A large portion of the blood from the lower parts of the body in returning to the heart passes through the liver. The vein (2) not being able, for the reasons expressed above, to empty its contents into the upper chamber of the heart as rapidly as necessary, a similar state of engorgement of the liver and the lower organs may take place, from the same cause as in the brain.

When the valve of the left heart is affected in the way just described with the right heart, the same consequences result to the lungs, as we have just seen are produced on the brain, liver, and other organs. The chamber c becomes gorged in the same way as the chamber a, just described, so that it will admit but sparingly the blood flowing through the lungs (A.) The vessels of the lungs therefore, being unable to empty themselves, congestion is the result.

These valves are subject to various other difficulties besides ossification, alike serious in their results, and productive of many of the same symptoms. Thus, the valves may be prevented closing, from warts or fleshy excrescences growing on their edges, or they may be too small, or perhaps holes may be ulcerated through them.

Similar valves or doors to those already mentioned are situated at f and i, where the blood passes out of the heart into the lungs and out of the other chamber into the great aorta. Supposing the valve where the blood flows out of the chamber d into the great artery i be diseased either by ossification or otherwise, so that the current of blood out of the heart into this vessels be obstructed, the chamber d of course becomes gorged and distended with blood, the heart contracts more strongly, and from the increased muscular exertion, the sides become hardened and swollen; thus constituting hypertrophy or enlargement of the heart. Congestion of the lungs is also the almost inevitable result. In the same manner by derangement of the valve f, hypertrophy of the chamber d is produced, together with congestion of the brain, liver, etc.

Surrounding the heart, which as we have before said, is lined both inside and outside by a smooth polished membrane, is a bag, applied loosely and allowing the heart to dilate and contract without the slightest impediment. This membrane may become inflamed, and in this state become firmly glued to the sides of the heart The free movement of the heart is thus prevented, its action is hampered, and it vainly struggles, and throbs to escape its imprisonment. The heart, thus cramped in its movements, the effect on the circulation will readily be perceived.

Treatment

See symptomatic indication.

Palpitation of the Heart.*

Perhaps this is as proper a place as any to introduce this unpleasant and very common variety of heart difficulty. It is frequently, as we have seen, a symptom of some severe form of heart-disease, and yet it is not uncommonly a very slight trouble easily relieved. The young, during the growing period, are often troubled with it, and the old from ossification of the valves.

It may also arise from derangement of the nervous system, produced by violent mental emotion, the abuse of ardent spirits, coffee, etc. It is of very common occurrence in persons of plethoric habit; during pregnancy, also by overloading the stomach, or eating at improper times.

* The treatment of heart-disease should be entrusted to the physician; under the above head, however, I have indicated some of the prominent remedies of service in heat-affections.

Treatment

If occasioned by congestion of the blood, or plethora: Acon., Bell., Coff.., Op., Nux.-v., Lach., Phos.

In nervous persons: Asa., Cham., Coff., Nux-v., Puls.

After moral emotions: Cham., Coff., Ign., Op., Nux-vom.

After a fright: Op., or Coff.

From disappointment: Cham. Ign., Nux-vom.

From joy: Coff.

Pear, or anguish: Verat.

After loss of blood: Phos.-ac., Chin.

After the suppression of an eruption: Ars., Caust., Lach., Sulph.

Symptomatic Indication

I have chosen, for the sake of easy reference by the patient, to note under the above head the symptomatic indication of some of the different remedies for the various diseases of the heart which I have described, both acute and chronic.

Spigelia

An all important remedy in most forms of heart disease. Inflammation of the heart, with and without articular rheumatism. Tumultuous pulsation with suffocative sensation and spasms in the chest, particularly when lying or sitting, aggravated by motion. Chronic affection of the heart, after inflammation, or with articular arthritis. Audible palpitation, increased on sitting down, bending the chest forward, and frequently accompanied with pain and oppression of the chest. Valvular disease, hypertrophy, dilation of the heart with their accompanying symptoms. Tremulous motion of the heart general heat, great soreness and debility of the limbs Palpitation in young plethoric persons. Quick and rapid pulsations of the heart; notwithstanding the pulse is slow and intermittent. Oppressive aching in the region of the heart, sometimes as if a heavy load were pressing upon it. Difficult respiration in the erect position from shooting pain. Inflammation and chronic affections of the heart with fullness in the chest and sensation of congestion in the head.

Aconite

Palpitation of the heart with great anguish.

Aurum

Violent palpitation of the heart, coming on in paroxysms, and attended with oppression. Shaking sensation of the heart on motion. Arthritic metastasis and organic affections of the heart.

Arsenic

Palpitation of the heart, irregular, with anguish, excessively violent, particularly at night, and when lying on the back. Inflammation and organic disease.

Belladonna

Great anguish about the heart, oppressed sensation, tremor with anguish and pain and a kind of bubbling sensation, in going up-stairs. Palpitation with intermittent pulse, also when at rest, increased by motion.

Lachesis

Palpitation with anxiety or weakness; felt in the back, debilitating with nausea; chronic; particularly in girls, also accompanying other affections, and frequently followed by oppressive pain in the chest. Irregularity of the pulsations, Great anguish about the heart with heaviness in the chest in rheumatism; constrictive sensation.

Arnica

Quivering pulsations, oppression or stitches in the heart with fainting fit. Pain as if the heart were squeezed together.

Natrum-Mur

Pains in the heart, particularly at night. Palpitation from the slightest motion, sometimes accompanied with anguish. Fluttering motions in the heart, irregularity or intermittent pulsations.

Digitalis

Intermittent and slow pulse with violent palpitation and shuddering.

Phosphorus

Coldness of the extremities, great op-sion about the chest and fluttering of the heart.

Administration

Two drops, or twelve globules, of the selected remedy, in a tumbler of water, a tablespoonful at a dose; or three globules, or a powder, on the tongue. In acute cases, a dose once in from a half hour to three hours. In chronic cases, once in from four to twelve hours. Diet. - Violent mental excitement and strong physical exertion, should of course be avoided. The nervous system should be kept as quiet as possible, and all strongly stimulating articles either of food or drink should be strictly prohibited. Pure air and a moderate amount of exercise are essential.