Definition

Inflammation of the lining membrane of the heart. It is usually confined to the valves, and, when spoken of correctly, it should be called valvular endocarditis. It is divided into two forms--acute and chronic.

The acute is characterized by the presence of vegetations and a loss of power to close. In the chronic form there is a slowly developing hardening, resulting in a thickening and more or less deformity.

Acute Endocarditis

This disease is without doubt a symptomatic affection. When the profession gets to the point of being exact in its language, this will be spoken of as an affection rather than as a disease.

Etiology

Endocarditis is always found in conjunction with other physical derangements. The profession instantly thinks of rheumatism when the disease is spoken of. Years of indiscretion in eating improperly combined foods, overeating on proteins, starches, and sugars, keeping the system in a plethoric state, and a decidedly toxemic state of the blood from absorption of toxins generated in the intestine, will bring about this condition. When it has developed to a point where resistance is broken down, rheumatism; and it may be that the patient will suffer rheumatic pains, but at no time be thrown into his bed with a four- to six-weeks' run of inflammatory rheumatism. Where rheumatism of this character develops, it seldom leaves the heart free. Indeed, the heart is subject to this blood infection continually, and with no rheumatic development it is possible for valvular endocarditis to develop without the patient ever having an attack of inflammatory rheumatism.

Since bacteriology has been accepted by the profession as the chief etiological factor in the development of all diseases, we find the very best authorities declaring that tonsillitis, rheumatism, etc., cause this form of heart disease, and that the cause of the rheumatism is absorption of germs through the tonsils.

I cannot readily understand why medical men generally should be at a loss to comprehend the etiology of rheumatism and endocarditis. Treatment for the disease has been so very unsatisfactory that there has been no settled conviction in regard to the cause, and bacteriology seems to have satisfied the medical mind. There is no question but that these diseases are all due to toxin poisoning, but it is not any different--the poisoning is not any different--from the toxin poisoning that is at the base of all other acute and chronic derangements of the human body.

Treatment

The treatment for this disease must be the same as for all diseases; namely, correct the nutrition, get rid of the source of infection, and then nature will eliminate the poison. If there are abscesses in any part of the body, they must be drained. If there is a source of infection--for example, from the pelvic organs--these organs must be properly treated. Drainage must be established to get rid of this source of infection. The feeding must be corrected. The care of the body must be made as nearly perfect as possible.

The treatment for simple endocarditis should be about as follows: If the cardiac symptoms are not too pronounced to preclude a two- or three-minutes' hot bath of a morning, a bath should be given as hot as the patient can bear, followed with a quick cold sponge-bath. This should be followed with a lot of dry towel-rubbing. Then, before going to bed at night, give dry towel-rubbing. If the patient is in full flesh, no food should be taken for at least one week. The second week the patient should not have anything more than fruit morning, noon, and night. The third week, two meals of fruit and one heavier meal--a dinner in the evening, consisting of meat--two or three times a week. The lightest meat should be used--lamb, chicken, fish, or eggs--with cooked, non-starchy vegetables and a combination salad. The alternate dinners should be a decidedly starchy food, with one or two cooked, nonstarchy vegetables and a combination salad. Patients should avoid worries and anxieties. Everything that has a depressing effect must be shunned. If the proper care is taken of the skin and the eating, according to the above instructions, the very worst forms of this trouble can be overcome.

Chronic Endocarditis

Treatment for this affection need not be any different from that of the acute form. Perhaps it will not be necessary to fast the patient for the first week. Give fruit for three meals a day; then take fruit for two meals, and the regulation dinner for the third meal. There are no two cases alike--no two people can be treated exactly alike; hence whatever conditions are necessary to be met, must be met. If rest is demanded more than anything else, such patients should be put to bed and all excitement of all kinds removed. If they are able to be up and around, attending to light duties, they must retire early and get up late, avoid all kinds of annoyance, and stay away from theaters and crowds where the atmosphere is bad.