Dr. Keller gives a few pertinent suggestions concerning a serious malady that is affecting an increasing per cent of the people in the world to-day.
Heart disease is and always has been a serious malady. It takes many lives and cripples others, but of late years the general public has almost developed a cardiophobia. Dr. Richard Cabot of the Massachusetts General Hospital, tells us that the first and most important point of all is to know that most heart disease is imaginary. Those who think and fear that they have heart disease usually turn out, on careful examination, to be free from it. Nearly 10 per cent of Harvard’s freshmen in one class examined by Dr. Roger I. Lee and his assistants, believed themselves to have weak hearts. There is a group of symptoms in which the patient complains of difficult breathing, pain over the region of the heart, and rapid action of the heart, yet has a normal heart. “Often it is a patient who has fainted or been dizzy, and had some pain over the heart, and the physician may have heard a harmless murmur.”
MANY HEARTS NEED REPAIR
However, recent statistics compiled by the Census Bureau showed heart disease to be the greatest single cause of death, and apparently indicated that the death rate from this cause in the United States is increasing. The association for the prevention and relief of heart disease makes a statement showing that 2 per cent of the persons examined for life insurance are rejected because of serious heart defects, that 2 per cent of industrial workers are subject to similar defects, and that from 1½ per cent to 2 per cent of school children who are examined have serious heart lesions. We could conservatively say that about two million persons in the United States suffer of heart disease. It is quite evident that that question calls for serious attention on the part of the medical profession, and although some may feel that they have heart disease and have not, it is very advisable that good prevention be carried into effect. It is universally recognized that heart disease is preventable and amenable to relief.
At one time I, with one hundred or more doctors from all over the United States, had an opportunity to attend some clinics given by Dr. Cabot at the Massachusetts General Hospital. He drew attention to the fact that failing hearts can be assembled into four distinct groups. He spoke of those due to (1) rheumatism; (2) syphilis; (3) hardened arteries, or high blood pressure; (4) nephritis, or heart disease in some ways associated with disease of the kidney. We could usually tell what type of heart disease he was bringing before the group of doctors.
Rheumatism: The patient was usually a young girl about twenty-two years of age. There was a history of rheumatism, some focal infection of the tonsils; in some cases there was a history of St. Vitus’s dance; and usually some heart complication.
Syphilis: Usually a man of about twenty to forty years of age. The blood test for syphilis had been positive, and there was a special murmur over the region of what we call the aortic valve.
Dr. Keller gives a few pertinent suggestions concerning a serious malady that is affecting an increasing per cent of the people in the world to-day.
High Blood Pressure: These cases were usually elderly people about fifty to sixty years of age, with hardened arteries and angina pectoris, that is, pain over the region of the heart. The heart was enlarged, irregular, and sometimes rapid.
Nephritis: In the nephritic type of heart disease in which there is an involvement of the kidney, we usually found the average age of the patient was thirty-six. There was dimness in vision and anaemia.
Toxic: There is another type of heart disease that is due to toxic condition, such as enlarged thyroid, which can be used as an illustration.
DIAGNOSTIC HELP
The laboratory has been of material help in diagnosing the various heart lesions. (1) The Wassermann reaction for syphilis; (2) the kidney function test for functional activities of the kidney; (3) the blood pressure records in high blood pressure; (4) X ray of the chest, which gives the shape and size of the heart; (5) basal metabolic rate, which discloses goiter; (6) electrocardiogram for tracing of heart action.
Dr. Dublin, author of the book “Health and Wealth,” makes the statement: “No other disease in the entire field of medicine, with the possible exception of cancer, offers so large an opportunity for life-saving service.” At the very outset two lines of attack present themselves. The first affects the individual and reduces itself to one of personal hygiene; the second affects the community as a whole. Each has its proper place.
The campaign as it concerns the individual:
Children must be protected against infection.
Give adequate convalescent care to cases of tonsillitis and sore throat, which appear often to bring on rheumatic complications.
The prevention of cases of typhoid fever, diphtheria, and scarlet fever through specific inoculations.
Among young adults the reduction of syphilis.
Saner and more temperate living on the part of all, with due regard to rest and exercise.
Annual medical examinations. Many persons who have heart disease have discovered it in the most accidental and casual fashion.
(Continued on page 15)6
How to Avoid Heart Disease
(Continued from page 5)
The campaign as it concerns the community:
Improvement in medical instruction.
Attention of the public, particularly the parents, teachers, school children, etc., by propaganda and lectures.
Investigation into the incidence of St. Vitus’s dance.
Hospitals with special department for children with heart disease.
Schedule of suitable occupations for heart patients.
A central power for organization and research.
Treatment of focal infections.
The treatment includes the following:
Rest: Its importance can hardly be exaggerated. This is the universal verdict of all authorities.
Diet: Many authorities advise a low-protein diet, but one that is nourishing. In high blood pressure it means an alkaline ash diet (fruits and vegetables), avoiding animal protein.
Exercise: Systematic exercise, but not to fatigue or embarrassment of the heart.
Physiotherapy and hydrotherapy: Both of which are directed toward the improvement of the heart muscle.
Drugs: In some cases this is necessary to strengthen the heart muscle and to regulate the heart action.
The treatment of heart disease should always be under the direction of a physician.
