Principles of pathology and practice of physic (Volume 2).

  • Mackintosh, John, -1837.
Date:
1837
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Licence: Public Domain Mark

Credit: Principles of pathology and practice of physic (Volume 2). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    may also be pain in the region of the heart, with constriction of the chest, and flatulent eructations.] Nervous palpitations are not to be neglected, as by frequent repetition they may lead to disease of structure, either in the heart itself, or in some other organ. Laennec says, that he has never seen any proof of the accuracy of this opinion, but I think I have. According to Laennec, in nervous palpitation, the first impres- sion conveyed by the stethoscope is, that the heart is not enlarged. The sound, though clear, is not heard loudly over a great extent, but this very much depends upon the thickness of the parietes of the chest. In thin people, I hear the sound during palpitation, in every spot on the anterior part of the chest; and when the heart is acting very violently, I have perceived it in the back also. With respect to the impulse, Laennec states, that in the nervous affec- tion, the head of the observer is never sensibly elevated. This, he says, is the most important and certain of any sign, when taken in conjunction with the frequency of the pulsations, which are always quicker than natural, most frequently from 84 to 96 in the minute. I have seen and felt the impulse of the heart in nervous palpitation, not only elevate'the head of the observer, but raise the bed-clothes. Dr. Ferrier, one of the most accurate of observers, in detailing a case of violent palpitation of the heart, states, (p. 205, vol. 1st,) Every stroke of the pulsation raised her clothes, so as to be visible at some distance; under the use of castor, with at- tention to her clothing and diet, siie recovered in the course of a few weeks. In this affection, there are rarely any signs of deter- mination of blood to the head or chest. It is rare that palpitations produced by functional derangement of the heart continue long at any time: they are in general tran- sient, and are perhaps less troublesome when the patient is taking exercise in the open air, than at other times. When of lono- con- tinuance, and without intermission, they will for the most part be found to depend on some organic lesion. [I have paid great attention, for the past few years, to what are called nervous palpitations, and have been astonished at their ex- treme frequency. I have made it a rule to interrogate every pa- tient on this subject, and am satisfied that at least one fourth of the whole number suffers with irregular action of the heart. It is even common in infancy; and although the patient may be loo young to describe his feelings, the intermittent pulse detects the