The bicarbonate of soda relieves the gas and swelling of the stomach,
while the rhubarb has a tonic action and relieves the bowels. The spirits
of peppermint stimulates the mucous membrane.
4. Poor Circulation, Remedy for Stout Person.--"Ten cents worth of salts,
five cents worth of cream of tartar; mix and keep in a closed jar. Take
one teaspoonful for three nights, then skip three nights." This is an
old-time remedy known to be especially good, as the salts move the bowels
and the cream of tartar acts on the kidneys, carrying off the impurities
that should be thrown off from these organs.
PHYSICIAN'S TREATMENT FOR PALPITATION.--When caused by valvular trouble,
digitalis can be given as above directed under heart failure.
When Caused by the Stomach.--From gas or too much food, take salts to move
the bowels. Hot whisky is good when caused by gas; or soda, one
teaspoonful in hot water is also good when gas causes palpitation.
[CIRCULATORY DISEASES 339]
Difficult Breathing.--If caused by gas, soda, hot whisky or brandy will
relieve. If caused by too fast beating of the heart, give digitalis as
above directed. If caused by dropsy, the regular remedies for dropsy. If
the dropsy is due to scanty urine you can use infusion of digitalis, dose
one to four drams; or cream of tartar and epsom salts, equal parts, to
keep the bowels open freely.
PHYSICIAN'S CAUTIONS:--Quiet the patient's mind and assure him there is no
actual danger; moderate exercise should be taken as a rule with advantage.
Regular hours should be kept and at least ten hours out of twenty-four
should be spent in lying down. A tepid bath may be taken in the morning,
or if the patient is weakly and nervous, in the evening, followed by a
thorough rubbing. No hot baths or Turkish bath. Tea, coffee and alcohol
are prohibited. Diet should be light, and the patient should avoid
overeating at any meals. Foods that cause gas should not be used. If a
smoker the patient must give up tobacco. Sexual excitement is very
pernicious, and the patient should be warned especially on this point.
Absolute rest for the distressing attacks of palpitation which occur with
nervous exhaustion. In these cases we find the most distressing throbbing
in the abdomen, which is apt to come after meals, and is very much
aggravated by the accumulation of gas.
Diet.--A person with heart disease should not bring on palpitation from
over-eating or eating the wrong kind of food. Such a person dare not be a
glutton. The diet must be simple, nutritious, but food that is easily
digested. Any food that causes trouble must be avoided; starchy foods,
spiced foods, rich greasy foods, are not healthy for such a person. The
stomach must be carefully treated by such a patient. The bowels should
move daily. The kidneys should always do good work and pass enough urine
and of the right color and consistency. Stimulants like alcohol, tea and
coffee are not to be used. Weak cocoa is all right in most cases. Hot
water, if any drink must be taken, at meals. Such a patient in order to
live and live comfortably, must take life easy. He cannot afford to run,
to over lift, or over exert, to walk fast upstairs, hurry or to "catch the
car." He must not get angry or excited. Games of all kinds that have a
tendency to make him nervous must be avoided. The same caution applies to
exciting literature. In short, a patient with organic heart disease must
be a drone in the hum of this busy, fast-rushing life, if he would hope to
keep the spark of life for many years. Sleep, rest and quiet is a better
motto for you than the strenuous life.
[340 MOTHERS' REMEDIES]
The Heart.--The heart is the central organ of the entire system and
consists of a hollow muscle; by its contraction the blood is pumped to all
parts of the body through a complicated series of tubes, termed arteries.
The arteries undergo enormous ramifications (branchings) in their course
throughout the body and end in very minute vessels, called arterioles,
which in their turn open into a close meshed network of microscopic (very
minute) vessels, termed capillaries. After the blood has passed through
the capillaries it is collected into a series of larger vessels called
veins by which it is returned to the heart. The passage of the blood
through the heart and blood vessels constitutes what is termed the
circulation of the blood. The human heart is divided by a septum
(partition) into two halves, right and left, each half being further
constricted into, two cavities, the upper of the two being termed the
auricle and the lower the ventricle. The heart consists of four chambers
or cavities, two forming the right half, the right auricle and right
ventricle, and two forming the left half, the left auricle and left
ventricle. The right half of the heart contains the venous or impure
blood; the left the arterial or pure blood. From the cavity of the left
ventricle the pure blood is carried into a large artery, the aorta,
through the numerous branches of which it is distributed to all parts of
the body, with the exception of the lungs. In its passage through the
capillaries of the body the blood gives up to the tissues the material
necessary for their growth and nourishment and at the same time receives
from the tissues the waste products resulting from their metabolism, that
is, the building up and tearing down of the tissues, and in so doing
becomes changed from arterial or pure blood into venous or impure blood,
which is collected by the veins and through them returned to the right
auricle of the heart.
From this cavity the impure blood passes into the right ventricle from
which it is conveyed through the pulmonary (lung) arteries to the lungs.
In the capillaries of the lungs it again becomes arterialized by the air
that fills the lungs and is then carried to the left auricle by the
pulmonary veins. From this cavity it passes into that of the left
ventricle, from which the cycle once more begins. The heart, then, is a
hollow muscular organ of a conical form, placed between the lungs and
enclosed in the cavity of the pericardium. It is placed obliquely in the
chest. The broad attached end or base is directed upwards, backwards and
to the right and extends up to the right as high as the second rib and the
center of the base lies near the surface underneath the breast bone. The
apex (point) is directed downwards, forward and to the left and
corresponds to the space between the cartilage of the fifth and sixth
ribs, three-fourths of an inch to the inner side, and one and one-half
inches below the nipple, or about three and one-half inches from the
middle line of the breast bone. The heart is placed behind the lower two-
thirds of the breast bone and extends from the median line three inches to
the left half of the cavity of the chest and one and one-half inches to
the right half of the cavity of the chest.
Size: In adults it is five inches long, three and one-half inches in
breadth at its broadest part and two and one-half inches in thickness.
Weight in the male ten to twelve ounces; in the female eight to ten. It
increases up to an advanced period of life. The tricuspid valve (three
segments) closes the opening between the right auricle and right
ventricle. Pulmonary semilunar valves guard the orifice of the pulmonary
artery, keeping the blood from flowing back into the right ventricle. The
mitral valve guards the opening to the left ventricle from the left
auricle. The semilunar valves surround the opening from the left ventricle
into the aorta and keep the blood from flowing back. If any one of these
valves becomes diseased it may not thoroughly close the opening it is
placed to guard and then we have a train of important symptoms.
[CIRCULATORY DISEASES 341]
PERICARDITIS.--This is an inflammation of the pericardium, the sac
containing the heart.
Primary or First Causes.--They refer in this disease to a peculiar
constitution. Children that have a tuberculous constitution are more
liable to this disease. Acute rheumatism or tonsilitis are the causes and
this trouble follows or goes with them. Infectious diseases also cause it.
Symptoms.--Slight pain in the heart region, fever moderate. These subside
or effusion may set in and this usually occurs with acute rheumatism,
tuberculosis and septicemia. Sometimes these symptoms are absent.
Treatment of Pericarditis.--The patient must rest quietly in bed and a
doctor should be in attendance. An ice bag placed over the heart
frequently gives relief and quiets the distress and pain. There is apt to
be liquid in the sac (pericardium) and to lessen the tendency to this
there should not be much drink or liquid food taken. There should be what
is called a dry diet. (See Nursing Department for this.)
ENDOCARDITIS.--Inflammation of the lining of the heart chiefly confined to
the valves; it may be acute or chronic.
Simple Kind, Cause.--Occurs at all ages, but most often in children and
young adults. It most frequently comes with acute rheumatism, chorea,
tonsilitis, scarlet fever, and pneumonia. The valves in the left heart are
most often affected, the mitral simply swollen or bearing small growths.
Symptoms.--If it is caused by acute rheumatism, there may be higher
temperature, without increase of joint symptoms. Heart beats faster and is
irregular. It may run into chronic valvular disease.
Treatment of Endocarditis.--Preventive.--Much can be done to prevent this
disease by closely watching the patient having the disease that causes it.
The heart should be closely watched. Acute inflammatory rheumatism is a
frequent cause and the heart must be watched continually in this disease.
When the patient has this disease he must be quiet and in bed. This is
essential. A doctor must be called, for the disease is serious and
dangerous.
Diet.--Should be liquid. Milk or preparations made with it is the usual
diet. Care must be taken that the stomach and bowels be not disordered.
Gas collecting in the stomach causes much distress to one who has
endocarditis or valvular disease.
Caution.--Avoid early exertion after getting well.
[342 MOTHERS' REMEDIES]
CHRONIC ENDOCARDITIS.--Usually occurs in persons under middle age.
Generally follows acute endocarditis. It may be caused by syphilis,
alcoholism, gout, and prolonged over-exertion. The edges of the valve
become thickened and then the thickened parts separate and cannot meet
exactly and therefore fail to close the opening they are set to guard.
CHRONIC VALVULAR DISEASE.--Results of valve lesions. Narrowing of a valve
causes increased difficulty in emptying the chamber of the heart behind
it. Insufficiency of a valve allows the return of the blood through the
valve during the dilation of a chamber, thus increasing the amount of
blood entering the chamber beyond the normal. Either trouble causes
dilation of the chamber and compensatory hypertrophy. Enlargement of its
wall must take place in order to perform the extra work demanded
constantly, for the normal reserve force of the heart muscles can
accomplish the extra task only temporarily. This enlargement increases the
working power of the heart to above normal, but the organ is relatively
less efficient than the normal heart, as its reserve force is less and
sudden or unusual exertion may cause disturbance or failure of the
compensation acquired by the enlargement. If this loss of reserve force is
temporary, compensation is restored by further enlargement and by
diminution, by rest, of the work demanded of the heart. Any valvular
lesion, whether a stenosis (narrowing) of the outlet or insufficiency from
the moment of its origin, leads to certain alterations in the distribution
of pressure upon each side of the affected valve. If the body of the heart
itself did not possess a series of powerful compensatory aids, that is,
the power of making good a defect or loss, or restoring a lost balance, to
improve this relation of altered pressure, then every serious lesion at
its very beginning would not only cause serious general disturbances of
circulation, but very soon prove fatal. Without compensation of the power
of making good the defect or loss, the blood in every valvular disease or
lesion would be collected behind the diseased valve. The heart's reserve
power prevents to a certain extent such a dangerous condition; the
sections of the heart lying behind the diseased valve work harder,
diminish the blood stoppage and furnish enough blood to the peripheral
arteries. The reserve force is used in stenosis to overcome the obstacle,
whereas in insufficiency it must force more blood forward during the
succeeding phase through the diseased valve. To effect this increased work
permanently, anatomic changes in the heart are bound to follow. The
changes consist in hypertrophy (enlargement of the heart muscle) and
dilatation of the different chambers. Under this head, compensation, is
included the increased filling and increased work of certain heart
chambers with their resulting dilatation and hypertrophy. But this
compensation cannot last forever. It fails sometimes and certain symptoms
follow as hereafter related. Therefore persons who have valvular disease
and who have been informed that the heart has adapted itself to the
condition by enlarging of its walls and chambers and thus forming the
condition called compensation, should be very careful of their mode of
living and not put any undue or sudden strain upon the heart that might
destroy the conditions that make compensation continue. In the following
pages symptoms are given showing what happens when compensation continues
and when it fails.
[CIRCULATORY DISEASES 343]
AORTIC INSUFFICIENCY OR INCOMPETENCY.--The valves are not doing their work
thoroughly.
Symptoms.--They are often long absent; headache, dizziness, faintness,
flashes of light, difficult breathing, and palpitation on exertion, and
pain in the heart region may occur early. The pain may be dull and
localized, or sharp and radiating to the neck or left arm. When
compensation fails, we have difficult breathing, which is worse at night,
swelling of the eyes and feet, cough, anemia. Sudden death is more common
in this than with any other valvular disease. You can hear a soft blowing
sound by listening with your ear.
NARROWING (Aortic Stenosis).--Caused by chronic endocarditis, etc. Their
valve segments are usually adherent to each other by their margins and are
thickened and distorted.
Symptoms.--When compensation is gone, diminished blood in the brain causes
dizziness and faintness.
MITRAL INSUFFICIENCY OR INCOMPETENCY.--This is the most common valvular
disease. The segments of the valve may be shortened and deformed. There is
often stenosis (narrowing) caused by this deformity. The effects are
regurgitation, flowing back of blood from the left ventricle into the left
auricle, which is also receiving blood from the lungs, causing dilatation
of the auricle and its enlargement to expel the extra blood; dilatation
and other enlargement of the left ventricle occurs on account of the large
quantity of blood forced in by the auricle; obstruction to flow of blood
from pulmonary veins due to extra blood in left auricle, hence dilatation
and enlargement of right ventricle which forces blood through the lungs;
dilatation and enlargement of right auricle.
Symptoms.--If compensation is slightly disturbed we have blueness
(cyanosis), clubbing of the fingers, hard breathing on exertion, and
attacks of bronchitis and bleeding from the lungs. If compensation is
seriously disturbed we are likely to have the blueness (cyanosis) more
marked, heart beat feeble and irregular, constant hard breathing, with
cough and water or bloody sputum, dropsy in the feet first and going up
and involving the abdomen and chest cavities.
MITRAL STENOSIS.--This is the narrowing of the valve opening. It is most
common in young persons, chiefly females. The narrowing of the valve
opening may be due to thickening or hardening of the valve segments,
adhesion of their edges, thickening and contraction of the tendinous cords
of the valve ring.
Symptoms.--Similar to mitral insufficiency, but they develop slower and
those symptoms of venous congestion of the lungs, liver, etc., are more
marked; bleeding from the lungs is more common.
[344 MOTHERS' REMEDIES]
TRICUSPID (VALVE) INSUFFICIENCY.--Cause.--Usually due to dilatation of the
right ventricle in mitral disease or with lung emphysema or other
obstruction to the lungs' circulation.
TRICUSPID STENOSIS (NARROWING).--Rare except in cases from the time of
birth.
Recovery from the valvular disease, depends upon the degree of
compensation maintained and is best when this is acquired spontaneously.
This is to be judged by the heart action. The prognosis is poor in
children. It is better in women than in men.
Treatment (a) While Compensated.--Medicine is not necessary at this
period. The patient should lead a quiet, regulated, orderly life, free
from excitement and worry; and the risk of certain death makes it
necessary that those suffering from a disease of the aorta should be
especially warned against over-exertion and hurry. An ordinary healthy
diet in moderate quantities should be taken, tobacco and stimulants not
allowed at all.
The feelings of the patient must control the amount of exercise; so long
as no heart distress or palpitation follows, moderate exercise will be of
great help. A daily bath is good. No hot baths should be taken and a
Turkish bath absolutely prohibited. For the full-blooded, fleshy patient
an occasional dose of salts should be taken. Patients with a valvular
trouble should not go into any very high altitudes; over-exertion, mental
worry and poor digestion are harmful.
(b) The stage of broken compensation. Rest. Disturbed compensation may be
completely restored by rest of the body. In many cases with swelling of
the ankles, moderate dilatation of the heart and irregularity of the
pulse, the rest in bed, a few doses of the compound tincture of cardamon
and a saline purge suffice within a week or ten days to restore the
compensation. For medicine a doctor must be consulted as each individual
case must be treated according to its peculiar symptoms.
FATTY HEART.--This occurs often in old age, prolonged, infectious, wasting
disease, anemia, alcoholism, poisoning by phosphorus and arsenic.
ANGINA PECTORIS.--True angina, which is a rare disease, is characterized
by paroxysms of agonizing pain in the region of the heart, extending into
the arms and neck. In violent attacks there is the sensation of impending
death. Usually during the exertion and excitement, sudden onset of
agonizing pain in the region of the heart and a sense of constriction, as
if the heart had been seized in a vise. The pains radiate up the neck and
down the arm. The fingers may be numb. The patient remains motionless and
silent, the face usually pale or ashy with profuse perspiration. Lasts for
several seconds or a minute or two.
[CIRCULATORY DISEASES 345]
Treatment.--Live an absolutely quiet life, avoid excitement and sudden
muscular exertion. During the attack, break a pearl of amylnitrite in a
handkerchief and inhale the fumes. These should always be carried. If no
relief is had in a minute or two chloroform should be given at once. It is
dangerous and you must look to your physician for advice and treatment.
ARTERIOSCLEROSIS.--A localized or diffused thickness of the inner coat and
then of the other coats of the arteries. Arteries look lumpy and are
crooked, dilated with stiff, thin or calcified walls. All coats,
especially the middle, show degeneration. It usually comes in later life.
Treatment.--Regulate the mode of life, avoid alcohol, excess of eating,
drinking, exertion, excitement and worry. Keep the bowels and kidneys
acting regularly. There is no medicine for it.
ANEURISM.--This is a local dilatation of an artery. A local tumor.
Treatment.--Absolute rest, restrict fluids. There is always danger from
rupture.
MYOCARDITIS.--This is an inflammation of the muscle substance of the
heart. It may be acute or chronic.
Causes.--Endocarditis and pericarditis in the course of rheumatism; acute
fevers like typhoid, etc.; clots lodging in the heart arteries, coming
from diseases such as septicemia and pyemia.
Symptoms.--The heart is weak. The pulse is rapid, small and irregular,
palpitation and fainty sensations come on suddenly during the course of
diseases mentioned. The outlook is serious and life may end suddenly.
Treatment.--The same as that given for endocarditis. Absolute rest is
necessary. A good nourishing diet must be given and a doctor is always
needed.
PHLEBITIS, INFLAMMATION OF THE VEINS.--Causes.--Some irritation of the
vein, as a puncture or any other injury accompanied by infection.
Symptoms.--Pain and tenderness along the course of the vein with
discolored skin and acute swelling (watery) below the obstruction. Pulse
rapid, high temperature, chills, dry and brown tongue and pain.
Treatment.--Absolute quiet is necessary, with the affected limb elevated.
Lead and laudanum wash should be applied, or hot antiseptic fomentations
if an abscess is forming. An abscess should be opened, keep up the
patient's strength.
[346 MOTHERS' REMEDIES]
VARICOSE VEINS (Varix).--This term means an enlarged, elongated, tortuous,
knotty condition of the veins. The term "varicose veins" is restricted in
general use to the veins of the extremities, and especially those
belonging to the lower extremity. The disease begins with a slow dilation
of the vein, which gradually becomes thickened and tortuous. The inner
lining membrane or coat of the vein is altered, the valves are shortened
and thus rendered insufficient to support the column of blood. The outer
coat becomes thickened. The varicose conditions affect chiefly the
superficial veins.
Predisposing Causes.--They are most frequent in the female sex. The
tendency increases as the age advances. Obstruction. Anything that
obstructs the full return of blood in the veins, as tight garters below
the knee, etc. Standing work may bring it on.
Exciting Causes.--Tumors in the pelvis; diseases of the heart and lungs;
pregnancy. These all obstruct the full return of blood in the veins.
PHYSICIANS' TREATMENT FOR VARICOSE VEINS.--Palliative.--Remove the cause
if possible. Treat the heart and lung troubles. Remove the pelvic tumors.
In pregnancy, the woman afflicted with this trouble should not be much on
her feet, but should remain lying down in bed as much as possible. This
position removes the weight of the pregnant womb from the veins and allows
a free return of the venous blood. An elastic bandage, or a perfectly
fitting elastic stocking, supports the veins, equalizes the circulation
and turns the flow to the deeper veins, which do not, as a rule, become
varicose. This silk stocking should be made to order. This treatment gives
much comfort in chronic varicose veins.