HEALTH NOTES.

New Zealand Mail, Issue 1679, 4 May 1904, Page 22

HEALTH NOTES.

COMMON HEART TROUBLES (By Dr. Andrew Wilson, F.R.S.E.) 'ln a previous article reference was made to the general work which the heart perforins in the body in circulating the blood, and a clear distinction •was made between affections of the heart-, indicating some temporary disturbance of its working, and these of a more serious character, due to some actual alteration of its substance. The former ailments were called “functional” in character, whilst to the latter was applied the name of “organic” ailments. It may be interesting to note here that the heart is an organ which is liable to be .affected in a kind of secondary way aa the result of disease -which tend to immediately concern it. It may be, therefore, well by way of warning to point out that in acute rheumatism or rheumatic fever the heart is liable, to be affected. This warning is of a necessary character, inasmuch as it pi aces us upon our guard to the effect that- when a case of acute rheumatism is under our care we have to keep in mind the possibility -of the heart being affected, and to take all means under the doctoi s orders of obviating any serious results accruing therefrom. One of the most common results of acute rheumatism is to produce an affection ‘of the heart substance itself, as of t-lie “pericardium,” or bag in which the heart is enclosed. This hag is liable to become inflamed, and in severe guises there can be little doubt affections of the heart itself are apt to follow upon this disorder. PALPITATION. -Amongst the most common ailments and affections of the heart, such as often give rise to a good deal of needless anxiety on the part of persons who suffer from them, “palpitation” stands out prominently. Under the term “palpitation” may he included a condition in virtue of which the heart’s action is first of all increased, and, second, where we may &:d. that action likewise to be of an irregular nature. These conditions sometimes produce somewhat distressing and alarming symptom®. A mere shifting position or the sudden rising from a sitting or a lying position into the erect position may be in some severe oases attended with Symptoms of faintness. Occasionally, a!so>, when the person is lying down -in bed he complains of what he terms “thumping” of the heart, the heating of the organ, being apparently very much increased in intensity!" If the case is one of ordinary - palpitation we may begin by noting that: the symptoms do not last, and are not in any sense of a permanent character. They may come and go. so to- speak, according as the case is represented in tine patient’s history, but, they do- not rer V a permanent institution in his ths_ latter for. if palpitation becomes -of a permanent character and irregular heart, action is more or less constantly present the case may undoubtedly be a grave one, and the services of a physican should. at once be secured. It is precisely this difference in the symptoms of palpitation—namely, where they -are more or less generally present or where they are only temporarily developed, which forms one of tlv* most important points for us in distinguishing between what may he a grave case of heart trouble and another of a comparatively trifling character. THE CAUSE. It is therefore of great importance in dealing with this subject to pay strict attention to the common causes of that ordinary form of palpitation which, however annoying, is not necessarily of a dangerous Character. The heart, it may -here be mentioned, is strongly under the influence of the nervous system. _ It has not merely a nervous apparatus of its-own which regulates its ordinary movements and work, hut it exist® ben tween what one may calll the push and pull of other two main .sets of nerve®. One of these nerves has the function of glowing its movements; the other of quickening them. In all probability it is through these two- nerves that we find the temporary disturbance of the heart’s work produced. We ail know in this case how the brain and what may be called even the passing moods of the mind, nmy have their distinct influence on the heart and its work. Anything which tends to upset the mental balance,- such as fright, worry, grief, or even' it may be joy, may thus disturb 'the working of the heart. In most oases such disturbances, however, are of the most passing character. Other and more common cases of tlhe palpitation of which I am speaking are found in the conditions affecting the 'ordinary life and habits of the patient. To take one ■ of the -most common cases, we find an over-loaded stomach, and consequently indigestion may produce a very marked effect in causing palpitation. We can •perfectly understand such a result when -we .reflect that the stomach lies immediately below the heart, and that in ail probability any pressure of the stomach upwards is bound to interfere with the

heart’s action. Other cases connected with food and with our habits are easily cited. For example, in many women over-indulgence in tea would appear to produce palpitation of the heart-, and this' fact should 'be duly noted, especially when palpitation occurs in females of a somewhat delicate habit of body. In -males the abuse of tobacco is one of the -rnos-t constant and common causes of palpitation. Tobacco wild not merely -in this way produce symptoms of irritability of the heart, but will likewise conduce to irregular action of the organ. THE AMENT. We must also note tlia.t in the case of delicate and anaemic females palpitation is liable to occur from another cause—namely, that the quality of the blood is not. what it should he. Hence when such persons are sent to the country to breathe fresh air, when their food is carefully supervised, and is of a nutritious character, and, above all, when they are treated with iron as a. tonic, taking, say, twenty drops of dialysed iron in water three times a day after meal®, the palpitation, a® a rule, will cease. Yet- another important cause of palpitation is not merely that seen in an overloaded sto-mach with indigestion. but is also to bo detached in the unwise practice exhibited by -many persons of taking exercise too soon after a meal. My own observations convince me that this is the most fertile cause of this common disturbance of the heart’s action. We see, that in treating ordinary cases of - palpitation the first duty of the individual as -a reasonable being is to revise his life and habits. He should examine very clearly into the conditions I have mentioned by way of detecting which -of them may be said in this sense to lie at the root of his trouble. Proper regulation of his food., the limitation of his alcohol and tobacco, and resting after meals are all important points in connection with the simple cure of this palpitation. If we are dealing with the case of an anaemic woman, I have already said, that her case will he better when her general health is restored. If a certain amount of pain exists in the case of palpitation, the person should loosen the clothing of the neck and chest, should lie down flat in bed, and may then have administered to him a tablespoonfiil of brandy in water. This should not be taken as one dose, but should be sipped. It may he also remembered that in oases where, constipation exists, -especially in women, there is frequently a liability t-o disturbance of the heart’s action. In both sexes, indeed, this condition is worthy of mention. As a rule, tonics are not needed in this ailment; but. if the system is in any way run down there will be no harm done by trying the effect of a teaspoonful of compound syrup of the hypo-phosphites in water after meals thrice daily.