104 THE TREATMENT OF DISEASES. 



a case like this, one naturally feels inclined to give a glass of hot gin or brandy and 

 water, but it seldom does much good ; the pain seems to be too great to be under its 

 control. The hands and feet should be briskly rubbed if they are cold or pallid. 

 You should send for a small bottle of nitrite of amyl as soon as possible, so as to be 

 prepared for any future attack, but a medical man should be called in at once. 



What should be done in the intervals of the attacks ? The general health should 

 be improved by every means in our power, and the greatest care be taken to 

 avoid worry and excitement of all kinds. Tranquillity both of body and mind, and 

 the suspension of all occupations, and even amusements, tending to excite the heart 

 or hurry the breathing, 'is essential. Moderate daily exercise on level ground, and 

 only to such an extent as is requisite for preserving the bodily health, and for 

 ensuring good digestion ; the avoidance of all kinds of food tending to flatulence ; 

 and the regular but strictly moderate evacuation of the bowels, either spontaneously 

 or by the mildest laxatives, are measures to which too much importance cannot be 

 attached. If stimulants are used at all they should be employed in the very strictest 

 moderation, none but the lighter wines being taken. Whether smoking should be 

 altogether abandoned or not we cannot say, for really every man is the best judge of 

 his own sensations, but it is obvious that excess in this, as in everything else, must be 

 strictly avoided. It must be always borne in mind that what might be a moderate 

 allowance for a healthy man, would be a debauch for a person in the critical condition 

 of an anginal subject. We have simply laid down the broad rules for the guidance 

 of the sufferer, and can do no more. They may have to be modified in individual 

 cases. A person who has long suffered from a complaint of this description soon 

 finds out what agrees with him best, and knows better than any doctor can tell him. 

 People are not all alike in illness, any more than in health, and an article of diet 

 which may agree admirably with one person might half kill another. We have, 

 as we have said, laid down the broad rules ; the details must rest with the patient 

 himself. 



When gout or dyspepsia occurs concurrently with the paroxysms, or in the 

 intervals of the attacks, it should be treated by the appropriate remedies 

 (GouT ; DYSPEPSIA), and the removal of the complication may be followed by the 

 alleviation or cure of the attacks themselves. It is generally considered that gouty 

 angina is more amenable to treatment than any other form. A visit to Carlsbad, 

 or Vichy, or Bath, may be attended with benefit should the patient's means 

 allow him to travel under favourable conditions as regards freedom from hurry and 

 excitement. Should the angina be associated with neuralgia, the different remedies 

 recommended for that complaint may do good (NEURALGIA) ; in fact, by some 

 eminent authorities it is supposed that angina pectoris is essentially a neuralgia itself. 

 In these cases the administration of arsenic is often attended with marked benefit. 

 When anaemia is a prominent symptom, it should be removed by the judicious use 

 of iron. Phosphorus has been recommended in angina pectoris, but has not 

 as yet come into general use. In one case under our care it was cautiously and 

 carefully tried, but the patient derived little or no benefit from it. 



