Shortness Of Breath
( Originally Published 1921 )
When a person moves about quickly the heart beats more rapidly and the breathing becomes quicker and deeper. Since this has happened to everybody, we do not think anything of it. We know that if several persons are suddenly called upon to run to the top of the house, some of them will arrive there without difficulty, others will arrive with rapid breathing and palpitating hearts. Others still will either have to stop half way up or will arrive at the top in distress. This is so much what one would expect from any ordinary roomful of people that not one of them would go to a doctor or think seriously of the fact that he was more or less short of breath after the exertion.
If, however, one of those persons had been accustomed to run to the top of the house and arrive there in good order and on this particular day suffered distress, that person would go to a doctor to find out what made him short of breath. In other words, shortness of breath is purely relative. It means that one is conscious of distress in breathing when (or after) doing something that he has been accustomed to do without distress. This is an important consideration, because much of the trouble that comes from disorder of the heart finds expression through the breathing, and because much of the improvement and proper treatment is indicated by an increased power to do things without becoming short of breath.
If no consideration whatsoever had been given to these matters, the first idea would be that shortness of breath was due to some trouble with the lungs. In fact it is quite customary to speak of shortness of breath as asthma, and we always like to blame the lungs as much as possible, because lung trouble carries so much less terror with. it than heart trouble. Nevertheless, the fact remains that the breathing is highly dependent upon the circulation of the blood in the lungs, and that in turn is dependent upon the heart.
It is true that a few people are short of breath on account of conditions affecting the lungs, and a few people are helped by treatment directed to the lungs. But the public should be warned against a fad that is common now attempting to cure diseases by so called deep breathing. This method has only a limited application, and is capable of doing real harm when abused. It is particularly true that when the heart is irritable forced breathing causes palpitation.
Whenever the heart is so affected by disease, or by any temporary debility, that it can not do its work, there are three signs that the heart gives, which we must enumerate frequently enough to make them understood by everybody who wants to know about the subject. One of these is the shortness of breath that we have been speaking about; the other two are, swelling of the feet and tenderness on pressure over the liver.
If a person has no shortness of breath, no swelling of the feet, and there is no tenderness when you press over the liver, that person is not suffering from the results of any heart condition that has interfered with the power of the heart to do its work. Of course, the heart may have many other things the matter with it. It may have a leaky valve, it may be the seat of severe pain, it may be irregular, or any one of fifty other troubles; but unless there is shortness of breath, swelling of the feet, or tenderness over the region of the liver, whatever may be wrong with the heart has not interfered with its particular task of circulating the blood.