PALPITATION is the term used to signify inordinately forcible pulsations of the heart, so as to make themselves felt, and frequently to give rise to a most troublesome and disagreeable sensation. It may be either functional or a symptom of organic dis ease of the heart. Here We shall merely consider it as a functional disorder. Although it may be persistent, it far more frequently comes ou in paroxysms. which usually ter minate ;within half an hour, recurring afterward quite irregularly, sometimes daily or several times a day, and sometimes not till after a long interval. The attack often comes on under some mental or physical excitement, but sometimes when the patient is quite composed. or even asleep. If the paroxysm is a severe one, the heart feels as if bound ing upward into the throat; and there is a sensation of oppression over the cardiac region, with hurried o• even difficult respiration. Excluding organic diseases, the causes of this affection are either (1) an abnormally excitable condition of the nerves of the heart, or (2) an unhealthy condition of the blood. • 1. Amongst the causes of disturbed innervation may be especially noticed the abuse of tea (especially green tea), coffee, spirits, and tobacco. Any irritation of the stomach and intestinal canal may be reflected to the heart; and hence palpitation may frequently be traced to flatulence, undue acidity, and intestinal worms, especially tape-worms. Everything that causes pressure on the heart, such as tight-lacing, abdominal dropsy, or an enlarged uterus, is also liable to occasion this affection.
2. If the blood is abnormally rich and stimulating it may give rise to palpitation, as in plethora (q.v.); hut-the opposite condition, known as antemia (q.v.). is a much more
commit cause of this affection. In anemia the blood is watery and deficient in fibrine, and (fa• more) in red corpuscles; and being thus in an unnatural state, it acts as an unnatural stimulant, and induces frequent, although not usually strong pulsations. In cases of this kind. singular murmurs (not unlike those which are heard when we apply certain shells to the. ear) are heard on applying the stethoscope to the neck over the course of the great jugular veins.
The age at which palpitation most usually comes on is from 15 to 25 yearn and the affection—especially if it arise from anremia—is very much more common in the female than in the male sex.
The treatment ofipalpitation must entirely depend upon its cause. The use of all nervous stimulants (tea, coffee, alcohol, and tobacco) should be suspended or abandoned. It' the patient is clearly plethoric, with a full strong pulse, lie should take saline cathar tics, and live upon comparatively low diet (including little animal food) until this con dition is removed. When,-on the other hand, the palpitation is due to an antrinie condition, the remedies are preparations of iron, aloetie purgatives, an abundance of animal food, bitter ale, the cold shower bath, and exercise, short of producing positive fatigue. in a pure bracing air. In the paroxysms, relief will often be afforded by the adailnistration of a diffusible stimulant, such as ammoniated tincture of valerian, aro matic spirit of amtnonia, etc.
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