ANGINA PECTORIS. 99 



happy, contented, and cheerful under the circumstances. The patient may be allowed 

 to sit up in bed cautiously to take his food, but at other times he will have to remain 

 iii the recumbent position. He is in no way debarred from the society of his friends, 

 and may read and be read to, and although he cannot write his letters himself he 

 may dictate them. Bed-sores must of course be carefully avoided, but they are 

 easily guarded against by a little attention and the daily examination of the back. 

 The diet is restricted to three meals a day taken at regular intervals. Usually it 

 consists of two ounces of white bread-and-butter, with two ounces of cocoa or milk, 

 for breakfast ; three ounces of broiled or boiled meat, three ounces of potatoes or 

 bread, and four ounces of water or light claret for dinner ; and two ounces of bread- 

 and-butter, and two ounces of milk or tea for supper ; in all ten ounces of solid and 

 eight ounces of fluid food in the twenty-four hours. We do not mean to say that 

 these weights and quantities are to be strictly observed, or that every article of food 

 must be weighed, but they serve to indicate about the amount of food that should 

 be taken. The object of this restriction in diet is to lessen the volume of blood, and 

 reduce the activity of the circulation so that a deposit from the blood may take place 

 in the interior of the tumour and so reduce its size. 



This dietetic treatment is often combined with the internal administration of 

 iodide of potassium. Five grains may be given three times a day, and gradually the 

 dose may be increased to ten, fifteen, or twenty grains. "We have at the present 

 time under observation a man with aneurism of the aorta, who has remained in 

 bed for the last eighteen months, and has taken iodide of potassium the whole of 

 that time, with very great benefit. When palpitation is a prominent symptom the 

 addition of five minims of tincture of aconite to each dose may do good. When 

 the pain is great it may have to be allayed by laudanum, or by hypodermic injec- 

 tions of morphia. When the tumour protrudes on the surface of the body, it 

 should be covered with belladonna plaster spread on leather to protect it from 

 accidental injury. 



Should the method of treatment we have indicated fail to effect a cure or 

 alleviate the symptoms, it may be necessary to resort to surgical measures. An 

 electric current passed through the tumour by means we need not describe in detail 

 is often attended with the happiest results. The application of a bag of ice to the 

 tumour for an hour once or twice a day often does good. We remember one case in 

 which it afforded the patient very great relief. 



Occasionally an aneurism bursts, and then, as a rule, nothing can be done. 



ANGINA PECTORIS. 



Angina pectoris, or the " suffocative breast-pang," as it is sometimes called, was 

 first described by the celebrated Dr. Heberden, in the year 1768. The symptoms 

 consist of paroxysms of intense pain about the chest, accompanied by a sensation of 

 impending death. The paroxysm quickly reaches its climax, and is relieved, or 

 disappears entirely, in a few minutes, or at the most within an hour. The attacks 

 recur at uncertain intervals, sometimes without any obvious cause, at others as the 

 result of exertion. The pain is peculiarly liable to be excited by walking up-hill. 



