Diseases Of The Circulatory System
DISEASES OF THE PERICARDIUM
to the best authorities on medicine, this disease is the result of
infective processes; but when the student desires to know what infective
process has brought it about, he will learn that it has been caused by
some other disease established by an infective process, and he gets
nowhere in his investigation in regard to the origin of the disease.
If the student will bear in mind
that, primarily, there is but one source of infection, and that is in the
alimentary canal, he will have no trouble in tracing all diseases back to
their own origin. Toxin poisoning from putrefaction in the intestine, plus
constitutional diathesis, or plus organic diathesis, supplies the origin
of all organic diseases, which should be called affections. Infection or
toxemia starts a process known as rheumatism. The same identical cause
will develop pericarditis in a subject who has a cardiac diathesis; and
this is the source of the infection that causes this disease.
Etiology.--It is very doubtful
if this disease is ever anything more than symptomatic. A wound in the
chest involving the pericardium, and an inflammation of the pleura, may
extend to the pericardium; but when this is true it is symptomatic; hence,
barring injuries to the pericardium, diseases of this character must be
symptomatic and due to infection through the blood. Injuries have been
found to come from passage of foreign bodies in the trachea, such as
needles, pins, or small pieces of bone which have found their way through
the esophagus. These are rare, however.
The disease is common at any age.
Children with scarlet fever, who are badly cared for, are liable to
develop this disease. The characteristic form in anemia is acute fibrinous
symptoms are precordial oppression. People with this disease will want to
sleep with the head high--with several pillows--especially if there is an
effusion in the sac. Pain is never very intense, and is usually more
marked in the early stages. The most pronounced case that has ever come
under my observation was that of a child five years of age. She had
scarlet fever. After the rash had disappeared and she appeared to be
convalescing, she lingered on and did not improve satisfactorily. She sat
up in bed, not being able to lie down on account of the difficult
breathing. When I was called I found radical dullness over the region of
the heart, and gave it as my opinion that there was an effusion in the
pericardium; which, at my next visit, I withdrew with an aspirator. The
fluid withdrawn appeared to be pure blood. However, it could not have
been. It was probably a little thinner than normal blood. I removed twelve
ounces, and the child made a good recovery. This was a case of hemorrhagic
pericarditis--the only case I have ever seen.
Pericarditis with Effusion
material thrown into the pleura is usually of the character of serum. The
symptoms generally are slight: a shortness of breath and an increasing
pallor. Seemingly without symptoms to justify it, the physician will find
a pronounced accumulation. Great restlessness is one of the principal
symptoms; and where the accumulation is large, relief must be procured by
aspiration, or the patient will be worn out from difficult breathing and
lack of sleep.
DISEASES OF THE HEART
of the lining membrane of the heart. It is usually confined to the valves,
and, when spoken of correctly, it should be called valvular endocarditis.
It is divided into two forms--acute and chronic.
The acute is characterized by the
presence of vegetations and a loss of power to close. In the chronic form
there is a slowly developing hardening, resulting in a thickening and more
or less deformity.
disease is without doubt a symptomatic affection. When the profession gets
to the point of being exact in its language, this will be spoken of as an
affection rather than as a disease.
always found in conjunction with other physical derangements. The
profession instantly thinks of rheumatism when the disease is spoken of.
Years of indiscretion in eating improperly combined foods, overeating on
proteins, starches, and sugars, keeping the system in a plethoric state,
and a decidedly toxemic state of the blood from absorption of toxins
generated in the intestine, will bring about this condition. When it has
developed to a point where resistance is broken down, rheumatism; and it
may be that the patient will suffer rheumatic pains, but at no time be
thrown into his bed with a four- to six-weeks' run of inflammatory
rheumatism. Where rheumatism of this character develops, it seldom leaves
the heart free. Indeed, the heart is subject to this blood infection
continually, and with no rheumatic development it is possible for valvular
endocarditis to develop without the patient ever having an attack of
Since bacteriology has been accepted
by the profession as the chief etiological factor in the development of
all diseases, we find the very best authorities declaring that
tonsillitis, rheumatism, etc., cause this form of heart disease, and that
the cause of the rheumatism is absorption of germs through the tonsils.
I cannot readily understand why
medical men generally should be at a loss to comprehend the etiology of
rheumatism and endocarditis. Treatment for the disease has been so very
unsatisfactory that there has been no settled conviction in regard to the
cause, and bacteriology seems to have satisfied the medical mind. There is
no question but that these diseases are all due to toxin poisoning, but it
is not any different--the poisoning is not any different--from the toxin
poisoning that is at the base of all other acute and chronic derangements
of the human body.
Treatment.--The treatment for
this disease must be the same as for all diseases; namely, correct the
nutrition, get rid of the source of infection, and then nature will
eliminate the poison. If there are abscesses in any part of the body, they
must be drained. If there is a source of infection--for example, from the
pelvic organs--these organs must be properly treated. Drainage must be
established to get rid of this source of infection. The feeding must be
corrected. The care of the body must be made as nearly perfect as
The treatment for simple endocarditis
should be about as follows: If the cardiac symptoms are not too pronounced
to preclude a two- or three-minutes' hot bath of a morning, a bath should
be given as hot as the patient can bear, followed with a quick cold
sponge-bath. This should be followed with a lot of dry towel-rubbing.
Then, before going to bed at night, give dry towel-rubbing. If the patient
is in full flesh, no food should be taken for at least one week. The
second week the patient should not have anything more than fruit morning,
noon, and night. The third week, two meals of fruit and one heavier
meal--a dinner in the evening, consisting of meat--two or three times a
week. The lightest meat should be used--lamb, chicken, fish, or eggs--with
cooked, non-starchy vegetables and a combination salad. The alternate
dinners should be a decidedly starchy food, with one or two cooked,
nonstarchy vegetables and a combination salad. Patients should avoid
worries and anxieties. Everything that has a depressing effect must be
shunned. If the proper care is taken of the skin and the eating, according
to the above instructions, the very worst forms of this trouble can be
for this affection need not be any different from that of the acute form.
Perhaps it will not be necessary to fast the patient for the first week.
Give fruit for three meals a day; then take fruit for two meals, and the
regulation dinner for the third meal. There are no two cases alike--no two
people can be treated exactly alike; hence whatever conditions are
necessary to be met, must be met. If rest is demanded more than anything
else, such patients should be put to bed and all excitement of all kinds
removed. If they are able to be up and around, attending to light duties,
they must retire early and get up late, avoid all kinds of annoyance, and
stay away from theaters and crowds where the atmosphere is bad.
FUNCTIONAL AFFECTIONS OF THE
is a functional derangement of the heart that may have many causes.
Indigestion is a common cause. Fright, worry--in fact, overworked
emotions--may become a cause of heart palpitation. Heart palpitation is
one of the first indications of depleted blood or loss of blood. Anemic
people suffer with palpitation. Those who use tobacco, coffee, tea, or
other stimulants daily and excessively arrive at a stage where they will
be troubled severely with heart palpitation.
When women are going through the
change of life, they are often troubled with this symptom. Young girls
coming into puberty are troubled with this symptom very often. The
hysteric and neurasthenic are very prone to have this symptom, but there
is nearly always dyspepsia as the exciting cause.
Onanism and excessive venery are
common causes. When a youth complains of palpitation, and there are
dilation of the pupils, cold, clammy hands and feet, and a doughy skin,
there is not only indigestion, but there is a strong probability of
self-abuse. The same symptoms developed in maturity point to excessive
venery. In some subjects the palpitation is accompanied by flushing of the
skin; in others, by deathly pallor. A palpitation that follows exertion,
or a short run, or violent exercise of any kind, indicates an absence of
exercise. Those who carry a little too much flesh, and whose hearts are
pressed upon, will have an increased action of the heart, with precordial
oppression--they will be pressed for breath. This is an indication that
more exercise should be taken.
the cause is. Where it is a result of the use of stimulants, stimulants
must be stopped. If it is the result of imprudent eating, overeating, or
anything of that kind, the cause must be removed,
means absence of rhythm of the heart-beat.
A flushing of the skin about the face
and neck, coming in patches, indicates sympathetic nervous irritation of
the heart. Where this symptom is extreme it is an indication of chronic
toxin poisoning from gastro-intestinal indigestion; or it may be due to
the use of stimulants--coffee, tea, alcoholics, tobacco, etc. Excessive
venery is one of the causes. Regulating the diet and correcting the life
of the patient will usually control the worst forms of this derangement.
Rapid Heart (Tachycardia)
people naturally have rapid hearts, and there are others who naturally
have slow hearts. This is told by the profession, and laymen will readily
believe that it is possible. Where the range is below sixty-four
pulse-beats to the minute, or above seventy-eight, regularly day after
day, there is a cause for it; it is not natural, but pathological. Where
the pulse drops below the normal it is due to obstruction of the
circulation, and also to abuse of the digestion and assimilation. This is
one of the symptoms of excessive venery in youth, to self-abuse. This
depressed condition, or slow heart-beat, may first be preceded by a too
rapid heart; for over-stimulation and shocks of all kinds will first send
the heart flying. Then, as the organism becomes accustomed to the abuse,
the heart requires more and more stimulation to keep it at its high rate
of speed; and as there is possibility of a falling-off of the exciting
cause from many reasons, it would be perfectly natural for the heart to go
below the normal, and continue below the normal until there has been a
readjustment and a reorganizing of nerve impulses--until the enervation
has been overcome and nerve resistance established.
Violent exercise and fever produce
rapid heart action. A continuous state of fear will develop rapid action
of the heart. Brain tumors, blood clots on the brain, etc., causing
pressure on the nerves of the heart, will cause rapid heart action.
Ovarian irritation and uterine diseases frequently cause rapid heart
action. But beyond and back of these symptoms are indigestion and more or
less emotionalism. Rapid heart action oftener comes from chronic
irritation of the stomach than from any other cause. The irritation may be
caused by acid fermentation of foods, coffee, tobacco, alcoholics, etc. We
cannot have irritation of the stomach without a cause; hence where there
is irritation of the stomach, causing rapid heart action, it must be
considered that the stomach is only a go-between which passes on the
effect from other causes.
(4) Slow Heart
is supposed to be a family peculiarity. Napoleon's heart-beat was about
forty to the minute, and he died of cancer of the stomach. No doubt the
mental strain under which he lived had a depressing effect upon his
digestion and heart action. There is no question but that he kept up a
constant gastric irritation from the anxiety he must have had concerning
his activities. His life was so intense that his nerve energy was drained
away, enervating the stomach and bowels, When he ate, he did not have the
nerve energy to do perfect digesting; hence more or less fermentation,
decomposition, and toxin poisoning took place. This produced hardening of
the tissues, especially ulceration and cancer of the stomach. This is the
price that an ambitious man pays for success.
of the heart, or breast pang, is a sympathetic affection. It is caused by
a hardening of the blood vessels. It is supposed that the root of the
aorta, and the coronary arteries, are hardened. The fact of the matter is
that such diseases often come from an enervated state of the nervous
system from overindulgence in stimulating foods, stimulating drugs, and
is characterized by agonizing pain in the region of the heart. The patient
will be walking along the street, be taken suddenly with a spasm, and be
compelled to take hold of any object that comes to hand, and hold to it to
keep him from falling. Not that the legs cannot hold him up, but the pain
is so excruciating that is is liable to force him to the ground. More men
are affected than women. In all severe cases the patients feel as if every
attack they have would be the last. It is strictly a disease of adult
life, and I should say it is a sign of premature aging.
If the disease follows apparently as
a sequel of other diseases, such as influenza, so far as the preceding
disease is concerned it has nothing to do, except that it is the last
straw which breaks down complete resistance and makes the victim subject
to the disease. The paroxysms are usually induced by a little exertion or
overstimulation--a. cup of coffee, or smoking a strong cigar, or walking
up a slight incline, or attempting to climb stairs; anything that takes
sudden muscular effort is liable to precipitate an attack. I believe that
those who have cultivated an irritable state of the mind and who are
steeped in stimulating habits are the type of people who come down with
Diagnosis.--The patient may
have a slight precordial pain and sense of distress or uneasiness in the
region of the heart, which radiates down the arm or up the side of the
neck. The first indication of it will probably follow a slight exertion;
it may be induced by an unusual meal or overindulgence at the table. Pain
in the region of the heart and radiating to the arm, in any subject who is
advanced in years or who is prematurely broken down, and who has lived a
strenuous life and is known to be the victim of stimulating habits, may be
declared to be due to angina pectoris.
Toxic angina embraces
those cases supposed to be brought on from tea, coffee, and tobacco.
that will right the errors of life is the proper thing to do. Certainly
stimulants must be tabooed. The patient should be put on fruit three times
a day, and put to bed, and kept there until comfortable. If there is no
desire for fruit, the eating of it is not to be urged; but the patient
The bowels should be cleared out with
copious enemas every day for a week. The attacks are remedied by most
physicians by the use of nitrite of amyl. Such drugs are not necessary.
Besides, the influence of this drug is detrimental. It may be a relief for
the time, but the dilation of the blood vessels caused by it only builds
more and worse trouble for the future.
Electricity is recommended. It should be
recognized as a stimulant, and, instead of being a benefit, it certainly
is injurious. Gentle massage to the region of the chest and over the spine
should be beneficial if not practiced too often; but the cure must come
from removing the causes, whatever they are.
DISEASES OF THE ARTERIES
thickened state of the intima or inner coat of the arteries. It is
sequential to changes that take place in the other coats of the arteries.
The condition is recognized in large arteries as atheroma and
Etiology.--When developed in a
normal, natural way, it is peculiar to old age. It means aging of tissue.
But when the disease presents itself in middle life, it is due to old age
of the tissue, if not old age of the patient. It means that those so
afflicted have lived a very imprudent life. They have lived in such a way
as to age themselves beyond their years. Apparently a certain percentage
of the people fall into this state more easily than others, showing that
they have inherited a diathesis peculiar to this derangement. It is a case
of: parents eat grapes, and the children's teeth are set on edge. Parents
have prematurely aged themselves, and this condition has been developing
in them sufficiently to build a tendency or a diathesis in the children;
and as each generation grows weaker or less resistant under the same
influences, they naturally develop symptoms on this order more easily than
Those predisposed to early aging will
be hastened into it by all kinds of stimulants--tobacco, tea, coffee,
alcoholics, excessive venery, excessive indulgences of all kinds that tax
the nervous system. Then eating to excess, bringing up arterial pressure,
and at the same time turning loose in the system toxins from decomposition
in the intestine, represent the most intense etiological factors in the
development of this disease.
Treatment.--Knowing the cause
is equivalent to knowing the cure. If a certain style of living brings on
arteriosclerosis, it should not require a physician to proscribe that
style of living to get rid of the disease; and this is the only treatment
necessary. If the inflammation of the lining of the heart and arteries
caused by toxins is developing a condition of arteriosclerosis, then
whatever is keeping up this toxin poisoning must be stopped. The commonest
cause is overeating, and excessive eating of carbohydrate and protein
foods, too often eaten together.
If the irritation of the heart and
arteries is due to alcoholism, then certainly consumption of alcohol must
be stopped. In nearly all cases, correcting all the errors of
life-stopping the use of all stimulants, abandoning excessive eating, and
getting rid of nerve irritations, worries, etc.--will bring the disease to
a condition of status quo. Then, if the patient is persistent in living
correctly, the arteries will soften. If he is in middle life, or even
younger, in the course of one to three years all symptoms of the disease
will disappear. If he is old, his life will be prolonged and made
comfortable by this treatment.
are different kinds of aneurisms. What is known as a true aneurism is one
in which the sac is formed by one or more of the arterial coats.
False aneurism is where there is a
rupture of the coats of the blood vessels and the blood is free (or
circumscribed) within the tissues. There is an aneurism produced by an
ulceration of the internal coat, the blood separating the coats of the
artery. This is known as the dissecting aneurism.
produced by an accident, as a rule. I have seen a blow on the wrist
resulting in an aneurism as large as an ordinary-sized pecan nut. Where
there is arteriosclerosis, breaking of the arteries is a common
occurrence, because the arteries are brittle.
Syphilis is supposed to cause
aneurism of the arteries. If this is true, then the statement should be
extended to take in scurvy (scorbutus, or what is more recently called
acidosis). Indeed, several years of toxin poisoning can put the subject of
gouty diathesis in a physical state where the arteries are hard and
brittle, and limy deposits will take place in the valves of the heart and
large arteries. This is the constitutional state which favors the
development of aneurism. In severe cases of arteriosclerosis the inner
coat of the blood vessel, known as the intima, may rupture in several
places in the length of the artery. These ruptures will be small, and they
lead to a bulging and a gradual production of a small cyst, or sac.
Embolic aneurism is produced by an
embolus being lodged in the forks of a blood vessel. The blocking causes a
dilation of the proximal side. The embolus does sometimes become limy.
Under such circumstances ulceration is liable to take place, and the limy
deposit will be thrown out.
Aneurism of the Thoracic Aorta
favors this disease, and, according to the leading authorities, syphilis
is recognized as the cause. I presume that there are very few, who treat
syphilis in the orthodox way, who are prepared to believe that the
treatment has as much to do with the hardening of the arteries and in
producing disease of the arteries as the so-called syphilis; but this is
true. Nearly all the patients with whom I have had to deal have lived in
such a manner as to produce acidosis, or the old-time scurvy; and when
scurvy is established in the body it will produce the very conditions that
are charged to syphilis. Indeed, the style of living that leads to scurvy,
and the treatment given to meet the symptoms that are diagnosed, will
produce very much the same results. Aneurisms of the thoracic aorta are
most commonly located in the arch, but the aorta is subject to the disease
in its entire length. Aneurisms of the ascending portion are often small
when a rupture takes place. When the rupture is in the pericardium, death
Those interested in the history and
diagnosis of aneurism of the various portions of the thoracic aorta, as
well as the abdominal, are referred to the leading textbooks on the
subject. Inasmuch as it is a disease which cannot be cured, I see no
reason why I should encumber this book with a lot of detail or description
that is of no special worth.
Symptoms.--All the best
authors say that there are no positive symptoms. A tumor may be the cause
of the chest-wall giving way, and there is no special pain experienced. It
is said that every physical sign may be present without a single symptom.
An important, but variable, symptom is pain, It is usually
paroxysmal-often very severe when the tumor is eroding the vertebrae or
perforating the chest-wall. Pain comes and goes. It often radiates down
the left arm or up the neck, and without enlargement the disease might be
mistaken for intercostal neuralgia or angina pectoris. Where the tumor
presses upon the bronchial tubes, a very distressing cough is liable to be
When there is pressure on the
recurrent laryngeal nerve, the cough may have a peculiar wheezing sound.
This is called "goose-cough." There is difficulty in breathing. In some
cases there is loss of voice; in others, wheeziness. In some cases
hemorrhage will take place into the bronchial tubes and trachea; in
others, into the pleura; and, as stated before, in still others into the
pericardium. A considerable percentage of these cases will enjoy pretty
fair health, with death painfully imminent all the time. When these cases
go, they go quickly. Some have heart symptoms, but it is of a neuralgic
character and points to the root of the aorta being affected. Dilation of
the pupil is common; this is when the sympathetic nerve is pressed upon.
X-ray examination will usually be required positively to diagnose cases
that are obscure--those located in the arch and the descending portion.
Treatment.--A few years
ago there was a coil or gold wire put in the aorta of a patient in
Philadelphia. The operation received considerable newspaper notoriety. It
was, however, absolutely unworthy of any attention. Such novelties detract
from the real purpose and object of what the physician should represent to
the people. If the profession would turn teacher instead of doctor, it
would be much better, because then such diseases would be prevented, No
one will have aneurism of the aorta who has not lived an abominable life
for years. He has lived a free and easy life, so far as eating, drinking,
and being merry is concerned. Life must be haphazard that will lead to the
development of arterial diseases. Preceding such conditions there must be
from fifteen to forty years of chronic toxin poisoning. If there were a
cure for the aneurism, if it could be obliterated in some way, that would
not cure the constitutional derangement and the disease of the arteries
which sooner or later will take the patient out of existence prematurely.
The reasonable, rational treatment
must be directed to lower the blood pressure, doing everything that can be
done to keep down the arterial pressure. If the feeding is proper, and
then the environment of the patient corrected so that there will be no
unnecessary irritations, excitement, or affairs that irritate the mental
nature, etc., he can be put in a very comfortable condition, and may live
for a number of years enjoying moderate comfort.