MEDICAL NOTES.

Auckland Star, Volume LXVI, Issue 22, 26 January 1935, Page 9 (Supplement)

MEDICAL NOTES.

INTERNAL PRESSURE. HOW VARIED. TREATMENT UNCERTAIN. (By PERTTUS.) If two lily, or similar, leaves are placed together, face to face and edge to edge, aiul so joined, at tlie edges only, the'veins of one leaf may represent the arteries of the body and the veins of the other- represent human veins; and if at the base of the leaf steins can be imagined a double-action pump sending out fluid to the extreme edges of the first leaf and back by the network of channels in the second, there is a rough idea of blood circulation; the blood flowing out from,large arteries to the smallest, and returning through tlie smallest of veins to the larger. Normally the arteries are soft and elastic, and the veins also, but the latter are supplied with valves to check any backward flow: Within this double network of blood vessels there is something less than nine pints of blood moving under a fairly steady pressure. tlt is easy to understand that if the blood is pumped through hard or constricted vessels tlie pressure is raised and the pump strained, and if the pump works too forcibly the arteries are stretched or strained. An over-working heart-' will damage the arteries, and defective arteries will damage the heart, but commonly tlicy balance each other, each adjusting itself to a defect in the other. Causes of Pressure. Internal pressure, is raised in many ways—by exercise, by emotion, food, drink, drugs, and diseases of heart, arteries, kidneys, and glands. Three internal glands secrete a fluid which, acting through heart and arteries raises internal pressure. In some circumstances this pressure is protective, and a physiological stimulant. Blood pressure then is more a symptom than a disease. The ohl remedy for high pressure was to remove half a pint of blood, but as this loss is almost immediately restored automatically by the body the remedy is temporary, only of use to tide over a dangerous period, mostly, in old days, induced by too much food and drink. There are several points for the doctor to consider. Is there much emotional disturbance? Arc all functions normally performed? Do heart or kidneys show signs of abnormality? All these may be helped or corrected, but, up to now, f can hear of no»ccrtain relief for pressure due to glandular action (or overaction) except that some artful doctors name it "essential liyperpiesis," as if giving an impressive name calmed the circulation by soothing the patient with sound. Jt is true that the nervous system is closely involved in excess pressure, and there is nothing to be gained by. alarming a patient. The

anxiety of consciously dodging death added to the normal care and worry of daily life may alone cause a hurried heart to hurry_ more. A calm and easy mind, and avoidance of sudden strains, and steady quiet exercises (even uphill) will equalise the circulation and the internal pressure. Over Forty. Hardened arteries may be produced by persistently high blood pressure; by certain body poisons and infection; and by senile changes. Inheritors of gout and rheumatism, or those with high pressure from inheritance, may show definite symptoms from ten years of age and upwards, ft is, however, chiefly men and women of forty who discover, or have discovered for them, that they have an internal pressure sufficient to break a small weak vessel in the brain, and so acquire apoplexy. The effect of a brain hemorrhage may be of any degree from slight to quickly fatal. It may leave a paralysis only transient, or cause a paralysis which sends the victim to bed helpless for many years, or until another hemorrhage or trouble—such as pneumonia—ends all.

In young people arteries will contract for a period and recover their tone, and perhaps be affected over certain areas only, but 111 elderly persons ("Never felt better, my dear") the discovery of this comes too late for much improvement to be made. Corrections in food and drink, checking alcohol and tobacco, emptying the bowels and testing urine (questioning the kidneys), arranging for regular graduated exercises, and a 14-day pressure reading is medical routine. There are four drugs (and two "patents") which sometimes reduce pressure. Of these, one is quite unreliable, another a nerve depressant, a third a dieuretic, but the fourth—a salt of mercury—is safe and sure, although calling for repeated use. A famous London physician says of this drug, "The good effect is so good and quickly felt as often to provoke clamations of gratitude from patients." Baths of all kinds have failed. 111 moderate diets, saline laxatives, and, better than all, graduated exercises, we have the most reasonable and natural treatment. It is possible to live to a good, and not unhappy, old age with high blood pressure. If the heart is sound, and the "tubes," as one doctor calls the arteries, are normally elastic and tough, there is 110 reason why anything should "give," but liigh-pressure subjects should avoid altitudes • ' ---? (say) 3 no '""'t.

The Doctor's Difficulty.

Defective arteries are common among the poor and the underfed and overworked, but the steady worker, indifrent about his health, neglects every symptom apart from pain, and plugs along until lie drops. The heavy woman with high pressure should go to bed for six weeks "oii a diet," bring her weight down by massage and laxatives, reduced food and drink (particularly drink), and so cleanse the system that arterial tissue ceases to harden. It is worth mentioning that certain cramps of hands and feet and calves, attributed to rheumatism, occur as a symptom of hardening arteries. The usual symptoms are those of morning depression, disturbed sleep, headache, insomnia, constipation, biliousness, loss of memory and giddiness, but all these may point in another direction, and the one thing the doctor should be able to do is to interpret such signs.