When for any reason the kidneys have difficulty in eliminating the nitrogenous waste of the system, the dietitian must eliminate protein food as closely as may be consistent with the body necessities. Besides restricting the amount of nitrogenous foods, the kidneys must be assisted in eliminating the nitrogenous waste and the products of inflammation by a copious drinking of water, unless the kidneys are so inflamed that complete rest is indicated.
Hot water and hot drinks are best in the morning, such as toast water, barley water, cream of tartar, lemon and acid drinks. Unless a dropsical condition is present one may drink freely of cool water.
In acute cases the patient is put on a diet of from two to three pints of milk a day, given one-half pint every three or four hours, diluted with one-third as much hot water. Complete rest is imperative.
In chronic cases, exercise, judiciously directed to the extremities, particularly to the legs and the back, will do more than anything to aid the elimination of an excessive accumulation of fluid as in dropsy. This condition is usually accompanied by constipation and poor circulation, and exercises directed to the liver and bowels aid in carrying off the excess of fluid by way of the intestines; this will rest the kidneys. A cure requires patience and perseverance.
In chronic cases it is also well to follow a milk diet for a number of weeks. The quantity of milk for an exclusive milk diet must depend on the age and size of the patient as well as on his ability to exercise. If he is confined to his room, from ten to sixteen glasses of milk a day are sufficient. If he is taking a great deal of exercise, he may take from eighteen to twenty glasses of milk a day. If he loses weight on the milk diet, bread and rice may be added, or potato soup, cereals, tapioca, and various gruels.
If the milk is not well borne, malted milk or predigested milk with butter and cream may be substituted. If the casein in the milk is not well digested, cheese must not be used. An egg once or twice a week and fruit and fresh vegetables may be given, but meat should be omitted.
A. F. Pattee gives the following diet in Bright’s disease.
DIET
Soup.—Vegetable or fish soup, broths with rice or barley.
Fish.—Raw oysters or clams, fresh fish broiled or boiled.