The fats and carbohydrates contain practically no substances that react on the body of the ordinary individual in a deleterious manner during their digestion. The extra work that is put on the heart by the formation of many new blood vessels in adipose tissue is the only harmful effect of overindulgence in these foodstuffs.
It has been found that nitrogen equilibrium can be maintained at a wide range of levels. Formerly 135-150 gms. of protein daily were considered necessary for a man doing light work. Now it is known that half that amount is sufficient to keep one in nitrogenous equilibrium, and to enable one to keep his weight. A person at rest requires even less than that. One who is engaged in hard physical labor burns up more fuel in the muscles, and so must have a larger fuel supply.
Although we habitually eat too much we drink too little water. For those who have any form of arterial disease an excess of fluid is harmful, as the vessels become filled up and a condition of plethora results, which necessarily reacts injuriously on the heart and circulation. The drinking of a glass of water during meals is, in the author's opinion, good practice. The water must be taken mouthful at a time, and not gulped down. If this is done, there results sufficient dilution of the solid food to enable the gastric juices successfully and rapidly to reach all parts of the meal.
Some are in favor of a rigid milk diet for those who have arteriosclerosis. Some men have lived on nothing but milk for several years and have not only kept in good health, but have actually gained weight and led at the same time active lives. It has been held by others that rigid milk diet is positively harmful on account of the relatively large quantity of calcium salts that are ingested. This was thought to favor the deposition of calcareous material in the walls of the already diseased arteries. While possibly there may be some danger of increased calcification, the majority of clinicians are in favor of a milk cure given at intervals. Thus the patient is made to take three to four quarts daily for a period of a month. There is then a gradual return to a general diet, exclusive of meat, for several weeks, then another rigid milk diet period.
If we are bold enough to follow Metschnikoff in his theories of longevity, we might advise resection of the large intestine, on the ground that it is an enormous culture tube that produces prodigious amounts of poisonous substances which are thrown into the general circulation. To combat such a grave (?) condition as the carrying of several feet of large intestine, we are recommended to take buttermilk or milk soured by means of the b. acidus lacticus. Clinical experience has taught that in arteriosclerosis buttermilk is of great value, whether it be the natural product, or made directly from sweet milk by the addition of the bacilli. The latter is a smoother product and has, to my mind, a delightful flavor. It may be diluted with Vichy or plain soda water. Cases that can not take milk or any other food will often take buttermilk, and do well on this restricted diet. From two to four quarts daily should be taken. It should be drunk slowly as should milk.
Medicinal
It has long been thought that the iodides have some specific effect on the advancing arteriosclerosis, checking its spread, if not really aiding nature to a limited restoration of the diseased arteries. It is possible that the eulogies upon the iodides owe their origin to the successful treatment of syphilitic arteriosclerosis, in which condition these drugs have a specific action. However that may be, there is no doubt that the administration of sodium or potassium iodide is good therapeutics in cases of arteriosclerosis.
Unfortunately many persons have such irritable stomachs that they can not take the iodides, even though they be diluted many times. They may be made less irritating by giving them with essence of pepsin. Unless the case is syphilitic, it is doubtful whether it is of value to increase the dose gradually until a dram or even more is taken three times daily after meals. Usually a maximum dose of ten grains seems to be quite sufficient. This may be taken three times a day, well diluted, for three months. There follows a month's rest, then the treatment is resumed for another period of three months, and so on. Either sodium or potassium iodide in saturated solution may be given. The sodium salt is possibly less irritating, and contains more free iodine than the potassium salt, although the latter is more generally used. The strontium iodide may also be used.
One sees a patient now and then who can not take the iodides, however they may be combined. For such patients one may obtain good results with iodopin, sajodin, or other of the preparations put up by reputable firms. Personally I have never yet seen a patient who could not take the ordinary iodides in some form or other, and I am opposed to ready made drugging.
The action of the iodides is to lower the blood pressure, and they are of greatest value when the blood pressure is high, and when headache and precordial pain are present.