PALPITATIONS. 



Convulsive contraction of the heart, functional or structural diagnostic 

 features of these. Significance of the functional disorder, genera most lia- 

 ble. Treatment, quiet, heart tonic, digitalis, correct other disorders. 



These consist in a sudden violent and convulsive beating of the 

 heart, not connected with any appreciable structural disease. They 

 differ chiefly from the palpitations of organic disease of the heart 

 in the absence of any apparent local change to account for their 

 occurrence. The following table from Bellingham furnishes a 

 number of criteria equally valuable in the lower animals as in 

 man. 



PALPITATION DEPENDENT ON OR- PALPITATION INDEPENDENT OF OR- 

 GANIC DISEASE OF THE HEART. ! GANIC DISEASE OF THE HEART. 



1. Palpitation usually comes on i. Palpitation usually sets in sud- 

 slowly and gradually. denly. 



2. Palpitation constant, though | 2. Palpitation not constant, hav- 

 more marked at one period than at ; ing perfect intermissions, 

 another. j 



3. Impulse of the heart usually j 3. Impulse neither heaving nor 

 stronger than natural, sometimes re- prolonged ; often abrupt knocking 

 markably increased heaving and and circumscribed, and accompanied 



prolonged ; at others irregular and 

 unequal. 



4. Palpitation often accompanied 

 by the auscultatory signs of diseased 

 valves. 



5. Rythm of the heart regular, 

 irregular, or intermittent; its action 

 not necessarily quickened. 



by a fluttering sensation (visible 

 jerking or lifting) in the precordial 

 region or epigastrium (flank and abr 

 domen). 



4. Auscultatory signs of diseased' 

 valves absent ; bellows sound often 

 present in the large arteries and ai 

 continuous murmur in the veins. 



5. Rythm of heart usually regu- 

 lar, sometimes intermittent; its 

 action generally more rapid than, 

 natural. 



6. Mucous membranes often red- ; 6. Mucous membranes generally 

 dened and congested ; dropsy of pale ; dropsy of hind limbs rare, 

 hind limbs common. 



7. Palpitation increased by exer- 7. Palpitation increased by close 

 else, by stimulants and tonics, etc. ; confinement ; by local and general 

 relieved by rest and frequently also bleedings, etc.; relieved by moderate 

 by local and general bleeding and an : exercise and by stimulants and 

 antiphlogistic regimen. tonics, particularly the preparations 



I of iron. 



