DIET AND REGIMEN


Important instructions for the Diet and regime in diseases of heart and arteries by J.H.Clarke….


DIET AND REGIMEN.

THERE are no more troublesome symptoms in many cases of heart disease than those referred to the digestion. The heart and stomach are very near neighbours. The mid-riff, or diaphragm- the thin muscular wall which divides the cavity of the chest from the abdomen, and plays such an important part in the function of breathing-is the only thing which separates the heart from the stomach. The lower part of the heart rests on the diaphragm, and the upper part of the stomach impinges against the diaphragm’s under-side. It follows that when the stomach is over-distended either with food or flatulence, or, which comes to the same thing, when the stomach, by reason of defective dress, is not allowed sufficient room for the discharge of its functions after a meal has been taken, the heart is incommoded and distressed.

But there is even a closer relation between heart and stomach than that of proximity; they are both supplied by the same nerve-the vagus, or pneumogastric-and each organ is thus in sympathy with the other, and apt to feel the effect of any disorder affecting it.

Thus it happens that many persons think they have heart disease when they have nothing worse than indigestion, whilst some who have heart disease find indigestion the most distressing of all their troubles. Several instances of this kind have been recorded in the foregoing pages.

When a damaged heart is fully compensated, and no symptoms are occasioned, the patient may be considered as cured, and no special rules need be laid down; he may eat and live generally, just as ordinary sensible people do. In those cases in which the compensation is incomplete, care will have to be observed in proportion to its defectiveness. In such a case the indulgence of a hearty appetite- a good meal of steak and beer for instance- is quite sufficient to put an end to a patient’s life. The best rule is in such a case for the patient to be dieted in exactly the same way as one who suffers from weak digestion. Meals to be taken at regular times; known indigestible or rich foods to be avoided; warm foods to be preferred to cold, and all done up meats to be forbidden. Stewed mutton is the most easily digested of all red meats. When there is much flatulence, soups are undesirable, and generally the quantity of liquids taken should be scrupulously regulated. One most important point should not be overlooked: a patient should never sit down to a meal when tired.

A rest before and after a meal must be the rule. If by any chance the meal-time comes, and finds the patient tired, something very light and warm must be given (such as a cup of scalded milk-cold milk into which boiling water has been poured in equal quantities-or a few tablespoonfuls of strong soup), and the patient must wait until rested before taking the proper meal.

In gouty cases, mutton broth and chicken broth are as a rule preferable to beef tea, when solid meat cannot b;e taken. A “three-meat-tea” made of mutton, veal and beef is better than beef tea alone. Bread is often a difficulty, and when it is, it should be avoided altogether, and some plain biscuits taken instead. I have known plain hard biscuits with finely grated cold corned beef spread over it make an excellent breakfast in an extreme case of heart weakness. Semi-digested foods, like Benger’s Food, are often useful and must be borne in mind.

Of course, this only applies to the period when the heart has not recovered its proper balance. When that result has been brought about the patient may be guided by his sensations, like other people.

There are times when a period of semi-starvation in necessary to a heart’s recovery. In a plethoric patient the heart may suddenly find itself, from a variety of causes, unable to deal with the mass of blood in the patient’s body.

Tumultuous and irregular action is then the result. In such a case absolute rest, and a diet that is just enough to keep the patient alive, the amount of fluids being reduced to a minimum, will, in a short time, relieve the over-burdened organ, and give it time to recover, and then proper remedies will come in to establish the cure.

The question of alcohol is to be decided by each individual case. Other things being equal, the habitual use of alcohol is undesirable for many reasons. In the first place, as it is such a valuable heart stimulant in emergencies, its effect as a medicine will be seriously discounted in one who takes it regularly. Then, like all special stimulants, its permanent effect is not to strengthen and nourish the stimulated organs, but the reverse. This is seen in the many cases of disease of the heart and arteries traceable to indulgence in alcohol, illustrations of which have been already given. Alcohol is not a nutrient, but on the contrary tends to deprave nutrition. At the same time it may be a question in any case whether the habitual use of a stimulant may be left off with advantage, or whether it will not be the less evil of the two to retain it. This must be left to the judgment of the medical attendant, who will take all the points into consideration.

Coffee and tea enter into the same category as alcohol, and of the two coffee is much the more powerful heart stimulant, and is often in emergencies of the greatest value as a palliative.

The propriety of their use must be judged in each case, but as a general rule their habitual use should be avoided.

REGIMEN.

Closely allied to the question of diet is that of air and exercise.

Air is a prime necessity in heart cases, in some of which “air-hunger” is extreme. The difficulty in our climate in winter is how to get it pure enough, and not too cold. When possible it is desirable to have two rooms on the same landing, entirely at the disposal of a patient. By this means I was able to provide the air necessary in an extreme case of heart suffering throughout one of the severest of recent winters in London. The patient was wheeled from one room to the other, and when one room was unoccupied, a large fire was kept up in it and the window opened; the door was also left open, and also the door of the room occupied by the patient. The windows of the latter room being closed, the air had to pass through the unoccupied room, and was thus warmed before it reached the room where the patient was.

Exercise in some form is as necessary for persons with diseased hearts and blood-vessels, as it is for other people.

The points to determine are, what kind of exercise and how much. In those whose valvular and arterial lesions are fully compensated, any exercise or work that can be performed with comfort may be indulged in. Until that stage has been reached, or when a heart is beginning to fail, walking on the level is the best form of exercise. Stairs are a great difficulty in many cases, and some have found great relief by going upstairs backwards. The limbs have better purchase on the body weight in this method, and there is no bending forward and cramping of the breathing space.

When the heart is very weak, no active exercise at all can be taken. In such cases general massage and passive movements are a great advantage. This secures all the effects of exercise without expense of energy on the part of the patient, without any strain on the heart and without fatigue.

In cases of heart disease in which the stage of possible recovery is passed, it becomes impossible for the patient any longer to lie in bed. The recumbent position places the breathing apparatus at a disadvantage, and gives rise to such a degree of breathlessness that rest or sleep is out of the question. The most comfortable position is sitting in a chair with the legs down, and a rest in front for the head. For a time propping up a patient in bed with pillows may suffice; but before the end the additional relief of letting the limbs hang down is often required.

The consequence of this is, the limbs become dropsical; the dropsy rising higher as the circulation becomes more feeble.

In such cases good nursing is a primary requisite; scrupulous attention to the skin is required to prevent bed- sores. The best means is the application of whiskey dabbed on the most tender parts, which are afterwards powdered. When there is any soreness, Hypericum oil is of immense utility. The swollen limbs tend to inflame, crack, and exude. Much comfort may be given by keeping the limbs powdered, and bandaged with light, open-wove bandages.

John Henry Clarke
John Henry Clarke MD (1853 – November 24, 1931 was a prominent English classical homeopath. Dr. Clarke was a busy practitioner. As a physician he not only had his own clinic in Piccadilly, London, but he also was a consultant at the London Homeopathic Hospital and researched into new remedies — nosodes. For many years, he was the editor of The Homeopathic World. He wrote many books, his best known were Dictionary of Practical Materia Medica and Repertory of Materia Medica