MEDICAL

Western Star, 13 June 1933, Page 4

MEDICAL

CAUSES OF FAINTING. LACK OF BALANCE Fainting seems to be increasingly common, to judge by recent reports. Formerly it was women who fainted on the slightest provocation, in the days of tight-lacing and bad - ventilation. Nowadays all sorts of people faint—boys at drill at school, soldiers at reviews, people in crowds, and. so forth. It ,is possible for a pedson standing too close to the edge of a railway platform, to' be made giddy by the rapidly-moving object, the approaching train. Owing to the giddiness on* tends to turn, and in turning to fa-1 over the edge of the platform on to the rails. People with any tendency to become giddy ought to be careful not to stand too close to the edge of a platform or a quay where a moving object, train or steamer, may come along close to them. LOWERING OF BLOOD PRESSURE

Apart from the tendency to giddiness, there is the much 1 commoner example of fainting from a sudden lowering of tlie, blood pressure.

This. Usually occurs when a person who has been asleep or resting sud denly jumps up and, feeling ‘queer’, loses consciousness for a few second: and falls down

Here the sudden change from tin horizontal to the upright posture lia: allowed the blood to “pool” in th: thin-walled and never full abdomina veins, so that, for an instant or two not enough blood reaches the heart and consequently not enough gets tc the brain. This diminution of blood supply to the brain is associated witl a- temporary loss of consciousness, anc" loss of conscipusness with an'upset o the equilibrium. HEAT PROSTRATION

Again, when a person has beei standing still foil a long time, and the inactiv© muscles, therefore, have no; been sending up. blood to the heart the blood pressure in the brain i liable to fall below the limit at which consciousness is maintained. This kind of inaction during hot weather, added to by til© general' enfeeblement caused through . the heat (heat prostration) will readily induce fainting. For this reason people who havf been obliged' to stand in the sun in r crowd are liable .to fall down in <• faint; and men are by no means ex empt from this lowering of blood pressure in the brain.

There is a. simple device to keep, uj the blood pressure—a tight abdoniina , bandage, l called in the tropics a “chol era pelt,” Professor Sir Leonard Hill. F.R.S., showed, many years ago tha' the fall of blood pressure due to pos tme might be-prevented, or counter acted by a bandage placed round, th ower part of the body. It should Ik laced from below upwards, and neec not be of thick material. BLOOD PRESSURE NORMAL VARIATIONS. In the routine examination o! middle-aged and elderdy patients it inow almost taken for granted that the blood pressure should be included. Bu there is probably no subject on which there t s a more general, and ven understandable degree of misapprehension.

'lilts may be attributed to the fact tiiat the general recording of blood pressure has been a matter of com parative recent practice; and there have necessarily been various adjustments of medical opinion as observations and data have accumulated. These are still m process of being collected and sifted, bu t one o r two general conclusions may be said to have emei'ged.

rite earlier ulea s 0 f what constituted an abnormally high blood p.essure and the gravitv with which tinwas regarded, have been .considerably modified. It has been clearly demon strated now that-, in the same person m different circumstances the blood pressure may vary within’very lar-c degrees. " ”

Physical exercise, mental activity, emotional excitement cr apprehension’ may all be potent factors in producing a high but usually temporarv anil not pathological blood pressure; and %se were factors a few years

ago were not perhaps sufficiently recognised

Again, extensive group investigations amongst young and healthy subjects have revealed the existence of what once were regarded as dangerously high blood pressures; and these have been found to be compatible with apparently perfect physical health. Meanwhile the present opinion of most expert and experienced cardiolo gists has come to ‘regard a comparatively high blood pressure, in the absence of any associated symptoms, with very much more equanimity than was once the case.

A very large number of cases lias now been followed up for a sufficiently long period to show that, even in middle-aged arid elderly persons, a relatively high blood pressure can be consistent with good 1 health and normal activity. From a practical point of view, while it may prudently be taken as a hint for moderation in eating and drinking, it heed nofc necessarily be the cause of alarm that it is so often apt to be.