Precautions To Be Observed
Categories: UncategorizedSources: Disturbances Of The Heart
As long as compensation is complete, there are no medication and
physical treatment necessary for the damaged heart. The patient,
however, should be told of his disability, and restrictions in his
habits and life should be urged on him. The most important are that
all strenuous physical exercise should be interdicted; competitive
athletics should be absolutely prohibited; prolonged muscular effort
must never be attempt
riding, carrying a heavy weight upstairs or overlifting in any form.
The patient should be taught that he should never rush upstairs, and
that he should never run rapidly for a car or a train or for any
other reason; he should not pump up a tire, or repeatedly attempt to
crank a refractory engine; even the prolonged tension of steering a
car for a long distance is inadvisable. He should be told that after
a large meal he is less capacitated for exertion than a man who has
not a damaged heart. It is better if he drinks no tea or coffee; it
is much better if he absolutely refrains from tobacco and alcohol.
Prolonged mental worry, business frets and mental depression are all
injurious to his heart. Anything which seriously excites him,
whether anger or a stimulating drug, is harmful. Any disease which
he may acquire, especially lung disturbances, as pneumonia or even a
serious cough, requires that he take better care of himself and be
more carefully treated and take more rest in bed than a patient who
has not a damaged heart. Anything which raises the blood pressure is
of course more serious for his heart than for a perfect heart;
therefore drinking large amounts of liquid, even water, is
inadvisable. It simply means so much more work for the heart to do.
Such patients should rarely be given any drug that causes cardiac
debility, and should never take one without advice. This applies to
all the coal-tar drugs, acetylsalicylic acid (aspirin), etc.
One other fact should be impressed on the person with a valvular
lesion and compensation, and that is that he has but little, if any,
reserve circulatory power. While he is in apparently perfect health,
it takes little circulatory strain to push his heart to the point of
danger or insufficiency. As nothing keeps this reserve so good or
increases it more than rest, he should expect to have a restful day
at least once a week, and a good rest of at least two or three weeks
once or twice a year.
A patient with these restrictions may live for years with a serious
valvular defect and may die of some intercurrent disease which has
nothing to do with the circulatory system.
It is easily recognizable that as the majority of acute lesions of
the valves occur in children, it is impossible to prevent them from
taking more or less strenuous exercise, and this is probably the
reason that we have so many serious broken compensations during
youth or early adolescence.
As referred to under the subject of myocarditis, many symptoms for
which a patient consults his physician are indefinite and
intangible, though due to cardiac weakness. If a patient with a
damaged heart has a sudden dilatation, of course his symptoms are so
serious that the physician is immediately summoned. If, however, he
has a slowly developing insufficiency of the heart muscle, his first
symptoms are more or less indefinite cardiac pains, slight shortness
of breath, slight attacks of palpitation, a dry, tickling, short
cough occurring after the least exertion, some digestive
disturbances, often sluggishness of the bowels, gastric flatulence,
possibly nosebleeds, and sooner or later some edema of the lower
extremities at the end of the day.
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Pathologic Physiology
The development of permanent injury to one or more valves of the heart may have been watched by the physician who cares for a patient with acute endocarditis, or it may have been noted early during the progress of arteriosclerosis or other conditi... Pathology
The part of the heart most affected is the part which has the most work to do--the left side of the heart--and of this side the left ventricle and therefore the mitral and aortic valves; the most frequent valve to be inflamed and to stiffer permanen... Pathology
The pathology of arteriosclerosis is a thickening and diminishing elasticity of the arteries, beginning with the inner coat and gradually spreading and involving all the coats, the larger arteries often developing calcareous deposits or thickened ca... Pathology
If the foreign body completely obstructs a main bronchus, preventing both aeration and drainage, such rapid destruction of lung tissue follows that extensive pathologic changes may result in a few months, or even in a few weeks, in the case of irri... Penetrating Projectiles
Foreign bodies that have penetrated the chest wall and lodged in the lung may be removed by oral bronchoscopy if the intruder is not larger than the lumen of the corresponding main bronchus (see Bibliography, 43) [FIG. 90.--Schematic illustration... Pericarditis Symptoms And Signs
If there is pain or much aching in the cardiac region, it tends to disappear with the exudate, if such is to occur, in the same way as does the pain of pleurisy. If there is much exudate, the pressure on the heart of course increases, the cardiac du... Period Of Desquamation Or Peeling-off
About the sixth or seventh day, the epidermis, or cuticle of the skin begins to peal off, commencing in those places which first became the seat of the rash, and gradually continuing all over the body. In such parts as are covered with a thin delica... Period Of Efflorescence Or Standing Out Of The Rash
During the first day or two of the period of efflorescence, which lasts three or four days, the above symptoms usually continue to increase. Sometimes, however, the patient is alleviated at once on the rash being formed. This alleviation always take... Period Of Eruption Or Appearing Of The Rash
Commonly, on the second day, towards evening, sometimes on the third, and only in very bad cases later, the rash begins to make its appearance, under an increase of the above symptoms, especially of the fever and delirium, and continues to come out ... Period Of Incubation Or Hatching
The time which passes between the reception of the contagious poison into the system and the appearance of the rash, is called the period of incubation; incubation or incubus meaning, properly, the sitting of birds on their nests, and figuratively, ... Perversions In The Guidance Of The Body
SO evident are the various, the numberless perversions of our powers in the misuse of the machine, that it seems almost unnecessary to write of them. And yet, from another point of view, it is very necessary; for superabundant as they are, t... Philosophy Of Disease And Cure
In every part of the animal economy, polar derangements in the electro-vital principle are liable to occur. These derangements are always the real foundation of disease. They may be occasioned by a thousand agencies, which act as the procuring cause... Phylacteries
They ware in their foreheads scrowles of parchment, wherein were written the tenne commaundements given by God to Moses, which they called philaterias. JOHN MARBECK, Book of Notes and Common-Places: 1581. There we... Physical Care
REST, fresh air, exercise, and nourishment, enough of each in proportion to the work done, are the material essentials to a healthy physique. Indeed, so simple is the whole process of physical care, it would seem absurd to write about it at all. The... Physical Signs In Esophageal Foreign Body
There are no constant physical signs associated with uncomplicated impaction of a foreign body in the esophagus. Should perforation of the cervical esophagus occur, subcutaneous emphysema, and perhaps cellulitis, may be found; while a perforation of... Physical Signs Of Bronchial Foreign Body
In most cases there will be limitation of expansion on the invaded side, even though the foreign body is of such a shape as to cause no bronchial obstruction. It has been noted frequently in conjunction with the presence of such objects as a common ... Physical Signs Of Tracheal Foreign Body
If fixed in the trachea the only objective sign of foreign body may be a wheezing respiration, the site of which may be localized with the stethoscope, by the intensity of the sound. Movable foreign bodies may produce a palpatory thrill, and the rum... Physics Of Aortic Lesions
Next in frequency to mitral insufficiency is aortic insufficiency, which occurs most frequently in men. The cavity of the heart that is most affected by this lesion is the left ventricle, which receives blood both from the left auricle, and regurgit... Physics Of Mitral Stenosis
Mitral stenosis, though less common than mitral regurgitation, is a frequent form of disease of the valves, especially in women. Often this condition is associated with regurgitation; but in a simple mitral stenosis the greatest hypertrophy is of ne... Piles - Hemorrhoids
One important matter in all cases of habitual piles, is, to keep the bowels regular. Much can be done for this purpose by diet and regimen. On rising from bed in the morning drink freely, from a gill to half a pint of cold water, at least half an ho... Plain Every-day Common Sense
PLAIN common sense! When we come to sift everything down which will enable us to live wholesome, steady, every-day, interesting lives, plain common sense seems to be the first and the simplest need. In the working out of any problem, whether... Plate V Laryngeal And Tracheal Stenoses:
1, Indirect view, sitting position; postdiphtheric cicatricial stenosis permanently cured by endoscopic evisceration. (See Fig. 5.) 2, Indirect view, sitting position; posttyphoid cicatricial stenosis. Mucosa was very cyanotic because cannula was re... Pleurisy
This is inflammation of the Pleura of one or both lungs, generally confined to one side. It is known by sharp pain in the side of the chest, increased by taking a long breath, or coughing, or by pressing between the ribs. The cough is dry and painfu... Pleuroscopes
As mentioned above the anterior commissure laryngoscope and the esophageal specula make very efficient pleuroscopes; but three different forms of pleuroscopes have been devised by the author for pleuroscopy. The retrograde esophagoscope serves very... Pleuroscopy
Foreign bodies in the pleural cavity should be immediately removed. The esophageal speculum inserted through a small intercostal incision makes an excellent pleuroscope, its spatular tip being of particular value in moving the lung out of the way. T... Pleuroscopy For Disease
Most pleural diseases require a large external opening for drainage, and even here the pleuroscope may be of some use in exploring the cavities. Usually there are many adhesions and careful ray study may reveal one or more the breaking up of which ... Pneumonia
Its Cause and Prevention. The other great disease of the lungs is pneumonia, formerly known as inflammation of the lungs. This is rapid and sudden, instead of slow and chronic like tuberculosis, but kills almost as many people; and unfortunately, un... Pneumonia
Take B D current, forceful as the patient can bear, and treat briefly--say five to seven minutes, several times a day, until relief is experienced. Place N. P., long cord, low on back of neck, and move P. P. over all the upper part of the lungs. ... Polar Antagonism
When the conducting cords are of equal length, as commonly they should be, each of the two poles or electrodes produces a polar effect in the patient directly the opposite of that produced by the other. Also, at any point in either half of the circu... Polarization
It may be proper, in this place, to spend a few words upon electrical polarization in general. Electrical polarity may be defined as a characteristic of the electric or magnetic fluid, by virtue of which its opposite qualities, as those of attrac... Polarization Of The Circuit
I have said, in effect, a little above, that, while the current is running, the entire circuit is one complete magnet, which extends from the inner or positive sides of the zinc plates, where the current commences, all the way around to the outer or... Position For Bronchoscopy And Esophagoscopy
The dorsally recumbent patient is so placed that the head and shoulders extend beyond the table, the edge of which supports the thorax at about the level of the scapulae. During introduction, the head must be maintained in the same relative positio... Positive And Negative Effort
DID you ever have the grip? If you ever have you may know how truly it is named and how it does actually grip you so that it seems as if there were nothing else in the world at the time--it appears to entirely possess you. As the Irishman sa... Positive And Negative Manifestations
Acute diseases are to be regarded as electrically positive, and chronic affections as negative. The exceptions are rare, if any at all. Malignant cholera, which is eminently acute, might by some be considered as an exception. In negative diseases, t... Practice On The Dog
Having mastered the technic of introduction on the cadaver and trained the eye and fingers by practice work on the rubber tube, experience should be had in the living lower air and food passages with their pulsatory, respiratory, bechic and deglutit... Practice On The Rubber-tube Manikin
This must be carried out in two ways. 1. General practice with all sorts of objects for the education of the eye and the fingers. 2. Before undertaking a foreign body case, practice should be had with a duplicate of the foreign body. It is ... Precautions To Be Observed
As long as compensation is complete, there are no medication and physical treatment necessary for the damaged heart. The patient, however, should be told of his disability, and restrictions in his habits and life should be urged on him. The most imp... Prejudice Of Physicians Against The Water-cure
The greatest, and the most serious, difficulty lies in the prejudice of physicians against the Water-Cure. This prejudice, although in the treatment of the diseases before us, it is founded on no other reasons but ignorance, lack of courage and the ... Preliminary Remarks
The author wishes to caution the reader not to rely merely on the forms of treatment here prescribed, but to study thoroughly the principles taught in the preceding pages, until he shall have mastered them, and can judge for himself of the correctne... Preparation Of Medicine
As it often becomes necessary for the practitioner to make more or less of his own dilutions and attenuations, some brief instructions especially to new beginners, may not come amiss. Medicine is prepared by mixing it with distilled water, or puri... Preventative Fasting
During the years it takes for a body to degenerate enough to prompt a fast, the body has been storing up large quantities of unprocessed toxins in the cells, tissues, fat deposits, and organs. The body in its wisdom will always choose to temporarily... Prevention
If the patient is weak, the circulation depressed, the blood pressure low, and the heart rapid, the drug advisable to produce rest and sleep is almost always morphin or some other form of opium. Morphin, with few exceptions, is a cardiac tonic and a... Priessnitz's Method The Wet-sheet-pack
a remedy which, alone, is worth the whole antiphlogistic, diaphoretic, and, indeed, the whole curative apparatus of the profession, in ancient and modern times, for any kind of fevers, and especially for eruptive diseases. Nor did the physicians bef... Problems
THERE are very few persons who have not I had the experience of giving up a problem in mathematics late in the evening, and waking in the morning with the solution clear in their minds. That has been the experience of many, too, in real-life problem... Prognosis
Janeway [Footnote: Janeway, T. C.: A Clinical Study of Hypertensive Cardiovascular Disease, Arch. Int. Med., December, 1913, p. 755.] presented statistics of 458 patients with high blood pressure, 67 percent of whom were men. Of these 458 patients 2... Prognosis
A foreign body lodged in the esophagus may prove quickly fatal from hemorrhage due to perforation of a large vessel; from asphyxia by pressure on the trachea; or from perforation and septic mediastinitis. Slower fatalities may result from suppuratio... Prognosis
If the foreign body be not removed, the resulting chronic sepsis or pulmonary hemorrhage will prove fatal. Removal of the foreign body usually results in complete recovery without further local treatment. Occasionally, secondary dilatation of a bron... Prognosis And Convalescence
The duration of acute endocarditis varies greatly; it may be two or three weeks, or the inflammation may become subacute and last for several months. Although mild endocarditis rarely causes death of itself, it may develop into an ulcerative endocar... Prolapsus Uteri Falling Of The Womb
Take the B D current, of good medium force, and give general tonic treatment (see page 95), on alternate days, ten minutes, passing briefly over the several parts. After this, treat five to eight minutes with uterine electrode, in the manner prescri... Prophylaxis
If one put into his mouth nothing but food, foreign body accidents would be rare. The habit of holding tacks, pins and whatnot in the mouth is quite universal and deplorable. Children are prone to follow the bad example of their elders. No small obj... Proteins Or Meats
Proteins, the First Foods. There are proteins, or meats, both animal and vegetable; and no one can support life without protein in some form. This is because proteins alone contain sufficient amounts of the great element called nitrogen, which forms... Pseudo-angina
While this name is more or less unfortunate, it has long been in vogue as a designation for pains and disturbances referred by a patient to his heart. Therefore with the distinct understanding that if the diagnosis is correct the name is a misnomer,... Pulmonary Insufficiency Pulmonary Regurgitation
If this rare condition occurs, it is probably congenital. A distinctive murmur of this insufficiency would be diastolic and accentuated in the second intercostal space on the left of the sternum. It should be remembered that aortic murmurs are often... Pulmonary Phthisis Consumption
After tubercles have been formed extensively in the lungs, and have softened down over considerable area, carrying down the pulmonary tissue with them into a state of pus, there is commonly but little hope of successful treatment. But where they are... Pulmonary Stenosis Pulmonary Obstruction
If stenosis is actually present in this location, the lesion is probably congenital. It might occur after a serious acute infectious endocarditis, but then it would be associated with other lesions of the heart. It has been found to be associated wi... Pulse Testing For Allergies
Coca's Pulse Tests are extraordinarily useful and simple tools for at-home allergy detection. My clients have succeeded at using this approach without supervision. Coca's test works on this simple principle: pulse elevations are caused by any allerg... Pulsus Alternans
By this term is meant that condition of pulse in which, though the rhythm is normal, strong and weak pulsations alternate. White [Footnote: White: Am. Jour. Med. Sc., July, 1915, p. 82.] has shown that this condition is not infrequent, as demonstrat... Punctures Case I
A.B. received a severe punctured wound by a hook of the size of a crow-quill, which pierced into the flesh between the thumb and fore-finger on the outside of the hand; scarcely a drop of blood followed, but there was immediately severe pain and tum... Punctures Case Ii
Mrs. Middleton, aged 40, wounded her wrist, on the ulnar side, by the hook of a door post; there was a considerable flow of blood at first, but this ceased suddenly and the arm immediately became affected with great pain and swelling. The lunar caus... Punctures Case Iii
A female servant punctured the end of the finger by a pin; there succeeded much pain and swelling, and it appeared that the nail would separate, and the cuticle all round the finger was raised by the effusion of fluid. This fluid was evacuated and a... Punctures Case Iv
The present case is somewhat more severe than those which have been already given, and what is of great importance, the caustic was not applied immediately after the accident. William Chantry, aged 50, received a stab in the wrist with a hay-fork ... Punctures Case Ix
James Joynes, aged 12, was bitten by an ass, on each side of the middle finger; the wounds were severe, and almost immediately followed by swelling and great pain. The lunar caustic was well applied within half an hour after the accident. On the ... Punctures Case V
Mr. Cocking's son, aged 12, received a stab in the palm of the hand from a penknife three days ago, which has been followed by much swelling and pain, the punctured orifice being nearly closed. I applied the lunar caustic as deep as possible within ... Punctures Case Vi
A little boy, aged 12, received a stab by a penknife a few days ago, in the fore part of the thigh; there are now great pain and swelling, the orifice is nearly closed, and he has feverishness with headach. I applied the lunar caustic deeply in the ... Punctures Case Vii
Mr. Parr, aged 30, of delicate habit, trod upon a needle which pierced the ball of the great toe; a free crucial incision was made but the needle could not be found; a poultice was applied to the wound and over the poultice a cold lotion. In the ... Punctures Case Viii
This case illustrates the mode of treatment by the lunar caustic, of those terrible effects of punctured wounds which have been neglected in the beginning. B. Unwin, aged 40, washerwoman, applied to me on July the 10th, 1820, with severe inflamma... Punctures Case X
Mr. Worth's daughter, aged six, was thrown down by a dog and bitten severely on the face and forehead in three places; one of the wounds in the cheek was deep from the penetration of the dog's front teeth, and the parts were much bruised. The lunar ... Punctures Case Xi
Mrs. G. was bitten by a little dog on forefinger about a fortnight ago. There is now a very irritable, inflamed, fungous sore. I removed the fungous by a pair of scissors and applied the lunar caustic to form an eschar. On the succeeding day, I f... Punctures Case Xii
A servant maid was bitten by a dog in four places--severely on the forearm--three days ago. Adhesive plaster had been applied. There is a wound across the arm two inches in length and three-fourths of an inch in breadth, attended by dull pain, and s... Punctures Case Xiii
Am old man applied leeches to the instep for inflammation occasioned by a bruise. Several very irritable sores were produced with some swelling. I applied the lunar caustic to form an eschar. On the following day, the eschars were adherent, the sw... Putrid Symptoms
Next to those most dangerous forms--most dangerous, because the organic power (the _vis medicatrix naturae_), from which the restoration of health must be expected, and without which no physician can remove the slightest symptom of disease, becomes ... Putrid Symptoms Gargle Solution Of Chloride Of Soda Drink: Chlorate Of Potass Liquor Calcii-chloridi
Should _putrid symptoms_ make their appearance (21), I would strongly advise the acid in full and repeated doses, as well as the frequent repetition of the packs. In putrid cases, not only the syrup, but also the gargle will do good service. Garglin...