upon the degree of
compensation maintained and is best when this is acquired spontaneously.
This is to be judged by the heart action. The prognosis is poor in
children. It is better in women than in men.

Treatment (a) While Compensated.--Medicine is not necessary at this
period. The patient should lead a quiet, regulated, orderly life, free
from excitement and worry; and the risk of certain death makes it
necessary that those suffering from a disease of the aorta should be
especially warned against over-exertion and hurry. An ordinary healthy
diet in moderate quantities should be taken, tobacco and stimulants not
allowed at all.

The feelings of the patient must control the amount of exercise; so long
as no heart distress or palpitation follows, moderate exercise will be of
great help. A daily bath is good. No hot baths should be taken and a
Turkish bath absolutely prohibited. For the full-blooded, fleshy patient
an occasional dose of salts should be taken. Patients with a valvular
trouble should not go into any very high altitudes; over-exertion, mental
worry and poor digestion are harmful.

(b) The stage of broken compensation. Rest. Disturbed compensation may be
completely restored by rest of the body. In many cases with swelling of
the ankles, moderate dilatation of the heart and irregularity of the
pulse, the rest in bed, a few doses of the compound tincture of cardamon
and a saline purge suffice within a week or ten days to restore the
compensation. For medicine a doctor must be consulted as each individual
case must be treated according to its peculiar symptoms.

FATTY HEART.--This occurs often in old age, prolonged, infectious, wasting
disease, anemia, alcoholism, poisoning by phosphorus and arsenic.

ANGINA PECTORIS.--True angina, which is a rare disease, is characterized
by paroxysms of agonizing pain in the region of the heart, extending into
the arms and neck. In violent attacks there is the sensation of impending
death. Usually during the exertion and excitement, sudden onset of
agonizing pain in the region of the heart and a sense of constriction, as
if the heart had been seized in a vise. The pains radiate up the neck and
down the arm. The fingers may be numb. The patient remains motionless and
silent, the face usually pale or ashy with profuse perspiration. Lasts for
several seconds or a minute or two.

[CIRCULATORY DISEASES 345]

Treatment.--Live an absolutely quiet life, avoid excitemen