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( Originally Published 1921 ) CONSIDERABLE has been learned by observation of the circulation in the hands and feet of people with heart and circulatory trouble. It is not easy, however, always to understand the significance of what we find. Either the circulation may be disturbed because of a general disturbance in the whole circulation, as when there is valvular heart disease or kidney trouble, or the circulation may be disturbed on account of the local effect of general causes acting through the nervous system. The disturbance that comes from the heart leads to the swelling of the hands and feet, but does not lead to that coldness and blueness that is so common from nervous causes. People with deprest nervous systems, such as people suffering from melancholia or nervous prostration, have a coldness and blueness of the hands and feet that has nothing to do with the power of the heart to do its work. When heart disease has existed from childhood, the circulation in the hands is impaired, and this results in the enlargement of the ends of the fingers. This is noticeable in some young people who have always had heart disease. While the circulation in the hands and feet is influenced by the general circulation of the rest of the body, it is also true that the circulation of the rest of the body can be controlled in a measure by controlling the circulation in the hands and feet. So, in heart failure, or shock after a severe accident, by bandaging the hands and feet firmly, the blood can be made to go to the center of the body where it is needed. This is a valuable resource in heart failure. The same thing is accomplished, if the patient is lying in bed, by quickly raising the foot of the bed so as to elevate the feet and cause the blood to flow toward the chest and head where it is needed. |
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