PAI^PITATIONS. 



Convulsive contraction of the heart, functional or structural diagnostic 

 features of these. Significance of the functional disorder, genera most lia- 

 ble. Treatment, quiet, heart tonic, digitalis, correct other disorders. 



These consist in a sudden violent and convulsive beating of the 

 heart, not connected with any appreciable structural disease. They 

 differ chiefly from the palpitations of organic disease of the heart 

 in the absence of any apparent local change to account for their 

 occurrence. The following table from Bellingham furnishes a 

 number of criteria equally valuable in the lower animals as in 

 man. 



PALPITATION DEPENDENT ON OR- 

 GANIC DISEASE OE THE HEART. 



1. Palpitation usually comes on 

 slowly and gradually. 



2. Palpitation constant, though 

 more marked at one period than at 

 another. 



3. Impulse of the heart usually 

 stronger than natural, sometimes re- 

 markably increased heaving and 

 prolonged ; at others irregular and 

 unequal. 



4. Palpitation often accompanied 

 by the auscultatory signs of diseased 

 valves. 



5. Rythm of the heart regular, 

 irregular, or intermittent; its action 

 not necessarily quickened. 



6. Mucous membranes often red- 

 dened and congested ; dropsy of 

 hind limbs common. 



7. Palpitation increased by exer- 

 cise, by stimulants and tonics, etc.; 

 relieved by rest and frequently also 

 by local and general bleeding and an 

 antiphlogistic regimen. 



PALPITATION INDEPENDENT OF OR- 

 GANIC DISEASE OE THE HEART. 



1. Palpitation usually sets in sud- 

 denly. 



2. Palpitation not constant, hav- 

 ing perfect intermissions. 



3. Impulse neither heaving nor 

 prolonged ; often abrupt knocking 

 and circumscribed, and accompanied 

 by a fluttering sensation (visible 

 jerking or lifting), in the precordial 

 region or epigastrium (flank and ab- 

 domen). 



4. Auscultatory signs of diseased 

 valves absent ; bellows sound often 

 present in the large arteries and a 

 continuous murmur in the veins. 



5. Rythm of heart usually regu- 

 lar, sometimes intermittent ; its 

 action generally more rapid than 

 natural. 



6. Mucous membranes generally 

 pale ; dropsy of hind limbs rare. 



7. Palpitation increased by close 

 confinement ; by local and general 

 bleedings, etc. ; relieved by moderate 

 exercise and by stimulants and 

 tonics, particularly the preparations 

 of iron. 



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