Angina Pectoris
Categories: UncategorizedSources: Disturbances Of The Heart
This is a name applied to pain in the region of the heart caused by
a disturbance in the heart itself. Heart pains and heart aches from
various kinds of insufficiency of the heart, or heart weakness, are
not exactly what is understood by angina pectoris. It is largely an
occurrence in patients beyond the age of 30, and most frequently
occurs after 50, although attacks between the ages of 40 and 50 are
becoming more fre
frequently attacks men, probably more than three fourths of all
cases of this disease occurring in men; in a large majority of the
cases the coronary arteries are diseased.
Various pains which are not true angina pectoris occur in the left
side of the chest; these have been called pseudo-anginas. They will
be referred to later. True angina pectoris probably does not occur
without some serious organic disease of the heart, mostly coronary
sclerosis, fatty degeneration of the heart muscle, adherent
pericarditis and perhaps some nerve degenerations. Various
explanations of the heart pang have been suggested, such as a spasm
or cramp of the heart muscle, sudden interference with the heart's
action, as adherent pericarditis, a sudden dilatation of the heart,
an interference with the usual stimuli from auricle to ventricle and
therefore a very irregular contraction, a sudden obstruction to the
blood flow through a coronary artery, or a sudden spasm from
irritation associated with some of the intercostal or more external
chest muscles causing besides the pang a sense of constriction.
Perhaps any one of these conditions may be a cause of the heart
pang, and no one be the only cause.
In a true angina, death is frequently instantaneous. In other
instances, death occurs in a few minutes or a few hours; or the
patient's life may be prolonged for days, with more or less constant
chest pains and frequent anginal attacks. Here there is a gradual
failing of the heart muscle, with circulatory insufficiency, until
the final heart pang occurs.
Anginal attacks before the age of 40, presumed, from a possible
narrowing of the aortic valve, to be due to coronary sclerosis, are
frequently due to a long previous attack of syphilis. In these
cases, active treatment of the supposed cause should be inaugurated,
including perhaps an injection of the arsenic specific, and
certainly a course of mercury and iodid, with all the general
measures for managing and treating general arteriosclerosis, as
previously described.
More
-
Accidents And Emergencies
Ordinarily, Accidents are not Serious. Accidents will happen--even in the best regulated families! While taking all reasonable care to avoid them, it is not best to worry too anxiously about the possibility of accidents; for a nervous, fearful sta... Acetic Acid
is a most efficient remedy applied to old irritable _varicose ulcers_ on the limbs of females who have suffered from _Phlegmasia Dolens_, (milk leg.) It may be applied as a wash to the part once or twice a day at the strength of 1-20th of the aci... Acetic Acid
Brown recommends diluted _Acetic Acid_ as a specific against all forms of scarlatina. Experience, however, has not supported his confidence in the infallibility of his remedy. ... Aconite
Is applicable to inflamed eyes, in the early stage, where the disease is in the conjunctiva, (that portion which lines the lids and covers the front of the ball), especially if there is a sense of scratching, as though some foreign substance is in t... Acquiring Skill
Endoscopic ability cannot be bought with the instruments. As with all mechanical procedures, facility can be obtained only by educating the eye and the fingers in repeated exercise of a particular series of maneuvers. As with learning to play a musi... Actinomycosis Of The Esophagus
Esophageal actinomycosis has been autoptically discovered. Its diagnosis, and differentiation from tuberculosis, would probably rest upon the microscopic study of tissue removed esophagoscopically, though as yet no such case has been reported. ... Action Of The Pack And Bath Rationale
The action of the wet-sheet pack is thus easily accounted for: According to a well-known physical law, any cold body, whether dead or alive, placed in close contact with a warm body, will abstract from the latter as much heat as necessary to equal... Action Of The Sitz-bath Explained
The _sitz-bath_ acts in a direct manner upon the abdominal organs and the spine, and through the latter on the brain. Indirectly, it helps in removing the inflammatory and congestive symptoms in the throat and head, by cooling the blood, which circu... Acute Cardiac Symptoms Acute Heart Attack
It is not proposed here to describe the condition of sudden cardiac failure, or acute dilatation during disease, or after a severe heart strain, but to describe the terrible cardiac agony which occurs, sometimes repeatedly, with many patients who ... Acute Diarrhea
Take B D current. Place N. P., long cord, upon the lumbar vertebrae and sacrum, moving it often along the spine, from a position opposite to the umbilicus down to the coccyx; and treat with P. P. over the abdomen, and more especially wherever pain o... Acute Dilatation Of The Heart In Acute Disease
It has for a long time been recognized that in all acute prolonged illness the heart fails, sooner or later, often without its having been attacked by the disease. The prolonged high temperature causes the heart to beat more rapidly, while the toxin... Acute Dilatation Of The Stomach
This condition is not well understood, nor is its frequence known, but not a few instances of shock are due to dilatation of this organ. The shock to the heart may be a reflex one through the pneumogastric nerves. It perhaps not infrequently occu... Acute Esophagitis
This is usually of traumatic or cauterant origin. If severe or extensive, all the symptoms described under Rupture of the Esophagus may be present. The endoscopic appearances are unmistakable to anyone familiar with the appearance of mucosal inflamm... Acute Mild Endocarditis
This inflammation of the endocardium is generally confined to the region of the valves, and the valves most frequently so inflamed are the mitral and aortic. There may be a slight inflammation or actual ulceration and loss of tissue. Vegetations mor... Acute Myocarditis
Probably most acute infections cause more or less myocarditis, depending on their intensity and their prolongation. This disturbance of the heart is often unrecognized, and has been simply referred to as "the heart growing weaker from the fever proc... Acute Pericarditis
As this inflammation is generally secondary to some other condition, its treatment cannot be positively outlined. Furthermore, it is often a terminal condition, and in such instances the results of treatment are of necessity nil. The most frequent... Acute Stenosis Of The Larynx
Etiology.--Causes of a relatively sudden narrowing of the lumen of the larynx and subjacent trachea are included in the following list. Two or more may be combined. 1. Foreign body. 2. Accumulation of secretions or exudate in the lumen. 3. D... Additional Rules For The Treatment Of Eruptive Diseases
In all these eruptive diseases, especially small-pox, all I have said, in speaking of scarlatina, about ventilation, air, diet, &c., ought to be duly observed. In small-pox, a constant renovation of the air is indispensable, as the morbid exhalation... Adherent Pericarditis
Following dry pericarditis or pericarditis with an exudate, especially when the exudate is fibrinous in character, the fibrous substance which is not absorbed or resorbed may develop into connective tissue, and the two pericardial surfaces become p... Affection Of The Brain
When the _brain_ is affected, the patient suddenly complains of violent headache, vomits repeatedly, loses his eye-sight, has furious delirium, or coma (a state of sleep from which it is difficult to rouse the patient); his pupils dilate; the pulse ... Affection Of The Cerebellum And Spine
In affections of the _cerebellum_ and _spinal marrow_, the patient complains of violent pain in the back of the head and neck, in the spine, and frequently in the whole body. These also frequently terminate with the destruction of life. During ... Agrippa
HEINRICH CORNELIUS AGRIPPA VON NETTESHEIM, a German alchemist, philosopher, and cabalist, of noble ancestry, was born at Cologne, on the Rhine, September 14, 1486. Having received a liberal education and being by nature versatile, he became in his y... Alcohol
It is rarely, if ever, advisable to use alcohol. In certain instances, however, especially in older patients who are accustomed to alcohol, a little whisky administered several times a day may act only for good, both as a food and as a peripheral di... Alcohol
Enough has already been said of the value and limitations of alcohol as a therapeutic agent. As a beverage, when constantly used, it is liable to cause obesity, gastric indigestion, arteriosclerosis, myocardial degeneration, chronic nephritis and ci... Alcohol
How Alcohol is Made. The most dangerous addition that man has ever made to the water which he drinks is alcohol. It is made by the action of the yeast plant on wet sugar or starch--a process called fermentation. Usually the sugar or starch is in the... Alkalies
Anything which tends to increase the acidity of the tissues and to diminish the alkalinity of the blood, whether from starvation or outer causes, seems to pro-duce endocardial and myocardial irritation, if not actual inflammation. Therefore in a dis... Altitude
It has long been known that altitude increases the heart rate and tends to lower the systolic and diastolic blood pressures; that these conditions, though actively present at first, gradually return to normal, and that after a prolonged stay at the ... Amaurosis Paralysis Of The Optic Nerve
Use B D current, moderate force, three or four times, and then change to C D. Apply the eye-bath, N. P., to the eye, and sponge-cup P. P. upon one of the upper dorsal vertebrae. Treat three to five minutes on each eye, three times a week. ... Amenorrhea Suppressed Menstruation
Treat as for chlorosis. But if the case be recent--the effect of taking cold--begin, in the first few sittings, to treat eight or ten minutes as for common cold; then conclude the sitting by treating, about as many minutes, in the same manner as pre... Amusements
THE ability to be easily and heartily amused brings a wholesome reaction from intense thought or hard work of any kind which does more towards keeping the nervous system in a normal state than almost anything else of an external kind. As a French... Anatomy Of Larynx Trachea Bronchi And Esophagus Endoscopically Considered
The larynx is a cartilaginous box, triangular in cross-section, with the apex of the triangle directed anteriorly. It is readily felt in the neck and is a landmark for the operation of tracheotomy. We are concerned endoscopically with four of its ca... Anchoring The Foreign Body Against The Tube Mouth
If withdrawal be made a bimanual procedure it is almost certain that the foreign body will trail a centimeter or more beyond the tube mouth, and that the closure of the glottic chink as soon as the distal end of the bronchoscope emerges will strip ... Ancient Medical Prescriptions
From early times it was a universal custom to place at the beginning of a medical prescription certain religious verses or superstitious characters, which formed the invocation, or prayer to a favorite deity. Angelic beings were frequently appeale... Anesthesia
No dyspneic patient should be given a general anesthetic; because any patient dyspneic enough to need a tracheotomy for dyspnea is depending largely upon the action of the accessory respiratory muscles. When this action is stopped by beginning unco... Anesthesia For Peroral Endoscopy
A dyspneic patient should never be given a general anesthetic. Cocaine should not be used on children under ten years of age because of its extreme toxicity. To these two postulates always in mind, a third one, applicable to both general and local a... Anesthesia In Heart Disease
While no physician likes to give an anesthetic to a patient who has valvular disease of the heart, and no surgeon cares to operate on such a patient unless operation is absolutely necessary, still in valvular disease with good compensation the progn... Angina Pectoris
This is a name applied to pain in the region of the heart caused by a disturbance in the heart itself. Heart pains and heart aches from various kinds of insufficiency of the heart, or heart weakness, are not exactly what is understood by angina pect... Angina Pectoris Management
While a number of causes of true cardiac pain may be eliminated by improvement in any loss of compensation, by improvement of the heart tone, by more or less recovery from myocardial or endocardial inflammation, and by the withdrawal of nicotin, whi... Angina Pectoris Symptoms
The pain of true angina pectoris generally starts in the region of the heart, radiates up around the left chest, into the shoulders, and often down the left arm. This is typical. It may not follow this course, however, but may be referred to the rig... Angioneurotic Edema
Angioneurotic edema involving the esophagus, may produce intermittent and transient dysphagia. The lesions are rarely limited to the esophagus alone; they may occur in any portion of the gastrointestinal, genitourinary, or respiratory tracts, and c... Angioneurotic Edema
Angioneurotic edema manifests itself by a pale or red swollen mucosa producing stenosis of the lumen. The temporary character of the lesion and its appearance in other regions confirm the diagnosis. Scleroma of the trachea is characterized by inf... Animal Fats
The Digestibility of Fats. We have now come to the last group of the real Coal foods, namely, the fats. Fats are the hottest and most concentrated fuel that we possess, and might be described as the anthracites, or hard coals of our Coal foods. They... Animal Magnetism
Although curative attributes were ascribed to the magnet in ancient times, and the same belief prevailed in the Middle Ages, the noted charlatan Paracelsus (1493-1541) was the first to propound the theory of the existence of magnetic properties in... Ankylosis
Fixation of the crico-arytenoid joints with an approximation of the cords may require evisceration of the larynx. This, however, should not be attempted until after a year's lapse, and should be preceded by attempts to improve the condition by endos... Anomalies Of The Esophagus
Congenital esophagotracheal fistulae are the most frequent of the embryonic developmental errors of this organ. Septic pneumonia from the entrance of fluids into the lungs usually causes death within a few weeks. Imperforate esophagus usually sho... Anomalies Of The Tracheobronchial Tree
Tracheobronchial anomalies are relatively rare. Congenital esophagotracheal and esophagobronchial fistulae are occasionally seen, and cases of cervicotracheal fistulae have been reported. Congenital webs and diverticula of the trachea are cited inf... Aortic Insufficiency Aortic Regurgitation
This lesion, though not so common as the mitral lesion, is of not infrequent occurrence in children and young adults as a sequence of acute rheumatic endocarditis. If it occurs later in life it generally is associated with aortic narrowing, and is a... Aortic Stenosis
Aortic narrowing or stenosis is a frequent occurrence in the aged and in arteriosclerosis when the aorta is involved. It is not a frequent single lesion in the young. If it occurs in children or young adults, it is likely to be combined with aortic ... Aortic Stenosis Aortic Obstruction
Valvular disease at the aortic orifice is much less common than at the mitral orifice, and while stenosis or obstruction is less common from rheumatism or acute inflammatory endocarditis than is insufficiency of this valve, a narrowing or at least t... Aphonia Loss Of Voice
This affection requires treatment variously, as it depends on one or another procuring cause. If it be the result of recent "cold," inducing acute catarrhal irritation in the larynx, treat first as for common cold, and close the sitting as follow... Aphorisms
Educate your eye and your fingers. Be sure you are right, but not too sure. Follow your judgment, never your impulse. Cry over spilled milk enough to memorize how you spilled it. Let your mistakes worry you enough to prevent repetition. ... Apthae - Thrush
This is a disease peculiar to nursing children. The mouth becomes sore, and the tongue, lips, and fauces are covered with a white crust, looking like milk curds, which, when removed, leaves the surface red, inflamed and very tender. It sooner or lat... Arsenicum
acts favorably on cancers, and is a specific when applied to the surface of _carbuncle_. ... Arthritis
Some years back my 70 years old mother came from the family homestead in the wilds of northern British Columbia to visit me at the Great Oaks School. She had gotten into pathetic physical condition. Fifteen years previously she had remarried. Tom, h... Artistic Considerations
ALTHOUGH so much time and care are given to the various means of artistic expression, it is a singular fact that comparatively little attention is given to the use of the very first instrument which should be under command before any seconda... Asepsis
Strict aseptic technic must be observed in all endoscopic procedures. The operator, first assistant, and instrument nurse must use the same precautions as to hand sterilization and sterile gowns as would be exercised in any surgical operation. The o... Asiatic Cholera
I was practicing in Cincinnati during the prevalence of Cholera in the years 1849, and 1850, and in Northern Ohio in 1854, and had abundant opportunity to observe and treat it. The disease generally begins with a diarrhoea, which may continue for se... Asphyxia Suspended Animation
Use B D current, pretty strong force. Place P. P. at back of neck--second or third cervical vertebra, and treat with N. P., over all the chest and along the lower margin of the ribs, so as to excite the pectoral muscles, lungs and diaphragm. ... Aspirating Tubes
Independent aspirating tubes involve delay in their use as compared to aspirating canals in the wall of the endoscopic tube; but there are special cases in which an independent tube is invaluable. Three forms are used by the author. The velvet eye ... Asthma
Use the A D current, medium force. Treat with P. P. over the shoulders and between the scapulae, and with N. P. in front upon the lungs, heart and diaphragm. Treat five to ten minutes, daily, for three or four days; after that, three times a week. ... Asthma
If an attack comes on from sudden cold, take _Aconite_ and _Ipecac_ every hour for a day, and if any symptoms remain, in place of the Aconite use _Copaiva_, _Arsenicum_ and _Phos. Acid_ with the _Ipecac_, giving them in rotation, a dose every hour. ... Auricular Fibrillation Auricular Flutter
Auricular fibrillation is at times apparently a clinical entity much as is angina pectoris, but it is often a symptom of some other condition. At times auricular fibrillation is only a passing symptom, and is rapidly cured by treatment. A real auric... Auricular Fibrillation Diagnosis
If the pulse is intermittent and there is apparently a heart block. Stokes-Adams disease should be considered as possibly present, and digitalis would be contraindicated and would do harm. A scientific indication as to whether a heart is disturbed... Auricular Fibrillation Occurrence
This condition of auricular fibrillation occurs occasionally in valvular disease, and perhaps most frequently in mitral stenosis; but it can occur without valvular lesions, and with any valvular lesion. If it occurs in younger patients, valvular dis... Auricular Fibrillation Pathology
Schoenberg [Footnote: Schoenberg: Frankfurt. Ztschr. f. Pathol., 1909, ii, 4.] finds that in auricular fibrillation there are definite signs in the node, such as round cell infiltration, showing inflammation, a fibrosis of the tissue, and perhaps a ... Auricular Fibrillation Prognosis
The prognosis depends on the condition of the myocardium of the vagus. If this muscle is intact, and there is no pathologic condition in the sinus node (which can be proved by the successful results of treatment), the removal of all toxins that coul... Auricular Fibrillation Treatment
The condition may be stopped by relieving the heart and circulation of all possible toxins and irritants, and by the administration of digitalis. One attack is frequently followed by others, perhaps of longer duration. Occasionally, however, the pat... Autodrownage
Autodrownage is the name given by the author to the drowning of the patient in his own secretions. Tracheobronchial secretions in excess of the amount required to moisten the inspired air, become, in certain cases, a mechanical menace to life, unles... Ballooning Esophagoscopy
By inserting the window plug shown in Fig. 6 the esophagus may be inflated and studied in the distended state. The folds are thus smoothed out and constrictions rendered more marked. Ether anesthesia is advocated by Mosher. The danger of respirator... Balsamo
One of the most notorious charlatans of the eighteenth century was Giuseppe Balsamo, who was born at Palermo, Sicily, June 2, 1743. Though of humble origin, this arch-impostor assumed the title of Count Alessandro di Cagliostro, and styled himself G... Bathing
The surface of the body should be kept clean, as far as possible, and to this end, in summer, should be well bathed at least once a day. In winter, though useful, it is not so indispensable; still no one should neglect the bath more than a week, and... Baths
During rheumatism the peripheral blood vessels are generally dilated and the skin perspires profusely. This is caused not only by the rheumatism, but also by the salicylates. The surface of the body should be sponged with cold, lukewarm or hot water...