552 FUNCTIOXAL DISORDERS OF THE HEART. 



cardiac rhythm will of course, when unconnected with altera- 

 tion of structure, disappear when the causes of its production 

 are removed. When of a permanent character, and accom- 

 panied with other symptoms, as sudden seizures of exhaustion, 

 syncope, or dyspnoea, then its merely functional character may 

 well be doubted. In such cases the probabilities are that the 

 disturbance is the result of organic changes. 



In palpitation and disturbance of cardiac rhythm, the result 

 of ansemia and debility, where the whole volume of the circulat- 

 ing blood may be diminished, or what is more generally the 

 case, where the formed materials of it are lessened in amount 

 and the blood is poor and thin, a condition found associated 

 with serious and wasting diseases, and where peculiar blood 

 sounds — anaemic murmurs — exist, treatment is usually ad- 

 visable. In this state, unaccompanied with organic change, 

 we may speak with tolerable certainty, and give fair hope of 

 ultimate recovery through the use of good, easily digested 

 food, together with rest, and the exhibition of tonics, of which 

 the chief are the preparations of iron. Although this condi- 

 tion often presents itself as a sequel of influenza, we must not 

 forget the great liability there is in this fever to alteration of 

 the true cardiac structures. 



The same general principles, by whatever means we may 

 23ropose to carry into action the details, must regulate our 

 management of those cases where the disturbance of cardiac 

 action is the result of perverted or vitiated blood. An endeavour 

 must be made to discharge the vitiating agent, while the 

 production and elaboration of healthy blood must be fostered, 

 so that a normal and pure stimulus may be furnished to the 

 great central circulatory organ, as well as sound food supplied 

 to the Avhole body. For the attainment of this end the same 

 means as already indicated are to be employed — good food, 

 correct sanitary conditions, mild stimulants, together with 

 regular doses of some salt of iron, which may, with advantage, 

 be alternated with arsenic. The forms of palpitation associated 

 with dyspepsia and acute indigestion will disappear when the 

 disturbed assimilation which operates in its production has 

 disappeared. 



In the management and medical treatment of those cases of 

 functional disturbance of the heart, believed to be the result of 



