On the use of rest in cardiac affections / by T. Lauder Brunton.

  • Brunton, T. Lauder (Thomas Lauder), 1844-1916.
Date:
1893?]
Catalogue details

Licence: Public Domain Mark

Credit: On the use of rest in cardiac affections / by T. Lauder Brunton. Source: Wellcome Collection.

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    ON THE USE OF BEST AND MASSAGE IN CARDIAC AFFECTIONS.1 By T. LAUDER BRUNTON, M.D., F.R.S. It is most cheering to a medical man to find his efforts to relieve pain and preserve life crowned with success, and I think there is hardly any class of cases in which treatment is more satisfactory than in cases of cardiac disease. In the treatment of such cases one of the most important elements is rest, and rest may not only be a remedial measure, but a preventive one— not only relieving severe symptoms when they are already pre¬ sent, but preventing their occurrence. As a remedial measure rest frequently requires to be absolute; as a preventive one it may be only relative. The gradations between slight and absolute rest are almost infinite, and the amount enjoined must be carefully proportioned to each case. It is in cases of ad¬ vanced mitral disease, where the power of the heart is failings that absolute rest gives such satisfactory results. In such patients we see, day by day, and hour by hour, the circulation of the patient approaching more and more closely to that which we find after death, namely, emptiness of the arteries and fulness- of the veins. During life we never get that condition, which occurs after death, of such absolute emptiness of the arteries as- led the ancients to suppose that they contained not blood, but air, and that tremendous fulness of the veins which is due to all the blood of the body being contained in them. But in advanced mitral disease we find a close approximation to this condition. The pulse is small and feeble, the arteries badly filled, and the veins of the body engorged so that the serum fiqds a ready exit from the capillaries and a slow return through the veins and lymphatics. Thus, we find fluid accumulating iu the feet and legs, in the abdomen, and in the lungs, giving rise to dropsical effusions, dyspnoea or orthopnoea, while the disten¬ sion of the liver and kidneys with venous blood gives rise to an 1 Read before the Brighton Medieo-Chirurgical Society, March 2, 1893.— Reprinted from The Practitioner, Yol. LI, No. 3. } p '0 ; ic' OA