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.