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Updated: May 8, 2025
Certainly the treatment should be used in cardiac insufficiency with a great deal of care, although it is often very valuable treatment. It should be emphasized that most patients with cardiac dropsy receiving the Karell treatment or a modification of it should also receive digitalis in full doses, and should have daily free movement of the bowels.
If thirst is excessive, the patient must have a little water, and if the desire for solid food is excessive, even Karell allowed a little white bread and at times a little salt. He sometimes even prolonged the period of treatment to five or six weeks.
The diet should be nutritious, but, of course, modified by the condition of the stomach, intestines and kidneys, and whether or not the patient is obese. The bulk of the meal should be small, and nutriment should be given at three or four hour intervals during the daytime. The Karell milk diet or so-called "cure" was first presented in 1865 by Phillippe Karell, physician to the Czar of Russia.
He finds that patients with uremia ordinarily should not be subjected to the Karell cure, such patients needing more fluid. As long as the patient remains in bed, and as long as his ability to exercise is at a minimum, gentle massage is advisable. In these cases of cardiac weakness, with or without dropsy, unless the diastolic pressure is very high, digitalis is valuable.
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