HEART DISEASES OF THE HEART. 329 



readily cured by good feeding, freedom from worry and anxiety, out-door exercise, 

 and a moderate allowance of stimulant. In nine cases out of ten, pain in the side 

 means general debility, and not disease of the heart. This is a point of some 

 importance, for it is one on which a great deal of misapprehension exists. Then 

 palpitation alone is never to be regarded as evidence of heart disease, although many 

 people get very much alarmed about it. It usually arises from the stomach and not 

 from the heart. A common cause of palpitation in young men is excessive smoking, 

 and if they will only consent to give up their pipes for a few weeks it gradually disap- 

 pears, to return perhaps on resuming the tobacco. We know of an instance where 

 a gentleman suffers from severe palpitation for days after indulging in even a single 

 cigar or pipe, and yet he is perfectly free from any heart affection. In women tea 

 often acts in the same way. We quote the following case as an example of the 

 mode in which palpitation often arises. " A friend of mine, a barrister, used to be 

 very anxious about himself, because a fluttering sensation frequently occurred at his 

 heart ; an intermission of one or two beats, and then a violent throb when the organ 

 again resumed its play. This is a sensation very familiar to my own consciousness, 

 and probably most persons have occasionally experienced it. However, it happened so 

 often to the gentleman I speak of that it made him very unhappy. He persuaded 

 himself that he had disease of the heart, and that he should some day suddenly drop 

 down dead. But there was no other symptom of cardiac disease, direct or indirect, 

 general or physical. He was accordingly told that the intermission depended upon 

 some fault in his digestive organs ; and he was advised to leave off different articles 

 of food and drink in succession, in order to discover whether any one particular 

 thing offended the stomach and gave rise to the symptom. He began by abstaining 

 from tea, of which he had been in the habit of drinking a large quantity ; and 

 thereupon the fluttering of the heart ceased. After a while he took to tea again, 

 and then the fluttering returned. He repeated the experiment many times, and 

 always with the same result, till at length his mind was satisfied ; and by renouncing 

 tea altogether he got rid of his palpitation and of his apprehensions." This is an 

 instructive case, well worth the attentive study of those who suffer from palpitation, 

 and think they have heart disease. We shall have more to say on this subject 

 presently (vide PALPITATION). 



Shortness of breath and cough may arise from many diseases other than those of 

 the heart, as, for example, winter cough and asthma. It is only in combination 

 with other symptoms that they are of any value in indicating disease of the heart. 

 Dropsy, as we have seen, is a frequent concomitant of heart disease, but it is also 

 a symptom of Bright's disease and many other affections, and may even arise from 

 pronounced anaemia, or poorness of the blood. It is often said that inability to lie 

 on the left side, combined with palpitation of the heart, is to be regarded as an 

 indication of serious mischief, but this is not strictly true, for patients with neuralgia 

 of that side can rarely endure the posture in question, and there are many other 

 exceptions to this rule. 



It might be supposed that the amount of pain and distress experienced in the 

 chest would form some guide to the condition of the heart, but such is not the 

 case, for, singularly enough, the amount of suffering entailed by mere functional 



