330 THE TREATMENT OF DISEASES. 



disturbance is, in the majority of cases, infinitely greater than that produced by 

 actual disease. A patient with a serious heart affection that may kill him at any 

 moment often experiences so little trouble from it as to express petulant annoyance 

 at having his chest examined, whilst another individual suffering from nothing but 

 indigestion and flatulence refuses to be persuaded of his freedom from some mortal 

 malady. If you think you have heart disease, it is ten chances to one that you 

 have not. The majority of people who really have some heart affection know 

 nothing about it till they are told by the doctor. 



Many persons suffer from habitual feebleness of the heart's action. This con- 

 dition may occur in conjunction with disease, but usually it is a mere functional 

 disorder of but little significance. The symptoms to which it may give rise are 

 coldness and clamminess of the hands and feet, a little swelling about the ankles and 

 insteps, shortness of breath, frequent inclination to faintness, sensations of languor 

 and ennui, low spirits, loss of appetite, disagreeable breath, and confined bowels. 

 This state of affairs often occurs in young women, frequently in association with 

 some disorder of the menstrual function. As regards treatment, such medicines as 

 iron (Prs. 1, 2, 3, 4, 6, and 7), quinine (Prs. 9 and 11), and cod-liver oil should be 

 given. The patient should be made to take a fair amount of exercise in the 

 open air. 



Many people suffer from pain in the left side, the chief seat of which appears 

 to correspond to a limited spot a little above and to the left of the nipple. It is 

 apparently situated at some little distance below the surface. Remaining limited 

 to this spot for a variable time, it may eventually extend downwards to the elbows, 

 or even to the tips of the fingers. The pain may be in character shooting or 

 grinding, and the sensation may be merely one of uneasiness, or it may give rise to 

 the greatest anguish. These symptoms are not to be regarded as affording indications 

 of heart disease, although it is to be feared that the more severe forms are allied to 

 that disorder which we have described as angina pectoris (vide ANGINA PECTORIS). 

 In slight cases relief may be obtained by a course of tonics, by attention to the 

 general health, and by wearing a belladonna plaster over the region of the heart. 



The act of bending forwards, especially in the sitting posture, and if accompanied 

 by some effort, as in drawing on a boot, is often followed by a peculiar pain, usually 

 referred to the heart. It is relieved more or less quickly by stretching out the 

 chest wall and pressing on the surface. Once produced it is often readily re-excited, 

 and many people are obliged to exercise the greatest caution, in order to prevent 

 its recurrence. The pain is muscular (vide MYALGIA), and is not an indication of 

 heart disease. Wearing a bandage round the chest, or the application of a bella- 

 donna plaster over the affected region might prove useful. 



Many people worry themselves very unnecessarily on the subject of a fatty heart, 

 for it is a complaint that is rarely detected. Although occasionally met with in 

 young people, the disease is essentially an appanage of middle and advanced life. 

 Women suffer from it much more rarely than men. It occurs in all ranks of 

 society, though, to a certain but undetermined extent, more in the upper and middle 

 classes than among those who earn their daily bread by manual toil. It does not 

 appear that indulgence in the good tilings of this life especially favours its production. 



