HOW THE PATIENT KICKS-OFF.

Star (Christchurch), Issue 18149, 7 May 1927, Page 1

HOW THE PATIENT KICKS-OFF.

-IEART DISEASE, CAPTAIN OF DEATH PRODUCERS. • Written frvr fbe “Star” by Dr H. T. J. Thacker. Will you sound me, doctor? Heart derangements. More commonly called “ heart disease.” If our motor-car has a noise or knock of any kind the skilled expert mechanic driver will almost think himself a criminal if he pursues his journey. He will test her substantially right through all her systems. The circulation of the blood through the body is governed by the heart and its many valves. Therefore for perfect health all the various parts of the heart and circulation should work in perfect co-ordination. Some Symptoms. Many folk who are walking about and doing their ordinary routine day by day and who have not been thoroughly overhauled, are unaware of any heart defect. They have certain symptoms such as general weakness, shortness of breath on mere exertion, poor circulation, daily swellings that disappear at night to next day towards night, due usually to a want of proper tone of the heart, its valves and blood vessels. Sometimes the valves are narrowed, hardened, and will not close completely . Sometimes there is a general thickening of the lining membranes of these organs due to a previous inflammation of some septic nature such as scarlet fever. This is a so-called unrecognised “ chronic disease ” that like a thief has arrived unseen in the night. Acute infection is a sudden affair that has caught its victim unawares and in an enervated devitalised condition, and soon blows a hole in our natural defence. Immunity. Immunity from disease depends on the strength of the defences. While acute disease is not altogether preventable, chronic disease is on a different footing. A community remains free from chronic disease as long as it lives in accordance with Nature’s laws of health (1). This important fact seems obvious, and yet is not taken into account by the authorities to whom students of medicine look for guidance. People who live under unhygienic conditions fall victims to chronic disease (2). Why? Because their tissues become unhealth y and lose their power of resisting the attacks of microbes. The most widespread and disastrous weakener of the tissues is toxemia. From a septic focus microbic toxins are poured into the general circulation. The focus may be in the teeth, the tonsils, the gallbladder or the appendix, to name only a few. The commonest and most universal focus of all is in the intestines. Since the tissues are supplied with toxic blood they lose their power of resistance and become vulnerable to attack. Any tissue may be attacked and fall a prey to chronic disease. For instance a chronic gastric ulcer never grows in the stomach of a healthy person. Those unfamiliar with this point of view demand proof; it is all too readily available. Take a case of gastric ulcer. The Proof. 1. The general appearances are not those of health. The complexion is dirty: the skin dry and scaly, stained and inelastic; the hands cold, the ears red. 2. The history reveals evidence of longstanding stasis. Constipation since infancy with perhaps a more recent transit on to mucous diarrhoeA. Socalled bilious attacks since childhood. 3. The physical examination discloses evidence of stasis: Thickened portions of the bowel can be felt; the iliac colon nearly aUvays; the terminal ileum in many cases. In many instances the ascending colon can be traced downward over the pelvic brim, indicating ptosis of the cecum. 4. The symptoms, though masked now by the severe pain of the ulcer, can be recognised as those of stasis. They are: Headache, backache, muscular pains, aching joints, neuralgia or neuritis, mental depression, loss of memory and many others. All the physical signs of stasis are confirmed, and many additional details gleaned, by X-ray investigation with ; bismuth. Common Causes. The principal causes of health derangements are: — (a) Overeating of all kinds of food and drinking of too much liquid ; (b) Starches and sugars used above Nature’s requirements, and in a commercial state and which cause digestion fermentations , and flatulence; (c) Improper combinations of food which are bound to produce gas and toxines. cabbage; (d) Gassy foods, onions and cooked cabbage, over-exertion by untrained athletes who never let up between contests, these are usually bad dope smokers. (Tobacco is no good in any form) ; (e) Pressures from without on the blood vessels and heart. Starting the Cure. The rational cures of these conditions are to cut out the causes. Start with a fruit and water fast, to be followed bv a very strict diet of proteids (meaty foods) and non-starchy ■vegetables. Eliminate all sugar foods that are not in their natural state, and all commercial starch. Cut down the liquids and make the blood volume less and of better quality. This will soon reduce fat, weight and take a load off the circulation. Every pound of surplus fat is giving the heart more work. Why carry about four stone of it, 56 pounds. It is a fat “bluey” to lump along that is quite unrecognised and unwarranted. Have the last meal long before bed time, and if the feet are cold and swollen, have a foot warmer, electrical for preference. The Best Holiday. A holiday of twenty-four hours in bed is the best holiday for a busy worker. The ten beats of the heart per minute saved in the lying repose position is 600 per hour. 14,000 per 24 hours. Mind, you take off an already busy and hard working member—- > our heart. Take regular and gentle exercise. Heart disease is now the captain of all death producers. It beats tuberculosis and cancer. It starts as a fuod poison in our circulation and soon has established that comparative new comer “blood pressure.” Listen to what the B.M.A. says of it: It is an insurance bogey. A “modern” only because it is being* now recognised. It has been for al! time, but science and skill can now enumerate it in terms of millimeters of mercury and accuracy. It is not a death sentence. Here, it must be confessed, time and experience have but served to accent the signiCrancf of the finding. High blood presmay, indeed, be but a passing frent, the expression perhaps of a Ni'>motor storm due to worry or overor oven the panic fear of a medical examination; or perhaps it is the signal of some fault of chemistry born of too much food or too much drink, or some other manageable external agency. But it is certain that the more

ot laDour snares. a man’s regular established blood pressure exceeds the modest scale allotted to youth, the less, proportionately, is his prospect of long living. High Pressure. What is a high blood pressure? The question is easier asked than answered, but informed opinion will not quarrel with Professor Gulland when he says that “the normal limit ranges between 110 and 150, with the proviso that, other things being equal, young people tend to have a pressure nearer the lower figure, old people nearer the higher.” There is, however, a wide range of pressures which all would agree in calling high without being able to agree upon the assessment _of their significance. This disability is inherent in the quality of the problem. High blood pressure is either a cause or a consequence of arteriosclerosis —- that is to say, it is attended by very widely spread lesions of the vascular system. The extent of the threat to life in any given case will be settled to a large extent by the precise points of impact of these lesions—that is, by their geographical caprice. And so it comes that one man will live for years on good terms with his blood pressure, although it is of a height which seems capable of putting another into immediate jeopardy of his life; the distinction between them, could we but see it, being perhaps no more than this, that the atheroma which is common to them both occurs harmlessly along the highway of the aorta of the first, while in the second it has barred the coronary or heart-muscle artery. Such are the abiding uncertainties of high blood pressure. Convalescent Period. Having relieved your heart derangement, now you must encourage your bettered condition by a strict convalescence. The management of convalescence is of great importance in that this determines the time and the completeness of a return to health and thus resumption of work. Convalescence should be considered as a stage in an. illness and not as a dissociated event. Adequate measures, therefore, should be employed to insure proper treatment during the convalescent state. At the present time convalescent management is unsatisfactory. The homes in existence are not correlated, the organisation in general is not a comprehensive one and the supply oi convalescent beds is far below the normal demands. Two Classes of Homes. Two classes of convalesce for medical cases should be p .od, one for private hospjtal and dispensary patients who are able to pay a moderate sum for their maintenance; another for those able to pay little or nothing. Both classes should make provision for adequate care of one or more of the different tvpes of medical convalescents., provision for quarters, staff and treatment. The correlation of the homes, their relationship to hospitals, dispensaries and physicians, and the distribution of ! patients to them, should be in charge i of a central agency. A comprehensive plan for convalescent relief should begin with the establishment of this central agency and the classification and where necessary, the reorganisation of existing homes. Our sunny Cashmere slopes is the most ideal spot.