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A Summing Up
GIVE up resentment, give up unhealthy resistance. If circumstances, or persons, arouse either resentment or resistance in us, let us ignore the circumstances or persons until we have quieted ourselves. Freedom does not come from merely yie...
About Christmas
THERE was once a family who had a guest staying with them; and when they found out that he was to have a birthday during his visit they were all delighted at the idea of celebrating it. Days before--almost weeks before--they began to prepare...
About Faces
WATCH the faces as you walk along the street! If you get the habit of noticing, your observations will grow keener. It is surprising to see how seldom we find a really quiet face. I do not mean that there should be no lines in the face. We a...
About Frights
HERE are two true stories and a remarkable contrast. A nerve specialist was called to see a young girl who had had nervous prostration for two years. The physician was told before seeing the patient that the illness had started through frigh...
About Voices
I KNEW an old German--a wonderful teacher of the speaking voice--who said "the ancients believed that the soul of the man is here"--pointing to the pit of his stomach. "I do not know," and he shrugged his shoulders with expressive interest, ...
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 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 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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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...
Blood Pressure
The study of the blood pressure has become a subject of great importance in the practice of medicine and surgery. No condition can be properly treated, no operation should be performed, and no prognosis is of value without a proper consideration o...
Blood Pressure And Insurance
An epitome of the consensus of opinion of the risk of accepting persons for insurance as modified by the blood pressure is presented by Quackenbos. [Footnote: Quackenbos: New York Med. Jour., May 15, 1915, p. 999.] Some companies have ruled that at ...
Blood Pressure In Children
May Michael, [Footnote: Michael, May: A Study of Blood Pressure in Normal Children, Am. Jour. Dis. Child., April, 1911, p. 272.] after a study of the blood pressure in 350 children, came to the conclusion that the blood pressure in children increase...
Bradycardia
The first decision to be made is what constitutes a slow pulse or slow heart. A pulse below 58 or 60 beats per minute should be considered slow, and anything below 50 should be considered abnormally slow and a condition more or less suspicious. A pu...
Bradycardia Symptoms
If a person has been long accustomed to a slow-acting heart, there are no symptoms. If the heart has become slowed from disease or from any acute condition, the patient is likely to feel more or less faint, perhaps have some dizzines, and often head...
Brain Impressions
THE mere idea of a brain clear from false impressions gives a sense of freedom which is refreshing. In a comic journal, some years ago, there was a picture of a man in a most self-important attitude, with two common mortals in the background gazi...
Bromids And Chloral
If there is much restlessness and the circulation is good, that is, if myocarditis is probably not present, the bromids may be of great value, especially in children. The dose should be sufficient to quiet the nervous system. The drug may be discont...
Caffein
Caffein can irritate the heart and cause irregularity and tachycardia, especially in certain persons. In fact, some can never take a single cup of coffee without having an attack of palpitation, and many times when coffee and tea have been unsuspect...
Cardiac Disease In Pregnancy
It is so serious a thing for a woman with valvular lesion or other cardiac defect to become pregnant that no young woman with heart disease should be allowed to marry. Perhaps every normal heart during pregnancy hypertrophies somewhat to do the extr...
Cardiac Drugs
Whether any drug should be used which acts directly on the heart is often a question for decision. As endocarditis is generally secondary to some acute disease, the patient has become weakened already, and the circulation is not sturdy; therefore su...
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 i...
Cardiovascular Renal Disease Arrhythmia
While this terns really signifies irregularity and intermittence of the heart, it may also be broadly used to indicate a pulse which is abnormally slow or one which is abnormally fast, a rhythm which is trot correct for the age, condition and acti...
Cardiovascular Renal Disease Treatment
While it is urged, in preventing the actual development of this disease, and in slowing its progress, that it is advisable to lower a high blood pressure, we must remember that this blood pressure mad be compensatory, and many times should not be mu...
Children
WORK for the better progress of the human race is most effective when it is done through the children; for children are future generations. The freedom in mature life gained by a training that would enable the child to avoid nervous irritants is, of...
Chronic Endocarditis
It is not easy to decide just whew all acute endocarditis has entirely subsided and a chronic, slow-going inflammation is substituted. It would perhaps be better to consider a slow-going inflammatory process subsequent to acute endocarditis as a sub...
Chronic Myocarditis Fibrous
Chronic myocarditis may develop on an acute myocarditis, but is generally a slowly progressive chronic process from the beginning; it occurs mostly in persons past middle life, and as a rule is not primarily associated with rheumatism or valvular di...
Classification Of Cardiac Disturbances
For the sake of discussing the therapy of cardiac disturbances in a logical sequence, they may be classified as follows: Pericarditis Acute Adherent Myocarditis Acute Chronic Fatty Endocarditis Acute, sim...
Clinical Interpretation Of Pulse Tracings
A moment may be spent on clinical interpretation of pulse tracings. It has recently been shown that the permanently irregular pulse is due to fibrillary contraction, or really auricular fibrillation--in other words, irregular stimuli proceeding from...
Conditions Causing Change In Blood Pressure
Woolley [Footnote: Woolley, P. G.: Factors Governing Vascular Dilatation and Slowing of the Blood Stream in Inflammation, THE JOURNAL A. M. A., Dec. 26, 1914, p. 2279.] quotes Starling as finding that the blood vessels dilate from physical and chemi...
Contrariness
I KNOW a woman who says that if she wants to get her father's consent to anything, she not only appears not to care whether he consents or not, but pretends that her wishes are exactly opposite to what they really are. She says it never fail...
Convalescence
When compensation has been restored, the patient may be allowed gradually to resume his usual habits and work, provided these habits are sensible, and the work is not one requiring severe muscular exertion. Careful rules and regulations must be laid...
Coronary Sclerosis
While disease of the coronary arteries may occur without general arteriosclerosis, it is so frequently associated with it that it is necessary to give a brief description of the general disease. Arteriosclerosis or arteriocapillary fibrosis is rea...
Decompensation
To understand the physiology, pathology and the best treatment for broken compensation, it is necessary to study the physics of the circulation under the different conditions. With the mitral valve insufficient, a greater or less amount of blood is ...
Diagnosis
If a more malignant form of endocarditis develops on a mild endocarditis, the diagnosis is generally not difficult. If, without a definite known septic process, malignant endocarditis develops, localized symptoms of heart disturbance and cardiac sig...
Diet
As intimated in the preceding paragraph, the diet during endocarditis must be carefully regulated. It must be sufficient, and appropriate for the disease in which the complication occurs, but it must be in such dosage and administered with such freq...
Diet And Baths In Heart Disease
The diet in cardiac diseases has already incidentally been referred to. The decision as to what a patient ought to eat or drink must often be modified by just what the patient will do, and, as we all know, it is absolutely necessary to make some c...
Disturbances Of The Heart In General
Of prime importance in the treatment of diseases of the heart is a determination of the exact, or at least approximately exact, condition of its structures and a determination of its ability to work. This is not the place to describe its anatom...
Do Not Hurry
HOW can any one do anything well while in a constant state of rush? How can any one see anything clearly while in a constant state of rush? How can any one expect to keep healthy and strong while in a constant state of rush? But most of m...
Don't Talk
THERE is more nervous energy wasted, more nervous strain generated, more real physical harm done by superfluous talking than any one knows, or than any one could possibly believe who had not studied it. I am not considering the harm done by ...
Drugs In Hypertension
The drugs that are mostly used to lower blood pressure are nitrites or drugs which are like nitrites, and these are nitroglycerin, sodium nitrite, erythroltetra nitrate and amyl nitrite, and the frequency of their use is in the order named. Other dr...
Emergencies
5. Cardiac Emergency Drugs.--Besides some of the drugs already mentioned (such as camphor hypodermically, nitroglycerin when indicated, strophanthin hypodermically or intravenously, caffein and strychnin), often ergot, suprarenal vasopressor princip...
Endocarditis
It should be understood that especially in acute conditions a positive separation of endocarditis from myocarditis is incorrect. Acute endocarditis can probably not occur without some inyocarditis, and myocarditis probably does not occur without s...
Endocarditis A Secondary Affection
Mild endocarditis is rarely a primary affection, and is almost invariably secondary to one of the diseases named above. Nearly 75 percent of secondary endocarditis occurs as a complication of acute articular rheumatism and chorea, or subsequently. O...
Etiology
One of the most common causes of hypertension is clue to excess of eating and drinking. The products caused by maldigestion of proteins, and the toxins formed and absorbed especially from meat proteins, particularly when the excretions are insuffici...
Etiology
Rheumatism is the cause of most instances of cardiac disease which date back to childhood or youth, while arteriosclerosis and chronic infection cause most cardiac diseases in the adult. In the former case it is the mitral valve which is the most fr...
Etiology
The cause of an irregularly acting heart in an adult may be organic, as in the various forms of myocarditis, in broken compensation of valvular disease, Stokes-Adams disease, coronary disease, auricular fibrillation, auricular flutter, cerebral dise...
Etiology Pathology
If a chronic endocarditis has followed an acute condition, some slight permanent papillomas or warty growths may he left from the healed granulating or ulcerated surfaces. Sometimes these little elevations on the valves become inflamed and then adhe...
Etiology Treatment
A subacute or a chronic infective endocarditis should be treated on the same plan as an acute endocarditis, which means rest in bed and whatever medication seems advisable, depending on the supposed cause of the condition. A chronic endocarditis ...
Etiology Treatment
One has but to refer to the enumerated causes of irregular heart action to determine the treatment. In that caused by extrasystole, the treatment has just been suggested. In irregular heart caused by serious cardiac or other lesions the treatment ha...
Factors Increasing The Blood Pressure
With normal heart and arteries, exertion and exercise should increase the systolic pressure, and generally somewhat increase the diastolic pressure. The pressure pulse should therefore be greater. When there is circulatory defect or abnormal blood p...
Fatty Degeneration
Fatty degeneration of the heart muscle may be caused by acute poisoning (as phosphorus, arsenic, etc.), by serious infections, or it may follow fibrosis of the heart or coronary artery disease. The symptoms are those of serious circulatory weaicnens...
Fatty Heart
The cause of deposits of fat around the heart or in between its chambers is the same as the cause of general obesity. These patients are likely to be obese, or at least to have large abdomens with large deposits of fat around the abdomen. This fat i...
Habit And Nervous Strain
PEOPLE form habits which cause nervous strain. When these habits have fixed themselves for long enough upon their victims, the nerves give way and severe depression or some other form of nervous prostration is the result. If such an illness ...
Heart Disease In Children And During Pregnancy
A common characteristic in a large proportion of middle-aged or old patients with heart disease is the presence of degenerative changes in the myocardium, the valves, or the arteries of the heart. In children, on the other hand, the most common di...
How To Be Ill And Get Well
ILLNESS seems to be one of the hardest things to happen to a busy woman. Especially hard is it when a woman must live from hand to mouth, and so much illness means, almost literally, so much less food. Sometimes one is taken so suddenly a...
How To Sew Easily
IT is a common saying that we should let our heads save our heels, but few of us know the depth of it or the freedom and health that can come from obedience to it. For one thing we get into ruts. If a woman grows tired sewing she takes it...
How To Sleep Restfully
IT would seem that at least one might be perfectly free in sleep. But the habits of cleaving to mistaken ways of living cannot be thrown off at night and taken up again in the morning. They go to sleep with us and they wake with us. If, ...
How Women Can Keep From Being Nervous
MANY people suffer unnecessarily from "nerves" just for the want of a little knowledge of how to adjust themselves in order that the nerves may get well. As an example, I have in mind a little woman who had been ill for eight years--eight ...
Human Dust
WHEN we face the matter squarely and give it careful thought, it seems to appear very plainly that the one thing most flagrantly in the way of the people of to-day living according to plain common sense--spiritual common sense as well as mat...
Human Sympathy
A NURSE who had been only a few weeks in the hospital training-school, once saw--from her seat at the dinner-table--a man brought into the house who was suffering intensely from a very severe accident. The young woman started up to be of wha...
Hurry, Worry, And Irritability
PROBABLY most people have had the experience of hurrying to a train with the feeling that something held them back, but not many have observed that their muscles, under such conditions, actually _do_ pull them back. If any one wants to p...
Hypertension
Arterial hypertension may be divided into stages. In the first stage the arteries are healthy, but the tone, owing to contraction of the muscular walls, is too great. This condition or stage has been termed "chronic arterial hypertension." This co...
Hyperthyroidism
The presence of a well marked case of exophthalmic goiter is not necessary for the secretion of the thyroid to be increased sufficiently to cause tachycardia; in fact, an increased heart rapidity in women often has hyperthyroidism as its cause. The ...
Hypotension
A low systolic pressure and a low diastolic pressure may not cause any symptoms or give any cause for anxiety. It does show, especially if the systolic pressure is below normal for the age of the person, a lack of reserve power, and such patients ...
Illness
AS far as we make circumstances guides and not limitations, they serve us. Otherwise, we serve them, and suffer accordingly. Just in proportion, too, to our allowing circumstances to be limits do we resist them. Such resistance is a nervous strain w...
Imaginary Vacations
ONCE a young woman who had very hard work to do day after day and who had come to where she was chronically strained and tired, turned to her mother just as she was starting for work in the morning, and in a voice tense with fatigue and trou...
Indications For Strychnin
Strychnin is a much overused drug. It is now given for almost everything and during almost every disease. It is true that the administration of strychnin is largely due to the evolution of the age in which we are now living. We have ceased to purge ...
Interpretation Of Tracings
The interpretation of the arterial tracing shows that the nearly vertical tip-stroke is due to the sudden rise of blood pressure caused by the contraction of the ventricles. The long and irregular down-stroke means a gradual fall of the blood pressu...
Intestinal Putrefaction
The most successful procedure in the management of intestinal putrefaction is to remove meat from the diet absolutely. Laxatives in some form are generally indicated, and one of tile best is agar- agar. Of course aloin and cascara are always good la...
Introduction
IN climbing a mountain, if we know the path and take it as a matter of course, we are free to enjoy the beauties of the surrounding country. If in the same journey we set a stone in the way and recognize our ability to step over it, we do so at once...
Iron
It is essential for the welfare of the patient, especially after a long illness before the complication of endocarditis could occur, and in rheumatic fever, in which all meat and meat extractives have been kept from the diet, that small doses of iro...
Irritable Husbands
SUPPOSE your husband got impatient and annoyed with you because you did not seem to enter heartily into the interests of his work and sympathize with its cares and responsibilities and soothe him out of the nervous harassments. Would you not...
Is Physical Culture Good For Girls?
A NUMBER of women were watching a game of basket-ball played by some high-school girls. In the interim for rest one woman said to her neighbor: "Do you see that girl flat on her back, looking like a very heavy bag of sand ?" "Yes," the an...
Laxatives
If the bowels are known to be in excellent condition and not loaded with fecal matters, brisk catharsis is not needed simply because endocarditis has developed. If the bowels have been neglected, a small dose of calomel, aided by a compound aloin ta...
Malignant Endocarditis Ulcerative Endocarditis
Since we have learned that bacteria are probably at the bottom of almost any endocarditis, the terms suggested under the classification of endocarditis as "mild" and "malignant" really represent a better understanding of this disease. They are not ...
Mind Training
IT will be plainly seen that this training of the body is at the same time a training of the mind, and indeed it is in essence a training of the will. For as we think of it carefully and analyze it to its fundamental principles, we realize t...
Mitral Insufficiency: Mitral Regurgitation
This is the most frequent form of valvular disease of the heart, and is due to a shortening or thickening of the valves, or to some adhesion which does not permit the valve, to close properly, and the blood consequently regurgitates from the left ve...
Mitral Stenosis: Mitral Narrowing
This particular valvular defect occurs more frequently in women than in men, and between the ages of 10 and 30, and is generally the result of rheumatic endocarditis or chorea, perhaps 60 percent of mitral stenosis having this origin. Other causes a...