Heart hurry : a clinical study / by Edward Blake.

  • Blake, Edward T. (Edward Thomas), 1842-1905.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Heart hurry : a clinical study / by Edward Blake. Source: Wellcome Collection.

    8/36 (page 6)
    some product of defective katabolism or else it may be hetero-toxic, as when it is induced by tea or by tobacco. I have certainly seen it caused in boys by tea-drinking. Some support is lent to the toxic view by the fact that, though occasionally seen in the young, tremor cordis is much more frequent after middle life and in hearts which are frail and are ready to dilate. It is true that tremor may occur at any age, in any and in every form of heart affection. On the other hand it may attack a heart to all appearances perfectly healthy. The distinction between the different forms of heart hurry, which, indeed, are often confused together, is not alone a matter of convenience. For these signs differ to to coelo as to cause, concomitants, mechanism, time of occurrence, treatment and prognosis. To make this clear it is needful to allude briefly to the chief methods by which the pace of the heart may be modified. The cardiac muscle may be rendered more or less active, both as regards force and frequency, in two ways; namely, by impulses acting on the circulation (1) From outside the heart and its appendages. (2) From the heart itself, its lining membranes or from the pericardium. The external, eccentric, or peripheral methods of modi¬ fying the heart’s action, are again divisible into two, which act along different routes. (1) By the vagal route. (2) By the sympathetic route. Speaking generally, the agencies which act through the pneumogastric, when it is in a normal condition, slow the heart, whilst those which affect it by way of the sympathetic both accelerate its pace and augment its vigour. It must be remembered that the existence of excito-motor fibres has never been demonstrated in the human vagus. It is possible to view heart hurry, either as a stimulated condition of the excito-motor apparatus or as a paresis of the inhibitory fibres. As a matter of fact, nearly all the cases we meet with, certainly all the sustained cases, are examples