The food given should be just sufficient for the needs of the body;
the patient should not be overfed or underfed. Any large bulk of
food or liquid should not be given. Pressure on the heart causes
discomfort and is therefore inadvisable. Food that causes flatulence
should be avoided. Theoretically the patient should receive a little
meat, an egg or two, cereal or bread, a small amount of simple
vegetables, a little fruit, often milk, a sufficient amount of
noneffervescent water, perhaps a cup of chocolate or cocoa, a simple
dessert, sometimes ice cream; in other words, a varied, limited diet
containing all the elements that are necessary to good nutrition.
The diet should be varied from day to day to encourage the appetite.
It has for several years been recognized that a salt-free diet in
dropsies due to disease of the kidneys is a valuable aid in causing
absorption of such exudates and of preventing greater exudations.
For this reason a salt-free diet is often ordered in dropsies
occurring in valvular disease. Its value, however, is not so great
as in kidney lesions, and if it causes hardship to the patient it
should not be continued rigorously. On the other hand, large amounts
of salt should of course be interdicted.
A most valuable aid in dropsies due to heart deficiencies is the so-
called dry diet, which means that as little liquid as possible
should be taken in order that the patient's blood may resorb the
exudate in the tissues and not have the blood vessels filled or
overfilled with liquid from the gastro-intestinal tract. When dropsy
is present, or even when serious pendent edemas are present, the
patient should drink as little liquid as possible with his meals,
and between meals should sip water rather than drink a large
quantity of it. This is one of tile reasons that a large milk diet,
even with kidney disturbance due to cardiac lesions, is generally
inadvisable. With cardiac or general circulatory weakness, a laige
amount of liquid to flush out the kidneys and the whole system, so
long ordered for all kidney defects or mistakes in metabolism, is a
seribus mistake. The Karel diet is described in the section on
cardiovascular-renal disease.
Whether it is better to give three or four small meals a day or to
give a small amount of nourishment every three hours during the
daytime must again depend on the individual and his ability to
digest without fermentation and putrefaction or discomfort. As
previously urged, not too much fluid, even milk, though it digest
perfectly, should be given, as the greater the amount of fluid the
greater the amount of work thrown on the heart.