On the Treatment of Incipient Hypertrophy of the Heart.

Abstract

I AM desirous of drawing attelntion to the treatment of heart disease by means of inhalation. All remedies are in a certain sense applied with a view to effect local changes; but it has not been sufficiently considered that by means of eudosmosis it is easy to bring our remedies into direct contact with the lining membrane of the left heart and aorta, as well as with the capillaries of the pulmonary tissue. A sedative, (for example, fox-glove or hydrocyanic acid,) suspended in the vapour of water, or in atmospheric air, and inhaled, must pass by a well-known law into the capillaries of the lungs, and accompany the newly-aerated blood which they contain through the pulmonary veins to the left auricle. The result of-this process of treatment is direct, as respects the left auricle and ventricle only; but it is this side of the heart principally which becomes affected by disease, particularly by that form of it-namely, hypertrophy, which is susceptible of relief or cure by the means to be presently pointed out. While it is impossible to cure hypertrophy of the heart in an advanced stage,* it is of great importance to know that it may be cured easily in an early form, especially when it is remembered that the affection, at first slight, is progressive, and is attended with peculiar distress to the patient from its invasion. The method pursued by me in the treatment of this disease is the following:-I order from five to ten drops, the increase being gradual, of diluted hydrocyanic acid to be inhaled three times a day in the vapour of hot water, at the hours of eleven, three, and seven, or midway between meals. The patient is directed to lie down for one hour after each inhalation of the acid. The.effect of the treatment is at once to subdue the increased impulse of the heart for the space of an hour or more after its application, and the mere rest thus acquired by the organ conduces to restore it to health. Faintness is experienced by the patient for some time after inhaling the acid, not to a sufficient degree to be distressing, yet to such an extent as to render the recumbent position advisable. In mild cases, at the end of four or six weeks, the periodical arrest of impulse produced in the heart becomes peristent, but this improvement is attended with distressing feelings of faintness, and a return of palpitation on the occurrence of exciting causes. But at this period of the treatment the organic affection has given way, the hypertrophy, or 6ver nutrition is checked, and it only remains to restore tone to the nervous system of the