int symptoms. Heart beats faster and is
irregular. It may run into chronic valvular disease.

Treatment of Endocarditis.--Preventive.--Much can be done to prevent this
disease by closely watching the patient having the disease that causes it.
The heart should be closely watched. Acute inflammatory rheumatism is a
frequent cause and the heart must be watched continually in this disease.
When the patient has this disease he must be quiet and in bed. This is
essential. A doctor must be called, for the disease is serious and
dangerous.

Diet.--Should be liquid. Milk or preparations made with it is the usual
diet. Care must be taken that the stomach and bowels be not disordered.
Gas collecting in the stomach causes much distress to one who has
endocarditis or valvular disease.

Caution.--Avoid early exertion after getting well.

[342 MOTHERS' REMEDIES]

CHRONIC ENDOCARDITIS.--Usually occurs in persons under middle age.
Generally follows acute endocarditis. It may be caused by syphilis,
alcoholism, gout, and prolonged over-exertion. The edges of the valve
become thickened and then the thickened parts separate and cannot meet
exactly and therefore fail to close the opening they are set to guard.

CHRONIC VALVULAR DISEASE.--Results of valve lesions. Narrowing of a valve
causes increased difficulty in emptying the chamber of the heart behind
it. Insufficiency of a valve allows the return of the blood through the
valve during the dilation of a chamber, thus increasing the amount of
blood entering the chamber beyond the normal. Either trouble causes
dilation of the chamber and compensatory hypertrophy. Enlargement of its
wall must take place in order to perform the extra work demanded
constantly, for the normal reserve force of the heart muscles can
accomplish the extra task only temporarily. This enlargement increases the
working power of the heart to above normal, but the organ is relatively
less efficient than the normal heart, as its reserve force is less and
sudden or unusual exertion may cause disturbance or failure of the
compensation acquired by the enlargement. If this loss of reserve force is
temporary, compensation is restored by further enlargement and by
diminution, by rest, of the work demanded of the heart. Any valvular
lesion, whether a stenosis (narrowing) of the outlet or insufficiency from
the moment of its origin, leads to certain alterations in the distribution
of pressure upon each side of the affected