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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    irregularity of the heart's action. It is more frequent, however, in later life, in women than in men, in the old than in the young, in those of a relaxed and irritable habit than in the robust. It is familiar to dyspeptic persons, in whom 1 have known it to be very harassing when the stomach was empty; for example, just before dinner: under such circumstances, moderate eating relieves the palpitation; but if the patient continues to eat to repletion, or in- dulges in stimulants, so as to render digestion laborious, the pal- pitation not only returns but is greatly aggravated. Mr. Teale refers this disease to a morbid state of the cervical ganglia of the sympathetic nerve. He also remarks, and I think with great truth, that palpitations purely nervous are principally distinguished from palpitations dependent upon organic disease of the heart, by the absence of other symptoms which denote a change of structure in that organ. In hypertrophy the pulsations of the heart are more vehement and more uniform: in dilatation they are felt over an unnatural extent of the chest: when there is obstruc- tion to the circulation from contracted orifices—from loss of func- tion in the valves, or from morbid alterations of the muscular structure, there are generally, in a greater or less degree, blueness, oedema, &c.*J Treatment.—Venesection, or the application of leeches, is sometimes advisable, particularly in young plethoric individuals, who are afi'ected at the sa:me time witli some febrile movement. French practitioners recommend the application of leeches to the anus in nervous palpitations. Laxatives, cold or warm bathing, moderate exercise in the open air, light nourishing diet, early hours, and avoiding the exciting cause, will usually be found suc- cessful. When the affection, however, resists these remedies, various antispasmodics have been recommended, as opium, ether, musk, castor, and valerian; of all these, perhaps the best is the vo- latile tincture of valerian. [1 have somewhere seen it asserted that twelve grains of cam- phor, given in divided doses through the day, will quiet the most tumultuous action of the heart. When palpitation can be traced to spinal irritation, Mr. Teale's plan of applying the remedies to the spine itself should not be omitted. It must, however, be acknowledged, that although leeching, cupping and blistering to the spine will sometimes re- [* Treatise on neuralgic diseases, p. 44.]