the hygienic system orthopathy chapter 11
Definition: An athletic heart, like an athletic arm, is a strong, well-developed and highly efficient heart. It is not a pathological heart.
Symptoms: It is larger, more vigorous more efficient than the non-athletic heart and is capable of greater and more prolonged action than the less well developed heart.
Tradition: Medical tradition has it that athletics strain the heart and produce enlargement (hypertrophy) and result in sudden death from heart failure. Athletes were said to "die young." Man could not indulge in the activities that the lower animals do — indeed, were the medical theory true, he never could have survived the long period of time before he developed labor saving devices
Any derangements that are thought to be brought on by hard exercise, like weight-lifting running, rowing, swimming, tennis, football, baseball etc., are supposed to be hard to "cure," and, by giving names suggestive of athletics to derangements of the heart and feet, doctors find their patients have more patience with them if they fail to get well in a reasonable time.
Definition: As the word implies, this is inflammation of the myocardium, or heart muscle. The term is very inaccurate for the condition is really one of degeneration, rather than inflammation of the heart muscle. It is occasionally the part of the heart affected, but in most cases it is associated with endocarditis or pericarditis. More or less parenchymatous or fatty changes in the muscle fibers always accompany the inflammation.
Symptoms: Difficult breathing, precordial discomfort, palpitation, pallor, and weakness, out of all proportion to the severity of the general condition are the important symptoms. There is usually rapid and irregular pulse, but there may be an abnormal slowness of the pulse. The heart may or may not be dilated.
Etiology: Acute myocarditis occurs in such infections as typhoid fever, diphtheria, and scarlatina, and with endocarditis and pericarditis. It seems to be the result of septic infection. Medical literature tells us that modern investigation has not added much to the etiology, pathology, or diagnosis of myocarditis.
Prognosis: Modern cardiology has established the fact that the weakened or damaged myocardium is the crucial factor in all heart pathology. The hope of recovery in every heart affection is in direct proportion to the capacity of the heart muscle. If the muscle can be restored to good condition, life can go on. Fortunately, this is possible in most cases.
Care of the Patient: In the majority of cases myocarditis is a heart trouble resulting from a general septic condition brought on by maltreating intestinal indigestion. Besides physical and physiological rest, the most important factor in the care of these cases is a careful regulation of the diet and general habits of living to the end that intestinal sepsis may end. At the right time exercise should be started and gradually increased as the heart muscle grows stronger.
ANGINA PECTORIS (Stenocardia)
Definition: This is a "sympathetic" affection of the heart most commonly associated with occlusion or hardening of the coronary arteries and degeneration of the heart muscle. It is characterized by severe paroxysmal pain in the heart region and a feeling of imminent death.
Symptoms: Agonizing pain which radiates from the heart to the shoulder and arm (usually the left), a sense of impending death, difficult breathing and a pale, anxious face, are the characteristic symptoms. The paroxysm may last from a few seconds to several minutes. Strong emotion, effort, gas pressure from indigestion or other tax upon the body may excite the paroxysm.
Hysteric Angina is the name given a pseudoangina (a neurosis) sometimes seen in women. True angina is rare in women, in these there is no organic affection of the heart, the paroxysms are nocturnal, and are of longer duration. Stigmata of hysteria, including emotional outbreaks such as moaning and crying are usually present.
Pseudo-Angina is the term given to a false form of angina that sometimes occurs in association with vasomotor disturbances and from the use of large amounts of tobacco.
Etiology: Angina is strictly an affection of adult life and is a sign of premature aging. Though most cases are associated with arteriosclerosis, Tilden says that it often comes on "from an enervated state of the nervous system from over-indulgence in stimulating foods, stimulating drugs, and excessive venery." Medical authorities tell us that "not infrequently the attacks have been preceded by prolonged mental anxiety." Those who have cultivated an irritable state of mind and are steeped in stimulating habits, are the ones who develop angina. Angina following acute affections is not due to the acute crisis. Toxic anginas embrace those cases supposed to be brought on by tea, coffee, and tobacco.
Prognosis: True angina is always a grave paroxysm. Death may occur in the first paroxysm, or there may be recurring paroxysms over a period of many years. Sudden death may occur at any time. In pseudo angina and hysteric angina, death rarely, or never, occurs. True angina is definitely remediable, at least, in its early stages.
Care of the Patient: The general care must be the same as that given for arteriosclerosis, which, see. All stimulants must be discontinued. Rest in bed is essential and a short fast followed by fruit three times a day, until complete comfort has returned will give immediate, relief. These cases must learn to live abstemiously and moderately and must practice self control. Very few sufferers from heart affection, be they doctors or laymen, fail to note by experience that their comforts depend to a very great extent upon the, care they give the stomach in eating. So-called heart "attacks," from simple acceleration and palpitation to the severe anginas, are, in the great majority of instances, due to indigestion, fermentation and distention of the stomach from overloading it.
Definition: This is an increased size of the heart with increased weight. The term means overgrowth. Two varieties are described as follow:
Simple Hypertrophy in which the heart muscle is increased in thickness but the cavities remain of normal size.
Eccentric hypertrophy (hypertrophy with dilatation) in which the muscle is thickened and the cavities are increased in size.
Symptoms: There are no symptoms except where the hypertrophy is more than compensatory. "Excessive hypertrophy" may result in distress in the region of the stomach and symptoms of hyperemia (excess blood) in the brain — headache, ringing in the ears, flashes of light, etc. The examiner will find an increase in the area of cardiac dullness, a downward and leftward displacement of the apex beat, heavy impulse, bulging of the precordium, a loud booming first sound, with accentuation of the aortic second sound or of the pulmonic second sound, depending on whether the walls of the 'right 'or the left ventricle are hypertrophied, and a strong, full pulse.
Etiology: Overwork of the heart is the cause of hypertrophy. Stenosis or insufficiency in one of the valves, or over-stimulation from toxemia, auto-intoxication, tobacco, tea, coffee, etc., is the cause. High blood pressure may overwork the heart and cause hypertrophy, as may also abnormal resistance in the circulation of the lungs, as in emphysemia, a cirrhosis of the lungs, or long-continued palpitation or tachycardia, as in exophthalmic goitre, or tobacco heart, and interference with the contractions of the ventricles by adhesion of the pericardium.
It is well to point out that this hypertrophy is merely an increase in the size of the heart muscle from increased work, and is no more pathological than the increase in the size of the arm from work or exercise. It is similar to or identical with athletic heart. The pathology in these conditions is not in the heart muscle, but in the heart valve, or in the arteries, or lungs, or elsewhere. The danger lies not in the increased size of the heart, but in the constant overwork of the heart.
Prognosis: This hypertrophy is not a pathological state and needs not be recovered from. The overstimulation or the antecedent pathologies should be overcome if possible.
Care of the Patient: The hypertrophy requires no attention. High blood pressure should be reduced, the tobacco, alcohol, tea, and coffee habits should be discontinued. Overweight should be reduced. Over-eating should be discontinued and the diet adjusted to the patient's digestive capacity. Rest and fasting will eliminate toxemia, rest the heart and clear up the cerebral symptoms. Aconite, bromids, nitrates, and other drugs should be discontinued.
This is a name sometimes given to affections of the heart by those who believe there is a "disease" called syphilis. Writing In the Journal of The American Medical Association, of Oct. 2, 1937 (p. 1123), James E. Paullin, M.D., Professor of Clinical Medicine, Atlanta, Ga., says in an article on "cardiovascular syphilis," that "* * * In the general detection of syphilitic aortitis, too much reliance must not be placed on the presence of a positive Wassermann reaction or on any other serologic test for syphilis. It is well known that from 10 to 20 per cent, of persons with latent cardiovascular syphilis will give a negative serologic reaction. * * * A patient who has not had rheumatic heart disease, and does not have hypertension, but who does give a history of syphilitic infection and presents any three of the aforementioned symptoms or signs (symptoms that could apply to heart ailment from any cause), even in the absence of a positive Wassermann reaction, should receive the benefits (sic) of anti-syphilitic treatment."
The plain truth is that if there is such a "disease" as syphilis there is no way to demonstrate it and the above quotation reveals that a diagnosis of syphilis of the heart is a mere guess. There are many kinds of poisons, including alcohol, tobacco and arsenic, that affect the heart and it is impossible for the physician to tell that "syphilis" is affecting the heart. So-called "syphilitic" heart is to be cared for as any other affection presenting the same symptoms without reference to "syphilis."
CHRONIC VALVULAR AFFECTIONS
The heart has four valves — the aortic, mitral, tricuspid and pulmonary valves. Each of these valves may present either stenosis or insufficiency. Stenosis is obstruction of the flow of blood from thickening or adhesions of parts of the valves. Insufficiency is failure of the valves to prevent a return (regurgitation) of the blood back into the heart chamber after it has been forced out and is due to enlargement of the valvular ring or to shrinkage of the valvular leaflets or to rupture of .the leaflet from mechanical strain or ulceration.
Compensation is the ability of the heart by an increase in strength and size of its chambers, to supply the arterial system with a normal amount of blood, notwithstanding obstruction (stenosis) or regurgitation (insufficiency). This ability depends more upon the strength and efficiency of the heart muscle than upon the defect in the valve. The heart is as good as its muscle notwithstanding the condition of its valves, for a good heart muscle will compensate for valvular defects. It is well to emphasize, also, that while there are ways of improving the heart muscle, there is no means of remedying damages to valves. Merely functional insufficiency of valves may usually be completely remedied. How long the heart muscle can continue to compensate for valvular defects depends upon the strength of the cardiac muscle, the nature and extent of the valvular defects, and the hygiene of the sufferer.
Symptoms: During the period of compensation there may be no definite subjective signs of heart impairment and, defects may be discovered only by physical examination, or by a lessened response of the heart to the demands of increased activity.
Decomposition is the inability of the heart to send a, normal supply of blood into the arteries, either because of weakness, atrophy or degeneration of the heart muscle, or increasing damage to the valves, or additional strain thrown upon the heart by increased arterial tension, work, pregnancy and parturition or mental shock.
Symptoms: These are varied but, in general, are due to stasis, local anemia, accumulation of carbon dioxide, toxic complications from associated liver or kidney pathology, or there may be hydrothorax, ascites, or infarct of the lungs. Decompensation may be constant or only upon exertion. In many cases it is worse at night. Cyanosis is of ten conspicuous. Cardiac asthma is often a feature. Many other symptoms in various parts of the body develop but it is not always possible to tell which of these grow directly out of systemic toxemia and which are secondary to circulatory stasis. Dropsy develops in many cases, perhaps in all cases in the worse stages.
Etiology: Rheumatism is given as the most common cause. Rheumatism can no more affect the heart than the tail can wag the dog. The processes that produce rheumatism were busy producing degeneration of the heart and arteries before the rheumatism developed. The same may be said for abscessed teeth, tonsils, etc., which are said to infect the heart. Heart pathologies are produced by toxemia and infection from gastro-intestinal decomposition. Putrefactive toxins are responsible for both rheumatism and heart affections as well as aortic affections.
Prognosis: Only in occasional cases does complete recovery occur. In most cases compensation may be improved and maintained throughout a long and useful life. When decompensation has developed compensation may often be restored. The character and intensity of the murmur is no adequate guide to the gravity of the lesion. The order of seriousness from the most to the least is, in general, as follows: tricuspid insufficiency, aortic insufficiency, mitral stenosis, aortic stenosis, mitral insufficiency. Cases of aortic regurgitation give the most frequent causes of "sudden" death. Unfavorable factors are early childhood, advanced age, marked hypertrophy of the heart, difficult breathing, irregular rhythm, arterial tension, poor general health and bad habits. If bad habits are discontinued and the sufferer will learn to live within his compensating capacity, he may live long and well in spite of an irreparable lesion.
It is now generally conceded that murmurs are unreliable in diagnosing heart affections. They are inconstant and indefinite and their differentiation is often impossible. They are found in conditions other than heart affections, or may be present in well-functioning hearts and absent in badly embarrassed hearts. When markedly present and unmistakably due to structural lesions they are regarded as having no prognostic value. The valve lesion is considered the result of a hidden myocarditis. It is the present view that the most serious conditions of the heart are those which have no necessary connection one way or another with valvular murmurs, or even with valvular defects.
Indications of a toxic or failing condition of the heart muscle, with lesions in the conduction system of the heart, and no murmurs, reveal a much more serious condition of the heart than loud murmurs with good compensation.
Undue attention to and dependence upon murmurs often leads to a wrong diagnosis and to a false sense of prognostic security and mislead the doctor and patient as to the true situation. A better estimate of the heart's condition may be obtained from the rate, regularity and quality of its beat.
Care of the Patient: First, last and all the time it is necessary to relieve the organism of its toxic overload. Careful watch of the heart is essential during a fast. All stimulant habits must be discontinued at once and permanently. No drugs (heart medicines) should ever be taken. Eating should be moderate and of natural foods.
Regular medical men waste a lot of time and weary their patients in splitting hairs over the diagnosis and guessing about the significance of the various sounds and then, whether the sound means one thing or another, give the patient a "heart tonic" — stimulant. The heart is already overstimulated from toxin poisoning. To stimulate it more, with drugs, is criminal practice. A fast lowers blood pressure and gives the heart a much needed rest.
Definition: This is fatty degeneration and fatty overgrowth of the heart.
In true fatty degeneration of the heart there is actual degeneration of the heart muscle. Fat infiltrates the walls of the heart and many of the muscle fibers are turned into fat. These fibers are lost as fat can never be turned back into muscle.
Symptoms: Fatty degeneration of the heart presents very little symptoms at first, but after the condition has progressed the heart often beats too rapidly, but the opposite may also be true. There is irregularity of the heart with decreased mental and physical powers. Sometimes there is angina pectoris and nervous crises. Difficult breathing is common. Sudden death sometimes occurs. In all cases, if the degeneration is not stayed, the weakened heart will fail.
The chief symptoms of fatty overgrowth is shortness of breath.
Etiology: Pressure upon the heart from excess fat, declining nutrition in the aged and the progressive degeneration of the whole body, as seen in cancer and tuberculosis and alcoholism are common causes of fatty degeneration of the heart. Those who have carried a lot of fat for years are prone to develop fatty degeneration. It frequently follows toxic states, empyemia, or pus absorption from any part of the body may produce fatty degeneration. Arsenic and phosphorus are two drugs that often produce fatty degeneration. Except where due to drugs, fatty degeneration is an endpoint in a toxemic chain.
Fatty overgrowth belongs to the obese. It accompanies corpulency of the entire body. All the cavities of the body are crowded and choked by the large amount of fat. Not only the lungs, but the whole body, pants for more oxygen. Overeating is, thus, the chief cause of fatty overgrowth.
Prognosis: Fatty degeneration may almost always be stayed and the condition of the heart greatly improved. If based on advanced tuberculosis or cancer no recovery can be expected. Fatty overgrowth of the heart is always a remediable condition.
Care of the Patient: In cardiac degeneration the care is the same as that given for chronic endocarditis, plus the care described for tuberculosis, or cancer, or empyemia. The subject must live so that the heart is not overstimulated or forced to work beyond its strength. In fatty overgrowth the remedy is weight reduction of the whole body. For directions see obesity. If these directions are faithfully carried out recovery will be complete
This is blood in the pericardium.Symptoms:
These are those of pericarditis.Etiology:
This condition results from trauma, the rupture of an aneurism, or the rupture of the heart itself.Prognosis:
Except in traumatic cases, this condition is a terminal development in long-standing heart and arterial pathology and the outlook is grave. Traumatic cases may recover.Care of the Patient:
See aneurism and myocardial degenerations. As a rule these patients have passed beyond help of any kind except palliation. Years of abuse of their bodies have brought on the trouble.
Definition: This is inflammation of the pericardium — the investing membrane of the heart. It may be either acute or chronic.
Symptoms: There are different forms and the symptoms vary with these. When there is but little exudate into the pericardium, it is called dry pericarditis. If there is much exudate it is called purulent, hemorrhagic, sero-fibrinous, etc., pericarditis depending on the character of the exudate — pus, blood, serum or fibrin.
Pain or discomfort in the stomach region, palpitation, difficult breathing, moderate fever, and weakness are the usual symptoms of acute pericarditis. In some cases the condition is "latent" and is discovered only upon examination. The face may be unduly pale or markedly cyanosed, the veins of the neck may be turgid, and occasionally, if the effusion is large, there may be hoarseness from pressure upon the recurrent pharyngeal nerve, or difficulty in swallowing from pressure upon the esophagus.
Purulent pericarditis presents the above symptoms plus the usual symptoms of sepsis — chills, irregular fever, sweats, pallor — and sometimes edema of the tissues over-lying the stomach.
Etiology: Inflammation of the pericardium is said to be always a "secondary process," except where due to trauma. It is said to be due to rheumatism, chorea, and to extension of "disease" from adjacent structures, such as the lungs, pleura, mediastinal glands, ribs, etc., and is a terminal symptom in chronic "diseases of various kinds," especially nephritis. It is said to be the result of an infective process, but if we try to find out what infective process has brought it about we learn that it has been caused by some "other disease" produced by an "infective process." We get into a vicious circle following a trail of "infective processes" that seem to have no known beginning.
Tilden says, "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 autotoxemia 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."
Prognosis: This is good in the dry and sero-fibrinous cases. In the purulent form the out-look is grave. The fibrinous form may persist for years and is followed by changes in the heart muscle. Weger says, "we have had such unexpected success in the treatment of heart affections that we hardly know where to draw the line and state with conviction in any given case that an attempt to reorganize the living habits would be futile. Everyone is entitled to his chance to improve or recover."
Care of the Patient: In acute pericarditis absolute rest, both physical and physiological, is important. If there is effusion the physiological rest will hasten its absorption. Heart infection, that is infection due to absorption from the intestine of the toxic end-products of indigestion, cannot recover so long as eating and putrefaction continue to pour toxins into the blood-stream. As this infection is always supplementary to toxemia it is essential that toxemia be eliminated also.
Weger says, "regardless of the special form of cardiac disease, the most satisfactory treatment is one that removes every possible tax on the circulation and particularly the burden of toxic poisons. With correct treatment, the body can in most instances be brought to such a high state of efficiency that infections and secondary heart complications can be entirely overcome."
In pericarditis with purulent effusion the death-rate under regular care is about 60 per cent. With proper care it should be much lower. In extreme cases it is well to incise the pericardial sac and establish the freest possible outlet for the pus.
Definition: This means absence of rhythm of the heart beat. It is said that "a heart that beats regularly can hardly be a functionally diseased heart," and "one of the first signs of deranged heart is irregularity, which may vary all the way from the apparent missing of beats to auricular fibrillation."
By means of the electrocardiograph some nine or ten different types of arrhythmias have been demonstrated in the heart cycle, but the difference between them are those of detail rather than of kind so that imperceptibly they merge into one another and all consist in the same fundamental pathology. We will here discuss briefly the four arrhythmias most generally recognized in the order of their severity.
Extra-Systoles: These are the simplest and commonest forms of arrhythmia and are sometimes called "premature contractions." They consist of single, relatively infrequent contractions of the heart muscle which are interpolated at intervals into the regular heart cycle. They are not sufficiently numerous or frequent to upset the cycle or to interfere with the pulse, except for their own occurrence. The irregularity can usually be made to disappear with exercise. They do not indicate any impairment of the heart nor, do they add to the gravity of any existing pathology.
Extra-systoles are relatively common in middle-aged persons who are more or less neuro-toxic from intestinal sepsis, wrong metabolism, tobacco smoking, coffee, etc. They disappear when their causative factors are removed.
Paroxysmal Tachycardia: Tachycardia means a rapid heart. Such a condition is seen in goitre, fever, after running and in several other conditions. This is not what is meant by the above term. Paroxysmal tachycardia seems to be a very rapid series of extra-systoles and results from the same neuro-toxic conditions of the body that produce the latter. The paroxysms begin suddenly and end suddenly, the pulse rate ranging between 140 and 220, and may be brought on by emotion, exercise or a change of position. The condition disappears when the toxic condition is overcome.
Auricular flutter and Auricular fibrillations differ from each other only in degree, and from the above two conditions in no essential particular. Sir James Mackenze called it "delirium of the heart," because every semblance of regularity is lost as the auricle of the heart, which can scarcely be said to beat at all, goes into a wild paroxysm of ineffective twitchings. The auricular rate ranges from 200 to 300 a minute in fibrillation. It should be obvious that this wild fluttering cannot long be continued without ending in exhaustion.
While considered as functional disturbances it is thought that no truly sound heart muscle, even under the influence of any save the most virulent toxins, would go into such a wild paroxysm. These severe arrhythmias are, therefore, regarded as indicative of a badly damaged heart muscle, aggravated by overwork and toxemia.
Definition: This is partial or complete interruption of muscular connection between the auricle and ventricle so that they beat independently of each other. It is a loss of coordination. Complete block is known as the Stokes-Adams syndrome. Partial block is sometimes caused by the use of digitalis.
Symptoms: Vertigo syncope and slight epileptic paroxysms are the usual symptoms. The heart beat appears to be very slow — as low as twenty and as high as forty a minute. Cases have been reported of six beats a minute but these are doubtful. It seems rather, that only six beats were forceful enough to be felt at the wrist.
Etiology: Functional disturbances of the heart's action are usually reflex in character; that is, there is nothing intrinsically wrong with the heart itself, but its action is disturbed by reflex irritations originating in other parts of the body, such as arise out of distention of the stomach and bowels with gas; or out of hyperacidity, stomach irritation, nervous imbalance, shock, fear, excitement, overwork, or out of stimulants and food excess.
Tilden says "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." Tobacco causes arrhythmia which usually disappears when smoking is stopped.
Prognosis: This is good in nearly all cases.
Care of the Patient: "Regulating the diet and correcting the life of the patient will usually control the worst forms of this derangement," says Tilden. It hardly seems necessary to add that all stimulant habits must be discontinued, the emotions regulated and toxemia eliminated.
PALPITATION OF THE HEART
Definition: Irregular or forceful heart action perceived by the individual.
Symptoms: Palpitation may last a few minutes to several hours, and may recur after exertion or excitement. There may, be only a sensation of fluttering with that of emptiness or distention of the ¾ heart, or there may be flushed skin, violent pulsation of the superficial arteries, rapid pulse, difficult breathing and nervousness. A forcible
apex beat may be noticeable by the patient.
Etiology: Palpitation is a neurosis and grows out of over-stimulation of the nervous system from hysteria, violent emotions, the use of tea, coffee, alcohol, or tobacco, and from distention (from gas or overeating) or dilatation of the stomach. It is common in neurasthenia. Indigestion, fright, worry, and overworked emotions are common causes. Sexual excesses are frequent causes. Anemic patients suffer with palpitation. It is sometimes seen in girls coming into puberty and in women going through the change of life; in both these instances it is a nervous phenomenon.
Care of the Patient: Correct the cause. Cut out the stimulants, stop the overeating, discontinue the sexual excesses, control the emotions, restore normal digestion, rest the nervous system. Build up the general health.
ANEURYSM OF THE AORTA
The aorta is subject to aneurysm in its entire length, perhaps because it bears the greatest load of pressure. The most common locations will here be noted.
Aneurysm of the Thoracic Aorta: This is most commonly located in the arch, but may be located in the ascending portion. Those in the ascending portion are often small when rupture occurs.
Symptoms: There are no positive symptoms. Pain is variable, usually paroxysmal, often very severe when the tumor is eroding the vertebrae or perforating the chest wall. On the other hand, the chest wall may give way and no special pain be experienced. The pain comes and goes. It often radiates down the left arm, or up the neck, and without enlargement the condition may easily be mistaken for neuralgia or angina pectoris. If the tumor presses against the bronchial tubes, a very distressing cough is likely to result. If the pressure is on the recurrent pharyngeal nerve the cough may have a peculiar wheezing sound — the so-called "goose cough." There is difficulty in breathing, in some cases loss of voice, in others wheeziness. Hemorrhage may take place into the bronchial tubes and trachea, producing hemoptysis, or into the pleura, producing hemothorax, or into the pericardium, producing hemopericardium. An X-ray examination is usually required to positively diagnose the condition.
Complications: Some of these were mentioned above. Perforation of the chest due to breakdown of bone and other tissue from constant pressure, rupture of the artery externally or into a cavity resulting in bleeding to death, are the most common complications.
Prognosis: The condition is incurable and death is painfully imminent at all times. Usually death comes quickly when it does come. Weger says of the cases handled by him: "while complete recovery was not expected, so much improvement was noted when the circulatory impulse was lessened by moderation in eating that most of the discomfort attributed to the dilatation disappeared in all except the very advanced types in which rupture of the aneurysm seemed imminent. Even in the advanced form, great relief is obtained and life is prolonged by a regimen of moderation in eating." In some cases the blood within the sac clots solidly. In medical circles this is called cure.
Aneurysm of the Abdominal Aorta: About ten per cent of aortic aneurysms are abdominal. This is more easily recognized than in the chest, especially in thin subjects, but in those with thick abdominal walls and lots of fat it may be difficult to diagnose.
Symptoms: The chief symptom is dull pain in the back which sometimes radiates to the sides. Often there is tumor with visible pulsation in the stomach region. Physical examination reveals a pulsating tumor, usually with a murmur corresponding to the heart beats.
Prognosis: The condition is incurable. Death may result from rupture, obliteration of the lumen of the artery by clots, or by embolism of the superior mesenteric artery or by paraplegia (paralysis of legs and lower parts of the body) caused by pressure.
This is commonly known as varicose aneurysm and occurs where an artery and a vein communicate together, forming a tumor. Varicose aneurysms usually develop from injuries. A few cases have been reported where the ascending portion of the arch of the aorta opened directly into the vena cava. The principal symptoms of this condition are cyanosis, edema, and great distention of the veins of the upper part of the body.
Care of the Patient: Aneurysm is not a curable condition. It is best prevented. No one will ever have an aneurysm who has not lived the free and easy life of eating, drinking and being merry, that is all too common. Years of abominable and haphazard living are required to lead to the development of arterial pathology. From fifteen to forty years of chronic toxemia and auto-intoxication always precede the development of an aneurysm. If it were possible to cure the aneurysm, that is, if it could be obliterated in some manner, this would not cure the systemic state back of its development, and sooner or later this constitutional perversion would kill the patient.
All that can rationally be done, once the condition has developed, is to lower blood, pressure and keep it down and avoid the strenuous life that tends to build more pressure. Irritations and stimulations must be avoided. Intense muscular effort must not be indulged. The diet must be corrected and overeating refrained from. Emotional poise is especially important. These things done, years of moderate comfort may be enjoyed.
LOW BLOOD PRESSURE
Definition: Any marked fall of blood pressure below the normal standard. It is not a "disease," but a symptom: it is merely an indication of lowered tonicity of the whole body with an, undue weakness and relaxation of the tissues.. It is doubtful if an adult should ever consider his or her blood pressure to be low if it is above 100.
Symptoms: Low blood pressure is a symptom of relatively minor importance and is significant only in connection with other demonstrable deficiencies and pathologies, which are major issues by comparison. In most cases the indications of low blood pressure are simply those of a chronic condition of subnormal health. There is likely to be weakness and a lack of energy, with a feeble, perhaps, rapid, pulse.
Etiology: Paradoxical as it may seem at first glance, the same mode of living that causes high blood pressure may also be responsible for low blood pressure. We say that low blood pressure is due to the same fundamental cause as high blood pressure. High blood pressure is due to overstimulation of the vaso-constriction centers: the brain centers that control contraction of the arteries. Low blood pressure is due to toxic overstimulation of the vaso-dilation centers: the nerve anti brain centers that control dilatation of the arteries. Chronic autointoxication, resting on a basis of wrong habits, forms the basis of both high and low blood pressure.
Anything that lowers the tone of the body tends to reduce the blood pressure in the beginning. Autointoxication, for instance, may first lower and, later, raise blood pressure. In youth and early adulthood depressing emotions tend to lower pressure. In both early and extreme dementia blood pressure is subnormal.
Low blood pressure is seen in early life in cases of tuberculosis. In later life, low blood pressure is often very pronounced in cancer cases. Heart weakness may also mean low blood pressure. It should be understood that blood pressure, whether high or low, is by, no means the result of uncomplicated heart lesions alone, but that the entire circulatory system — heart, arteries, veins, capillaries, and lymph. channels — is involved.
Care of the Patient: The same correction of cause that reduced tension in cases of high blood pressure will increase pressure in cases low blood pressure. Normal blood pressure depends upon normal living. Blood pressure improves as health improves and as the tone of the general system approaches normal. If there is either tuberculosis, cancer, or heart lesions, care for these as directed under their respective heads.
Definition: Inflammation of a vein. So-called milk-leg is phlebitis of the great veins of the legs.
Symptoms: The vein is inflamed, swollen, hard and painful and much throbbing is experienced. It may be either acute or chronic.
Complications: The circulatory disturbance may lead to coagulation of the blood followed by rupture. An embolus may form and be carried into the general circulation to lodge in some vital organ and cause serious trouble. Pus in the surrounding area of inflammation may infect the stagnant blood and the pus may be carried to other parts of the body.
Etiology: Phlebitis may result from the extension of inflammation from adjacent structures to the vein, it may result from obstruction of the vein by an embolus; but in most cases it is due to septic infection. Sepsis may be absorbed from the digestive tract or from an abscess somewhere in the body. It is a frequent development in suppressed pneumonia, typhoid, etc.
Prognosis: This is good in the great majority of cases. In old and very debilitated subjects recovery is slow or does not take place.
Care of the Patient: Rest of the part is very essential, as is rest of the whole body. Physiological rest will relieve the body of its toxic and septic burden and permit healing. Sun baths after the acute stage is passed are very important. The diet after the fast should be fruits and green vegetables.
Definition: This is defined as a vascular tumor of the rectal mucous membrane. It is varicose veins of the rectum.
Symptoms: Piles are generally of slow development and may be present for some time before they make themselves felt. Pain at stool, slight bleeding when the pile is internal, and feeling of soreness or irritation after evacuations attend their development. Frequently there is intense itching. As the condition of the rectum grows worse the piles increase in number, inflammation of the rectum (proctitis) grows worse, the pain becomes intense and bleeding becomes more profuse. The swellings, which at first are the size of a pea, grow to the size of a plum. They tend to be forced out of the rectum with each bowel movement and bleeding may become continuous.
Etiology: Hemorrhoids are not merely "diseases" as is commonly believed. They are local manifestations of a constitutional state based on enervation and toxemia. Chronic constipation with its consequent straining at stool is only a predisposing factor and not the primary cause. They are frequent developments in pregnancy, but it is safe to say that no healthy pregnant woman ever develops them.
Prognosis: In young subjects and in not very advanced cases recovery is easily achieved. In old subjects and in very severe cases complete recovery is rarely attained.
Care of the Patient: Dr Richard C. Cabot says of operation for hemorrhoids, that "it is not always satisfactory," for, "if the cause that produces the hemorrhoids in the first place persists the hemorrhoids will come back again no matter how thoroughly they are operated on the first time." This same is true of the at present popular coagulation treatment. No plan of care that ignores cause can ever be successful.
All causes of enervation and toxemia must be removed., Toxemia must be eliminated. Nerve energy must be restored, through rest. Constipation must be remedied. The tone of the whole body must be improved. The exercises given for this condition in Vol. IV of this series will be very helpful.
When hemorrhoids protrude they must be replaced. If allowed to remain outside the rectum they become irritated and painful and may suppurate. They may and must be kept inside the bowel.
We recommend the use of an occasional enema while fasting if hemorrhoids are present. This will avoid straining and aggravation of the condition when the bowels start moving after the fast is broken.
AFFECTIONS OF THE LYMPHATIC SYSTEM
This is inflammation of a lymphatic gland. Retro-pharyngeal abscess, tonsilitis, appendicitis, and inflammation of the glands of the neck and groins (bubo) are familiar examples.Symptoms:
Symptoms often begin with a chill or rigor, followed by vomiting, diarrhea and high fever. Locally there is heat, redness of skin, pain, enlargement of the gland and, if the process runs on suppuration, the symptoms of ordinary abscess develop.Etiology:
Infection, most often of gastro-intestinal origin, but en from external sources and from abscesses, is the cause.Care of the Patient:
Local care is of no value. In rare cases it nay be necessary to drain the abscess. The usual procedures for detoxicating the body — rest and fasting — are all-sufficient.LYMPHANGITIS
This is inflammation of a lymphatic vessel and is generally associated with inflammation of the glands.Symptoms:
Tenderness, swelling and pain along the course of the lymph vessel are the usual symptoms.Etiology:
Infection from wounds or bruises, or from bites aid stings, is the most common cause. Intestinal infections and infection from an abscess may also cause the condition.Care of the Patient:
When it results from a wound this should be thoroughly cleansed — drained. Any abscess should be drained whenever possible. Intestinal decomposition must be stopped. Rest and fasting will complete the care.SCROFULADefinition:
This is a tubercular condition of the lymphatic glands and bones. See tuberculosis.