A systematic treatise, historical, etiological, and practical, on the principal diseases of the interior valley of North America : as they appear in the Caucasian, African, Indian, and Esquimaux varieties of its population / By Daniel Drake, M. D. Ed. by S. Hanbury Smith and Francis G. Smith.
- Daniel Drake
- Date:
- 1854
Licence: Public Domain Mark
Credit: A systematic treatise, historical, etiological, and practical, on the principal diseases of the interior valley of North America : as they appear in the Caucasian, African, Indian, and Esquimaux varieties of its population / By Daniel Drake, M. D. Ed. by S. Hanbury Smith and Francis G. Smith. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
952/998 page 948
![existence; for the very object of the knowledge is the prevention of structural derangement. If our patient have a quiet heart, and an equable not over frequent pulse, we may pronounce that cardiac inflammation does not exist; but on the other hand, if his heart beat convulsively and frequently, inflam- mation may or may not be present. Now, there are conditions of the system which produce this kind of pulse when no cardiac inflammation co-exists; and it is the function of the physician to distinguish between them. But still further, some of these conditions, as we shall see in a sub- sequent section, are themselves causes of cardiac inflammation, and hence palpitations which were at first altogether nervous and sympathetic, come at length to be inflammatory; thus, still further increasing the perplexity of the case. The diatheses or morbid conditions which generate palpitations, simula- ting those from subacute cardiac inflammation, as I have observed them in this country, are chiefly the following: a. Th Dyspeptic; I. The Icteric; c. The Ilysteric; J. The ChJorotic; c. T/te Uiero-Hetnorrhagic, or Menor- rhagie; f. 77c Plethoric} which we most consider seriatim. a. 77ie Dyspeptic.—It is well known that dyspepsia is a wide-spread- ing and prevalent endemic of this country, and that it affects young men more than any other class of persons, they being at the same time most liable to cardiac inflammation. Now, dyspepsia produces palpitation of the heart, and gloominess of mind, both of which are present in the early not less than the latter stages of cardiac inflammation. Still further, many cases of dyspepsia are inflammatory, and, of course, accompanied by more or less feverishness after a full meal, or in the evening. A case of this kind pre- sents broad ground for doubt and hesitation as to the condition of the heart, while that of the stomach can scarce]}- be misunderstood. If, upon exami- nation, the precordial region should be found tender, or the seat of pain, the conclusion ought to be, that incipient carditis is superadded to more advanced gastric inflammation, for there is a high probability that suchjs the case; and if it should be otherwise, the treatment which the dyspepsia demands will not be injurious. If the dyspepsia, upou a careful inquiry into the signs of a phlogistic diathesis, should be found not to be inflammatory, of course the cardiac affection ought to be regarded as consisting simply in morbid irritability. Palpitations depending on this cause, it has been said, are not increased by exercise, while those which accompauy cardiac inflam- mation are; I feel assured, however, that muscular effort docs, in many cases, increase them; though it will not excite the pain or anguish in the region of the heart, and the tendency to fainting, which it is wont to occa- sion when inflammation is present. Still, palpitations arising solely from an irritable state of the heart may lesseu during protracted exercise, while those depending on inflammation will not. The former abate when the patient is quiet in bed, but the latter are often augmented under Buoh cir- cumstances. Finally, when the patient lies on his left side, he will feel](https://iiif.wellcomecollection.org/image/b21026816_0952.jp2/full/800%2C/0/default.jpg)
