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Discussion of the Treatment of the Heart in Its Various Disorders,
With a Chapter on Blood Pressure
OLIVER T. OSBORNE, A.M., M.D.
Professor of Therapeutics and formerly Professor of Clinical
Medicine in Yale Medical School NEW HAVEN, CONN.
THE JOURNAL of AMERICAN MEDICAL ASSOCIATION
Five Hundred Thirty-Five
North Dearborn Street, Chicago
The second edition of this book is offered with the hope that itwill be as favorably received as was the former edition, The texthas been carefully revised, in a few parts deleted, and extensivelyelaborated to bring the book up to the present knowledge concerningthe scientific therapy of heart disturbances. A complete section hasbeen added on blood pressure.
That marvelous organ which, moment by moment and year by year, keepsconsistently sending the blood on its path through the arteriovenoussystem is naturally one whose structure and function need to becarefully studied if one is to guard it when threatened by disease.This series of articles deals with heart therapy, not discussing theheart structurally and anatomically, but taking up in detail thevarious forms of the disturbances which may affect the heart. Thecordial reception given by the readers of The Journal to this seriesof articles has warranted its issue in book form so that it may beslipped into the pocket for review at appropriate times, or kept onthe desk for convenient reference.
Preface
Preface to First Edition
Disturbances of the Heart in General
Classification of Cardiac Disturbances
Blood Pressure
Hypertension
Hypotension
Pericarditis
Myocardial Disturbances
Endocarditis
Chronic Diseases of the Valves
Acute Cardiac Symptoms: Acute Heart Attack
Diet and Baths in Heart Disease
Heart Disease in Children and During Pregnancy
Degenerations
Cardiovascular Renal Disease
Disturbances of the Heart Rate
Toxic Disturbances and Heart Rate
Miscellaneous Disturbances
Of prime importance in the treatment of diseases of the heart is adetermination of the exact, or at least approximately exact,condition of its structures and a determination of its ability towork.
This is not the place to describe its anatomy or its nervousmechanism or the newer instruments of precision in estimating theheart function, but they may be briefly itemized. It has now beenknown for some time that the primary stimulus of cardiac contractiongenerally occurs at the upper part of the right auricle, near itsjunction with the superior vena cava, and that this region may bethe "timer" of the heart.
This is called the sinus node, or the sino-auricular node, andconsists of a small bundle of fibers resembling muscle tissue. Lewis[Footnote: Lewis: Lecture in the Harvey Society, New York Academy ofMedicine, Oct. 31, 1914.] describes this bundle as from 2 to 3 cm.in length, its upper end being continuous with the muscle fibers ofthe wall of the superior vena cava. Its lower end is continuous withthe muscle fibers of the right auricle. From this node "theexcitation wa