None
193. 198 dilatation in, 193, 198 dropsy in, 197 effect of position on pain in, 197, 198 of smoking on pain in, 198 exhaustion in, 193, 197 heart-failure in, 197 increased pulse rate in, 193, 198 intestinal disturbances in causation of, 196 liver, enlarged in, 197 p«m in, 197 pallor of hand5 and fingars in, 198 palpitation in, 193, 198 patient's sensations in, 193, 197 physical si^ns of, 198 prognosis in, 199 symptoms of, 196, 197, 198 systolic murmur in, 193, 198 tobacco as cause of, 196 treatment of, 199 vasv'-motor irritability in, 197, 198 Pregnancy in relation to heart affections, 211 aortic regurgitation in, 212 auricular fibrillation in, 212 breathlessncss in, 211 diastolic murmur in, 212 (iropsy in, 211 I. >r bidden in heart cases, 213 mitral stenosis in, 212 presystolic murmur in, 212 Premature beat, 149 INDEX '^261 PrcBystolic murmur, loq disappearing in auricular fibrilla- tion, ( 10, 165, 106 Principles of treatment, 220 Production of symptoms, 51 Prognosis in heart afTections, 21, 207 effects of treatment in relation to, 208, 209 formation of, 210, 211 guarded, 217, 218 in anaesthesia, 213 in angina pectoris, 79, 209 in aortic regurgitation, 117, 118, 119, 120 in auricular fibrillation, 167, 210 in auricular flutter, 175 in congenital heart disease, 214 in elderly patients, 209 in extra-systole, cases with, 153 in hypersensitive nervous system, 84 in palpitation, 179 in paroxysmal tachycardia, 182, 183 in patent ductus arteriosus, 214 in poisoned heart, 199 in pregnancy, 211 in pulsus alternans, 155 in relation to functional efficiency of the heart muscle, 207 in relation to signs of heart failure, 208, 209 mystery in relation to, 216 personal element in, 215 "reserve force" in relation to, 208 "rest force," 209 statistical methods in, 219 Progress of disease, need of recog- nition of symptoms of, 17 Protective symptoms, value of, 53 "Pseudo angina," 83 Puerperal septicemia, endocarditis in, 192 Pulsation, epigastric, 124 Pulsation, liver, in paroxysmal tachy- cardia, 181, 182 Pulse — in aortic regurgitation, 1 18 in palpitation, 179 in paroxysmal tachycardia, 181 in pyaemia and puerperal sep- ticsemia, 192 rapid, in auricular flutter, 175 rhythm of, in auricular fibrillation, 164, 165 Pulsus alternans, 137, 153 auscultatory method of diagnosing 154 diagnosis of, 154 differentiation from pulsus bi geminus, 154, 156 digitalis as cause of, 232 evidences of heart-failure with, 155 heart, sounds in, 154 in relation to cardiac asthma, 59 musical murmurs with, 154 prognosis in, 155 Pulsus bigeminus, 150, 151 conditions in which it appears, 154 differentiation from pulsus alternans 154, 156 Purpura in septic endocarditis, 192 Pyaemia, endocarditis in relation to, 192 Questioning tke patient, 93 Sapid pulse (auricular fluttsr), 172, 175 Eate of heart — in aortic regurgitation as index of cardiac vigour, 1 18 in paroxysmal tachycardia, 180 in poisoned heart, 193, 198 persistent increase of, in acute fevers, 106 "Eeserve force," 40, 45, 208 Eespiratory irregularity, 144 Eesponse to effort as index of sig- nificance of systolic murmurs, 104 Best— in treatment 01 angina pectoris, 80 exhaustion of the heart, 226 dropsy, 226 hypersensitive nervous system, 84 " Eest force," 40, 45, 208 Eetinal embolism in septic endo- carditis, 192 Eheumatic fever, 19, 27, 107, 136, 169, 212 auricular fibrillation or flutter as remote eflfect of, 189 262 INDEX Bheamatic ferer {c/yn/.) cause of aortic regurgitation, 119 diastolic murmur in, 189 dilatation of the heart in, 189 drugs in, 191 followed by extra-systoles, 153 followed by irregular action of the heart, 145, 147 in acute afl'ections of the heart, 189 in relation to auricular flutter, 172 mitral stenosis, loS, 113 in relation to paroxysmal tachy- cardia, 182, 183, 1S8 pericarditis in, 190 positive evidence of heart mischief in, 190 presystolic murmur in relation to, 190 soft systolic murmur in, 189 symptoms of invasion of heart in, 189 treatment of acute aflections of the heart in, 190 Rhythm, gallop, in myocardial cx- luuistion, 136 Rigors in septic endocarditis, 191 Riva-Rocci blood-pressure instrument , 206 Rough murmur indication of dam- aged valve, 103 Behott, resistance-exercises ot, 229 Second Bonnd, doubling of, 109 Sedatives, 241; Senile change! in relation to auricular Ihiller, 172 Sensations of patient (sec under Patient'! sensations) Sensation, fluttering, in the chrst, 104 Seme of exhanition, 87 Ssneitivoneii of viscera, 13, 53 Septic endocarditis, loi Shivering in hypersensitive nervoa! !ystem, 83 Sine auricular node, 144 Sinus irregularity, 145 Skin, yellow, acconnianying sense ol exhaustion, 90 Sleeplessness — and heart exhaustion, 74, 82, 224 provoking cause of extra-spioles, treatment of, by sedatives, 245 Slowing of whole heart, transient, 144 Sodium nitrite, 244 " Soldier's heart," 194 infection in relation to, 194 patient's sensations in, 194 Sphygmo-manometer, 200 Spiritus tetheris nitrosi, 244 Squills, 243 Starling, I'rofcssor, on dilatation of the heart, 122 Stenosis — aortic, 105 mitral, loS Stomach- fullness of, in relation to angina pectoris, 75 palpitation in connexion with, 179 Strophanthus, 243 as substitute for digitalis, 243 intravenous administration of, 243 Strychnine, 247, 24S Sudden heart failure, 1S4 Sulphonal, 245 Symptoms, rapid disappearance of, m paroxysmal tachycardia, l8l, 182 Synoope, 60, 87 and hcait'block, 61 due to extreme frequency of heart- rale, 65 due to vagal stimulation, 60 in aortic regurgitation, II9 Syphilis - anil angina pectoris, 77 in aortic regurgitation, IIQ Systolic blood pressure, 203, 206 Systolic murmurs — acconipaiiymg heart failure, 105 in poisoned heart, 193, 19S meaning of, in fevers, loto organic in origin, 103 physiological and functional. 102 Tea - as provoking cause of extra systoles, in palpitation, 179 Teeth, defective, 91 Temperature — elfcct of, on heart and blood vessels, 187, 188 INDEX 263 Temperature {cent.) in relation to acute affections of the heart, 187 Tenderness — in chest wall in auricular fibrilla- tion, 167 in left chest, 81 over liver, in auricular fibrillation, 167 Thrill preceding first sound, 109 Tobacco — as cause of poisoned heart, 194 as provoking cause of extra-systole-;, in angina pectoris, 78 Toxins as cause of sense of exhaus- tion, 90 Treatment, 220 and the care of the heart muscle, 224 baths in, 229 by alcohol, 247 by atropine, 247 by digitalis, 231 by sedatives, 245 by strophanthus, 243 by the nitrites, '243 change of occupation in, 225 diet in, 227 essential object of, 222 exercise in, 228 in relation to diagnosis, 224 heart-failure, 223, 224 progressive disease of the heart, 223 valve defects, 223 of angina pectoris, 79 of auricular fibrillation by digitalis, 232 flutter, 175. 176 flutter by digitalis, 237 of dilatation, 129 of hypersensitive nervous sx'stem, 84 of palpitation, 179 of paroxysmal tachycardia, 183, 1 84 of poisoned heart, 199 of sense of exhaustion, 89, 90 principles of, 220 rest in, 226 Tricuspid murmur, loud rasping in septic endocarditis,, 192 Tubercle and congenital heart disease, 215 Typhoid fever, 187 ITnconsciousness — due to auricular flutter, 61, 174 faulty cardiac action, 61 heart-block, 61 heart-failure, 185 paroxysmal tachycardia, 181 with convulsions, 63 Uterus, eflfect of disturbances of, palpitation, 179 " Vagns irregularity," 144, 145, 148 Valves, vegetations on. 192 Valvular defects in relation to treat- ment, 223 Valvular disease — palpitation in, 178 paroxysmal tachycardia in, 183 youthful type of irreij;ularity in, 14S (see also under Murmurs) Vaso-dilator drugs in treatment of angina pectoris, 80 Vaso-motor disturbance, associated with angina pectoris in aortic regurgitation, 119 associated with syncope, 1 19 as symptom of hypersensitive nervous system, 83 in aortic regurgitation, 119 in poisoned heart, 197, 198 Vegetations on valves, 192 Veins, jugular — filling as result of pressure on abdomen, 89 in paroxysmal tachycardia, 181 Ventricle, fibrillation of, 169, 214 Veronal, 245 W Wasting in auricular fibrillation, 167 Withering, Dr., on digitalis, 231 Worry in relation to heart exhaustion, 74, 82, 224, 245 264 INDEX Youthful type of irregularity {etni. RC Mackenzie, (Sir) James 681 Principles of diagnosis and M25 treatment in heart affections BioMed PLEASE DO NOT REMOVE CARDS OR SLIPS FROM THIS POCKET UNIVERSITY OF TORONTO LIBRARY. 