Disturbances of the Heart: Discussion of the Treatment of the Heart in Its Various Disorders, With a Chapter on Blood PressureOsborne, Oliver T. (Oliver Thomas)
Science
Disturbances of the Heart: Discussion of the Treatment of the Heart in Its Various Disorders, With a Chapter on Blood Pressure
Osborne, Oliver T. (Oliver Thomas)
Blood pressure; Heart -- Diseases
Alcohol is also a valuable treatment of this pain, when the drugs
mentioned are not at hand. The dose should be large; whisky or
brandy is best, and should be administered in hot or at least warm
water. The physiologic action of alcohol, which dulls or benumbs the
nervous system and dilates the peripheral blood vessels, is exactly
in line with the clinical indications.
If a patient is home and at rest at the time of an attack, a hot-
water bag but slightly filled, or a pad electrically heated, may be
placed over the heart some times with marked advantage and relief
from pain. Occasionally even such gentle applications are not
tolerated.
After the attack is over, absolute rest for some hours, at least, is
positively necessary. If the attack was severe, the patient should
rest several days, as there seems to be a great tendency for such
attacks to come in groups, the cause being acutely present for at
least some time. But little food should be given; nothing very hot
or very cold, and no large amount of liquids; gentle catharsis may
be induced on the following day, if deemed advisable; no stimulating
drugs should be administered, and nothing which would raise the
blood pressure.
The question often arises as to whether or not the patient shall be
told of the seriousness of his condition. It is hardly wise to
withhold this knowledge from him, and generally is not necessary.
The ordinary alert patient knows how serious the condition is by his
own feelings, and will even reprove or joke with his physician for
minimizing the danger. It is best that the whole subject be
discussed carefully with him and his life regulated and ordered, and
emergency drugs prepared and given him with proper instructions, to
the family, so that he may possibly prevent other attacks and, if
they occur, may have the best immediate treatment.
The acute symptoms being over, a careful analysis of the probable
cause of the anginal attack should be made. If it is a general
sclerosis, the treatment should be directed to that condition. If it
is a myocarditis, a fatty degeneration of the heart or a fatty
heart, this should be properly treated as previously described. If
it is due to a toxemia from intestinal disturbance, that may readily
be remedied. If due to nicotin, it need not again occur from that
reason, and perhaps the damage caused by the nicotin may be removed.
Any organic kidney trouble must, of course, be managed according to
its seriousness, and if there is hypertension without any serious
lesion, the treatment should be directed toward its relief.
Not infrequently, whether a patient is suffering from real angina
pectoris or a pseudo-angina pectoris, the absorption of toxins irons
the intestines, due to indigestion and fermentation, adds to these
cardiac pains, and may even be a cause of them. Consequently,
eliminative treatment and a temporary rigid diet, and various
treatments to prevent intestinal indigestion, are of great value in
angina pectoris.
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