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
During the acute faint attack, camphor is one of the best
stimulants. Alcohol may be of benefit. If syphilis is a cause of the
condition, iodids are always valuable. If syphilis is not a cause
and arteriosclerosis is present, small doses of iodid given for a
long period are beneficial, although it may not much reduce the
blood pressure or decrease the plasticity of the blood. Iodid is a
stimulant to the thyroid gland, and therefore it is on this account
valuable.
An excellent stimulant to the heart is thyroid secretion or thyroid
extract. Theoretically thyroid extracts should be the treatment for
a slow-acting heart. It sometimes seems of benefit to these
patients, but it often causes such nervous excitation and
irritability as to preclude its use. The dose of thyroid for this
purpose would be small, about one-fourth to one-half grain of the
active substance three times a day. To be of any value, the
preparation must be good.
Epinephrin has been shown by Hirtz [Footnote: Hirtz: Arch d. mal. du
coeur, February, 1916] to overcome experimental heart block. It is
not clear just how it acts, but it could well be tried in heart
block when the blood pressure is not too high. A few drops of an
epinephrin solution 1:1,000 may be placed on the tongue, and
repeated three times a day, or from 5 to 10 minims of a weaker
solution may be given hypodermically.
The usual precautions against overeating, overdrinking, severe
physical exercise, sudden movements, overuse of tobacco, etc.,
should all be urged on the patient. The disease is sooner or later
fatal, although the patient may live some years. Death is generally
sudden.
It is understood that this disease must he separated from the
condition of bradycardia inherent in a few persons who have a slow
pulse throughout their life, without any untoward symptoms.
CARDIOVASCULAR RENAL DISEASE
With the strennousness of this era, this disease or condition, which
may be regarded as one of the accompaniments of normal old age, has
become of grave importance, and nowadays frequently develops in
early middle life. If it is diagnosed in its incipiency, and the
patient follows the advice given him, the progress of the disease
will generally be inhibited, and a premature old age postponed.
In the beginning the symptoms and signs of this disease are
generally those of hypertension, and the treatment and management is
that advised in hypertension. If the kidneys show irritation, as
manifested by the presence of albumini and casts in the urine, or if
they show insufficiency in the twenty-four-hour excretion of one or
more salts or other excretory product, the diet and life must be
more carefully regulated than advised in hypertension, and the
treatment becomes practically that of chronic interstitial
nephritis.
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