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January 4, 1947

DIET LOW IN SALT (SODIUM) IN CONGESTIVE HEART FAILURE

Author Affiliations

Boston

From the Massachusetts General Hospital; Graduate Assistant in Medicine (Dr. Wheeler), Commonwealth Fund Research Fellow, 1945-1946 (Dr. Bridges) and physician, Massachusetts General Hospital (Dr. White).

JAMA. 1947;133(1):16-20. doi:10.1001/jama.1947.02880010018004
Abstract

The importance of quantitative restriction of salt, that is, sodium, in the treatment of congestive heart failure has not been generally appreciated, despite the slow accumulation of clinical and laboratory evidence of its place in the control of water balance in the body. With a few notable exceptions, casual limitation of salt and fluid has been the custom throughout the country, and generally more stress has been placed on the restriction of fluid than on that of salt.

Karrell1 as early as 1866 observed that a diet consisting of 600 to 800 cc. of milk a day often caused diuresis in edematous patients, but he apparently did not realize that the low salt content of such a regimen was largely responsible for its beneficial effects. Physicians have employed this type of therapy successfully down to the present day, generally without appreciating that the restriction of salt rather than of

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