Thompson: The Cardiac Case 
31 
to teach him to care for himself. Some may say this should come 
first, but it cannot be done with good results until later. When 
he first presents himself for treatment he is usually in such a 
weakened condition that all the care must come from the outside. 
He should be taught to care for himself before he is dropped, so 
as to prevent a return to the former condition. 
He should be trained in some of the fundamental rules of 
hygiene. He should be taught to eat nourishing food in small 
quantities rather than large amounts of the cheap material that 
has little or no food value. He must learn to avoid infectious 
diseases, but if they are contracted to have them treated at once. 
Above all, he must know his limitations and not exceed them. 
When the public once sees the need of training people to keep 
themselves well, as the Chinese hire their doctors to do for them, 
such training as the above will be put in the factories and places 
of work as well as in the schools. 
When all possible has been done with the individual patient, 
his family must be educated. This has been mentioned above. 
The home conditions must be studied and changed, if necessary, 
to suit the welfare of the sick one. If it is found that the patient 
is sleeping on the second floor in a closed room when he should 
have no steps to climb and have plenty of fresh air, this ques- 
tion must be taken up with the family. Shifts of one kind or 
another can usually be made if the family is made to see the 
necessity of such. Again, if cheap food is given to the patient 
who should have a condensed diet, arrangements to suit this 
requirement must be made. In some such cases, it has been 
necessary to call in the aid of one of the relief agencies and have 
the food furnished. 
The hardest families to educate are the foreigners who cannot 
understand our language, and the selfish ones who do not see the 
need of sacrificing for the sick member. 
CASE MR. S. One foreign man came to the dispensary with 
a very serious heart condition. He was told to stop work for a 
time and be very careful of his diet. The Charity Organization 
Society was called upon to furnish provisions for the family. 
This was done, but after a time the patient became dissatisfied 
with the groceries given and was determined to return to work. 
By going back to work he was forced to cease treatment. If he 
could have understood why it was necessary for him to follow 
directions, he probably would have helped to carry out the plans 
made for him. 
