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The Care Of The Heart-pump

Source: A Handbook Of Health

The Effect of Work upon the Heart. Whatever else in this body of ours
may be able to take a rest at times, the heart never can. When it stops,
we stop! Naturally, with such a constant strain upon it, we should
expect it to have a tendency to give way, or break down, at certain
points. The real wonder is that it breaks down so seldom. It has great
powers of endurance and a wonderful trick of patching up break-downs and
adjusting itself to strains.

Every kind of work, of course, done in the body throws more work upon
the heart. When we run, or saw wood, our muscles contract, and need more
food-fuel to burn, and pour more waste-stuff into the blood to be thrown
off through the lungs; so the heart has to beat harder and faster to
supply these calls. When our stomach digests food, it needs a larger
supply of blood in its walls, and the heart has to pump harder to
deliver this. Even when we think hard or worry over something, our brain
cells need more blood, and the ever-willing heart again pumps it up to
them. This is the chief reason why we cannot do more than one of these
things at a time to advantage. If we try to think hard, run foot races,
and digest our dinner all at one and the same time, neither head,
stomach, nor muscles can get the proper amount of blood that it
requires; we cannot do any one of the three properly, and are likely to
develop a headache, or an attack of indigestion, or a stitch in the
side, and sometimes all three. So the circulation has a great deal to
do with the intelligent planning and arranging of our work, our meals,
and our play. If we are going to increase our endurance, we must
increase the power of our heart and blood vessels, as well as that of
our muscles. The real thing to be trained in the gymnasium and on the
athletic field is the heart rather than the muscles.

Fortunately, however, the heart is itself a muscle, alive and growing,
and with the same power of increasing in strength and size that any
other muscle has. So that up to a proper limit, all these things which
throw strain upon the heart in moderate degree, such as running,
working, and thinking, are not only not harmful, but beneficial to it,
increasing both its strength and its size. The heart, for instance, of a
thoroughbred race-horse is nearly twice the size, in proportion to his
body weight, of the heart of a dray-horse or cart-horse; and a deer has
more than twice as large a heart as a sheep of the same weight.

The important thing to bear in mind in both work and play, in athletic
training, and in life, is that this work must be kept easily within the
powers of the heart and of the other muscles, and must be increased
gradually, and never allowed to go beyond a certain point, or it becomes
injurious, instead of beneficial; hurtful, instead of helpful. Over-work
in the shop or factory, overtraining in the gymnasium or on the
athletic field, both fall first and heaviest upon the heart.

Importance of Food, Air, and Exercise. At the same time, the system
must be kept well supplied through the stomach with the raw material
both for doing this work and for building up this new muscle. When
anyone, in training for an event, gets stale, or overtrained, and
loses his appetite and his sleep, he had better stop at once, for that
is a sign that he is using more energy than his food is able to give him
through his stomach; and the stomach has consequently gone on a

How to Avoid Heart Overstrain and Heart Disease. The way, then, to
avoid overstrain and diseases of the heart and blood vessels is:--

First, to take plenty of exercise, but to keep that exercise within
reasonable limits, which, in childhood, ought to be determined by a
school physician, and in workshops and factories by a state factory

Second, to take that exercise chiefly in the open air, and as much of it
as possible in the form of play, so that you can stop whenever you begin
to feel tired or your heart throbs too hard--in other words, whenever
nature warns you that you are approaching the danger line.

Third, to keep yourself well supplied with plenty of nutritious,
wholesome, digestible food, so as to give yourself, not merely power to
do the work, but something besides to grow on.

Fourth, to avoid poisonous and hurtful things like the toxins of
infectious diseases; and alcohol, tobacco, and other narcotics, which
have a harmful effect upon the muscles, valves, or nerves of your heart,
or the walls of your blood vessels.

Fortunately, the heart is so wonderfully tough and elastic, and can
repair itself so rapidly, that it usually takes at least two, and
sometimes three, causes acting together, to produce serious disease or
damage. For instance, while muscular overwork and overstrain alone may
cause serious and even permanent damage to the heart, they most
frequently do so in those who are underfed, or badly housed, or
recovering from the attack of some infectious disease. While the poisons
of rheumatism and alcohol will alone cause serious damage to the valves
of the heart and walls of the blood vessels, yet they again are much
more liable to do so in those who are overworked, or underfed, or

The Disease of the Stiffening of the Arteries. The points at which our
pipe-line system is most likely to give way are the valves of the heart,
and, more likely still, the muscles of the heart wall and of the walls
of the blood vessels. These little muscles are slowly, but steadily,
changing all through life, becoming stiffer and less elastic, less
alive, in fact, until finally, in old age, they become stiff and rigid,
turning into leathery, fibrous tissue, and may even become so soaked
with lime salts as to become brittle, so that they may burst under some
sudden strain. When this occurs in one of the arteries of the brain, it
causes an attack of apoplexy, or a stroke of paralysis. Overstrain,
or toxins in the blood, may bring about this stiffening of the arteries
too soon, and then, we say that the person is old before his time. A
man is literally as old as his arteries.

The causes which will hasten the stiffening of the arteries are, first
of all, prolonged overwork and overstrain,--due especially to long hours
of steady work in unwholesome shops or surroundings; second, the
presence in the blood of the poisons of the more chronic infectious
diseases, like tuberculosis; third, the waste products that are formed
in our own body, and are not properly got rid of through lungs, skin,
and kidneys; and fourth, the use of alcohol, tobacco, and other

The Bad Effects of Alcohol. Alcohol is particularly likely to damage
the walls of the blood vessels and the heart, first, because it is a
direct poison to their cells, when taken in excess, and often in what
may appear to be moderate amounts, if long continued; secondly, because
it is frequently taken, especially by the poorer, underfed class of
workers, as a substitute for food, causing them literally to spend
their money for that which is not bread, and to leave their tissues
half-starved; and thirdly, because, by its narcotic effects, it
decreases respiration and clogs the kidneys and the skin, thus
preventing the waste products from leaving the body.

How the Heart Valves may be Injured. The valves of the heart are
likely to give way, partly because they are under such constant strain,
snapping backward and forward day and night; and partly, because, in
order to be thin enough and strong enough for this kind of work, they
have become turned, almost entirely, into stringy, half-dead, fibrous
tissue, which has neither the vitality nor the resisting power of the
live body-stuffs like muscles, gland-cells, and nerves. They are so
tough, however, that they seldom give way under ordinary wear and tear,
as the leather of a pump valve, or of your shoes, might; but the thing
which damages them, nine times out of ten, is the germs or poisons of
some infectious disease.

These poisons circulating through the blood, sometimes set up a severe
inflammation in the valves and the lining of the heart. Ulcers, or
little wart-like growths, form on the valves; and these may either eat
away and destroy entirely parts of the valves or, when they heal, leave
scars which shorten and twist the valves out of shape, so that they can
no longer close the openings. When this has happened, the heart is in
the condition of a pump which will not hold water, because the leather
valve in its bucket is broken or warped; and we say that the patient
has valvular or organic heart disease.

The disease which most frequently causes this serious defect is
rheumatism, or rheumatic fever; but it may also occur after pneumonia,
typhoid, blood poisoning, or even after a common cold, or an attack of
the grip. This is one of several reasons why we should endeavor, in
every way, to avoid and stop the spread of these infectious diseases;
not only are they dangerous in themselves, but although only two of
them, rheumatism and pneumonia, frequently attack the heart, all of them
do so occasionally, and together they cause nearly nine-tenths of all
cases of organic heart disease.

Should you be unfortunate enough to catch one of these diseases, the
best preventive against its attacking the heart, or causing serious
damage, if it does, is a very simple one--rest in bed until the fever is
all gone and your doctor says it is perfectly safe for you to get up;
and avoid any severe muscular strain for several months afterward.

This is a most important thing to remember after all infections and
fevers, no matter how mild. Even where the heart valves have been
seriously attacked, as in rheumatism, they will often recover almost
completely if you keep at rest, and your heart is not overtaxed by the
strain of heavy, muscular work, before it has entirely recovered. Ten
days' taking it easy after a severe cold, or a bad sore throat, may
save you a serious strain upon the heart, from which you might be months
or even years in recovering.

But even where serious damage has been done to the heart, so that one of
its valves leaks badly, nature is not at the end of her resources. She
simply sets to work to build up and strengthen and thicken the heart
muscle until it is strong enough to overcome the defect and pump blood
enough to keep the body properly supplied--just as, if you are working
with a leaky pump, you will have to pump harder and faster in order to
keep a good stream of water flowing. It is astonishing how completely
she will make good the loss of even a considerable part of a valve.

Doctors no longer forbid patients with heart disease to take exercise,
but set them at carefully planned exercise in the open air, particularly
walking and hill-climbing; at the same time feeding them well, so as to
assist nature in building up and strengthening the heart muscle until it
can overcome the defect. In this way, they may live, with reasonable
care, ten, fifteen, or twenty years--often, in fact, until they die of
something else.

Don't worry about your heart if it should happen to palpitate, or take a
hop-skip-and-jump occasionally. You will never get real heart disease
until you have had some fever or serious illness, which leaves you short
of breath for a long time afterward.

Danger to the Heart through the Nervous System. The other chief way in
which the heart may be affected is through the nervous system. Being the
great supply pump for the entire body, it is, of course, connected most
thoroughly and elaborately by nerve wires with the brain and, through
it, with every other organ in the body. So delicately is it geared,--set
on such a hair-trigger, as it were,--that it not only beats faster when
work is done anywhere in the body, but begins to hurry in anticipation
of work to be done anywhere. You all know how your heart throbs and
beats like a hammer and goes pit-a-pat when you are just expecting to do
something important,--for instance, to speak a piece or strike a fast
ball,--or even when you are greatly excited watching somebody else do
something, as in the finish of a close race.

Two-thirds of the starts and jumps and throbbings that the heart makes,
are due to excitement, or nervous overstrain, or the fact that your
dinner is not digesting properly; and they don't indicate anything
serious at all, but are simply useful danger signals to you that
something is not just right.

In work and in athletics for instance, this rapid and uncomfortably
vigorous action of the heart is one of nature's best checks and guides.
When your heart begins to throb and plunge uncomfortably, you should
slow up until it begins to quiet down again, and you will seldom get
into serious trouble. The next time you try the same feat, you will
probably find that you can go a little farther, or faster, without
making it throb. Indeed, getting into training is very largely getting
the heart built up and educated, so that you can run or play, or wrestle
hard without overtaxing it. Whatever you can do within the limits of
your heart is safe, wholesome, and invigorating; whatever goes beyond
this, is dangerous and likely to be injurious.

Occasionally, however, some of the nerves which control the heart become
disturbed or diseased so that, instead of the heart's simply beating
harder and faster whenever more blood is really needed, it either throbs
and beats a great deal harder and faster than is necessary, or goes
racing away on its own account, and beats for dear life, when there is
no occasion for it, thus tiring itself out without doing any good, and
producing a very unpleasant feeling of nervousness and discomfort. This
may be due to overwork, whether with muscles or brain; or to worry or
loss of sleep, in which case it means that you must put on the brakes,
take plenty of rest and exercise in the open air, and get plenty of
sleep. Then these danger signals, having accomplished their warning
purpose, will disappear.

Other Causes of Heart Trouble. At other times, this palpitation is due
to the presence of poisons in the blood, either those of infectious
disease, or of certain waste products produced in the body in excess,
as, for instance, when your digestion is out of order, or your skin,
kidneys, and bowels are not working properly; or it is due to tea,
coffee, or tobacco.

Effects of Tea and Coffee. Tea and coffee, if taken in excess, will
sometimes produce very uncomfortable palpitation, or rapid over-action
of the heart, with restlessness and inability to sleep. They usually act
in this way only when taken in large amounts, or upon a small percentage
of persons who are peculiarly affected by them; and this palpitation is
seldom serious, and disappears when their excessive use is stopped.

Tobacco and its Dangers to the Heart. Tobacco has a very injurious
effect upon the nerves of the heart in the young, making them so
irritable that the heart will beat very rapidly on the least exertion;
so that gradually one becomes less and less inclined to attempt exertion
of any sort, whether bodily or mental, and falls into a stagnant, stupid
sort of condition which seriously interferes with both growth and

In other cases, tobacco dulls and deadens the nerves controlling the
heart, as it does the rest of the nervous system and the brain, so that
the smoker feels as if nothing were worth while doing very hard, and it
becomes difficult for him to fix his mind upon a subject. At the same
time, it dulls the appetite so that one takes less wholesome food; and
it checks, or clogs up, the sewer-pipes of the skin, the liver, and the

Of course, as you know, all trainers and coaches, even though they be
habitual smokers themselves, absolutely forbid tobacco in any form to
athletes who are training for a contest, on account of its effects upon
the nervous system and the heart.

A certain percentage of individuals are peculiarly susceptible to
tobacco, so that it has a special poisonous effect upon the nerves of
the heart, causing a rapid pulse and shortness of breath, known as
tobacco heart. This is not of very common occurrence; but it is
exceedingly troublesome when it does occur, and it takes a long time to
get over it, even after the use of tobacco has been stopped entirely.
Sometimes it leads to permanent damage of the nerves and of the heart.

Give your heart plenty of vigorous exercise, but don't make it beat
uncomfortably hard. Give it plenty of food, sleep, and fresh air; avoid
poisoning it, either with the toxins of diseases, or with your own
waste-poisons, or alcohol, or tobacco; and it will serve you faithfully
till a good old age.

Next: How And Why We Breathe

Previous: The Heart

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