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Other drugs are considered in the discussion of hypertension. If the heart actually fails, the treatment becomes that of chronic myocarditis and of dilatation. Not infrequently in sclerosis of the arteries, especially of the coronary arteries, the blood pressure is not high, but low, and the heart is insufficient.
#Thoracic Aneurysm.# All varieties of aneurysm occur in the aorta, the fusiform being the most common, although a sacculated aneurysm frequently springs from a fusiform dilatation. The clinical features depend chiefly on the direction in which the aneurysm enlarges, and are not always well marked even when the sac is of considerable size.
The rules, composed of platina and copper, which LAVOISIER and BORDA imagined for measuring bases, without having occasion to calculate the effect of dilatation, are a singular invention, and greatly surpass what RAMSDEN made for the bases measured in England. LAPLACE has discovered in the Moon inequalities with which we were not acquainted.
We shall, therefore, proceed to state briefly the outlines of that which befell them in after-life, regretting, at the same time, that the legitimate limits of a modern tale will not admit of such dilatation of many a merry or striking scene as might create the pleasing hope of beholding hereafter some more of our rude sketches quickened into life by the spirited pencil of Dunlap.
The increased action of the muscles of the heart and the blood-vessels increases the efficiency of the circulation; the secretion of the adrenal gland causes a rise in the blood-pressure; the increased action of the thyroid gland causes an increased metabolic activity; there is evidence that glycogen is actively called out, this being the most immediately available substance for the production of energy; the increased activity of the respiration is needed to supply the greater need of oxygen and the elimination of the increased amount of waste products; the dilatation of the nostrils affords a freer intake of air; the increased activity of the sweat-glands is needed to regulate the temperature of the body which the increased metabolism causes to rise.
If the rapid heart continues until a myocarditis has developed and a weakening of the muscle fibers occurs, or dilatation is imminent or has actually occurred, operative interference is serious, and most patients under these conditions die after a complete operation, that is, the removal of from one half to two thirds of the thyroid.
These are intense pallor, faintness, giddiness, dilatation of pupils, paroxysmal dyspnoea, rapid, intermittent, and weak pulse, nausea and vomiting, intense prostration verging on collapse, and convulsions.
In hyperæmic headache cupping and blood-letting have been recommended; but as a rule both procedures are not only unnecessary but positively inadmissible, as exclusion of the superfluous amount of blood by compression upon the carotids, followed by a corresponding dilatation of the peripheral circulation by means of the foot-bath, will almost always be sufficient to cause a permanent cessation of the symptoms.
But, if a vessel containing both is heated, the liquid experiences a dilatation which is gradually augmented till it equals and even exceeds that of the gas; whence, of course, an equal volume of the liquid will weigh less and less. On the other hand, a constantly larger quantity of vapor is formed, which accumulates above the liquid and becomes heavier and heavier.
If now we lift the mantle and gills, we find beneath the principal organs: the stomach, with a winding alimentary canal; the heart and liver; the blood-vessels, branching from either side of the heart to join the gills; and a fleshy muscle passing from one valve of the shell to the other, enabling the animal by its dilatation or contraction to open and close its shell at will.
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