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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    beate tonic with the view of increasing the nutrition and aiding the oxidation of fat in the cardiac walls. Another medical friend of mine, who had also seen this gentleman, scoffed greatly at me because I had not recommended our patient to give- up all his work and confine himself to one room or even to bed. My reason for not doing this was that I did not think the patient ill enough, and that I regarded gentle exercise as more likely to bring about a healthy condition of the heart than absolute rest. The plan of treatment that I had recom¬ mended really was in substance the same as that which has been so fully developed by Oertel, namely, graduated exercise. The same system is, I think, suitable in cases where the heart is beginning to fail from imperfect blood-supply due to atheroma of the aorta. You can readily see that, if the aorta becomes athero¬ matous close to the valves, the lumen of the coronary arteries- may be encroached upon, and moreover the atheromatous struc¬ ture is not elastic but is rigid and unyielding, and will, therefore, not respond to the call of the heart for increased blood-supplv when any extra work is thrown upon it. In regard to this con¬ dition I think it is of extreme importance to auscultate very carefully over the aorta in people of middle age, because we may frequently hear a slight murmur indicative of commencing atheroma, before there is any sign whatever of cardiac failure or indeed of any discomfort whatever in the patient. By careful attention to hygienic conditions, and also by the- employment from time to time of iodide of potassium in ten- grain doses three times a day, we may do such patients a con¬ siderable amount of good, and if we do not prevent we may perhaps retard the progress of the atheromatous process in their vessels. If this process is not looked after it is likely to lead to cardiac enfeeblement, and whenever the left ventricle becomes feeble in comparison to the resistance it has to overcome, and has thus difficulty in emptying itself thoroughly, it is apt, like- other hollow muscular organs whose evacuation is opposed, to- become the subject of severe pain, pain which in this case- we know under the name of angina pectoris. I have lately however, discussed this subject at some length1 and shall not 1 Laucler Brunton, “On Cardiac Pain and Angina Pectoris” Practitioner, vol. xlvii, p. 241 ; and “Nervous Diseases of the Heart,” in Hare's System of Practical Therapeutics, vol. ii. Philadelphia: Lea Bros, and Co.