of the body have become
impaired, there can be no hard and fast rule covering the treatment or
diet for all cases, but, as in nephritis, the condition of the
individual, his symptoms, and the progress and extent of the disease
must be taken into consideration in order to formulate a diet
calculated to adequately nourish the body, while at the same time
imposing the smallest amount of work with the least expenditure of
labor upon the part of the diseased organ.

~Division of Treatment.~--The treatment of the disease then may be
said to be divided into three stages: first, the stage of
compensation; second, that of moderate compensation; third, that of
decompensation. The diet is directed, first, toward relieving as far
as possible the strain which is imposed more or less by all the food
eaten; and second, keeping up the general nutrition of the body.

~Dietetic Treatment.~--No matter what has caused the impairment of the
heart functions, the treatment must necessarily remain the same as far
as diet is concerned. The patient is no longer able to handle a full
and unrestricted diet. As long as compensation is good, the
restrictions are scarcely noticeable; alcoholic beverages and possibly
tobacco may have to be, to a certain extent, curtailed, and in some
cases avoided altogether. However, if the individual desires to live
and be comfortable while so doing, he must lead a wholesome, simple
life, since he cannot with safety indulge in any excesses, either in
diet or in any other particular.

~Diet in Second Stage.~--When the second stage sets in, that is, when
the heart muscle is unable to perform its normal function, attention
must be directed toward two main points; first, the work of the heart;
second, the pressure upon that organ from other sources, namely, the
stomach and intestines. As long as the food does not disagree, that
is, so long as there is no fermentation or putrefaction of the