HYPERTROPHY OF THE HEART. 32Q 



bowels be regularly moved, thus relieving the aorta and its branches 

 from the pressure of the abdominal viscera. The practice of repeated 

 and systematic blood-letting in treatment of hypertrophy of the heart, 

 which originated with Valsalva and Albertini, is still adhered to by 

 the French, but with us is falling more and more into disuse. Vene- 

 section diminishes the volume of blood for a short time only, and is 

 apt to be followed by an erythism of the heart, and seems to favor 

 degeneration of the substance of the organ. We do not mean that 

 there never is any indication for bleeding, as in case of a threatened 

 apoplexy proceeding from hypertrophy of the heart. The application 

 of a seton in the region of the heart is more customary with us, as 

 soon as a hypertrophy or in fact any trouble whatever about the heart, 

 becomes apparent. This procedure must also be pronounced useless, 

 and even dangerous, although commended by classical authority. 

 Iodine and mercury are of course both inadmissible and useless. The 

 patients often do well under the use of the " whey-cure." The grape- 

 cure also has a good effect, but not unless we restrict the supply of 

 other kinds of food. If we permit the patients to take their ordinary 

 meals, and then daily to eat three or four pounds of grapes besides, 

 dangers may easily arise, particularly that of congestion of the brain 

 and apoplexy. I once saw a fresh attack of apoplexy occur in a per- 

 son, who, after having been for four weeks at Marienbad, where he 

 had done very well, was then daily eating four pounds of grapes at 

 Vevay, as an " after-treatment," without, however, making any reduc- 

 tion in the amount of his other food. 



Digitalis in pure uncomplicated hypertrophy is unsuitable. As has 

 been brilliantly demonstrated by Dr. Reich, the results of experiments 

 made with this medicine upon dogs stand in glaring contradiction to 

 the conclusions drawn from experience at the bedside. (" On the 

 Employment of Digitalis in Disease of the Heart." Inaugural ad- 

 dress under President Prof. Niemeyer, Tubingen, 1864.) The ac- 

 tion of digitalis, under the use of which, in innumerable cases of 

 disease of the heart, cyanosis, dropsy, hepatic engorgement, and 

 suppression of urine have been made to subside, is not to lower the 

 centrifugal pressure of the arteries, but rather to increase it. Its 

 use is indicated in diseases in which the action of the heart is weak- 

 ened, but never in cases where it is augmented. The application of 

 cold, in the form of a tin flask filled with ice-water, and worn upon 

 the region of the heart, is of great benefit to many patients. 3 



