Softening Of The Heart
( Originally Published 1921 )
This is a serious condition and may be either functional or organic. When it is functional, it is due to temporary loss of tone in the heart. By tone I mean a condition of partial contraction that exists in all healthy muscles. It is this partial contraction that gives firmness to the flesh of a healthy young person, and it is the loss of this tone that makes the paralyzed limb and, generally, the muscles of some so flabby.
The heart, after all, is only a complicated muscle, and is liable to the same loss of tone which may happen in any other part of the body. When this is due to nervous causes and to temporary debility, and not to any permanent change in the muscle itself, it is called functional.
Organic softening of the heart is much more serious. This is found when there has been an inflammation of the heart muscle caused by some infectious disease, such as grippe, diphtheria, or from some form of poisoning; or when a person has become afflicted with fatty degeneration of the heart. The loss of tone that is seen under these conditions is not due to a change in the action of the muscle, but to injury of the muscle itself. Of course, such troubles, as a rule, are much more difficult to cure, and it is necessary to remove the cause of the injury. The heart is often softened by poisons circulating in the blood that have gotten there from the digestive organs when there has been putrefaction in the intestines.
The treatment of softening of the heart, whether it is functional or organic, consists in removing the cause and strengthening the heart by means of physical development. When a boy trains for a race, at the same time that he trains his legs he trains also his heart muscle to meet the demands on it for rapid circulation of the blood while he is running. When a person does anything that improves the general health, there is at the same time an improvement of the circulation of the blood.
The cause of softening of the heart must be found by a careful physical inspection and by a chemical examination of all the processes of the body. By an examination of the nerves, diet, and habits of the patient the cause may often be discovered.
Also, the degree of softening can frequently be determined by a test as to what the heart is capable of doing in the way of keeping up the circulation when the person exercises. Loss of breath in going upstairs may be a sign of softening of the heart, because the weakened heart does not cause the blood to circulate properly in the lungs.
In this condition, the nurse will generally be called upon to enforce absolute rest; and it is necessary for her to understand what is meant by this term; it means that the person must remain in bed and must not rise or get up in any way whatsoever. This often requires great tact and skilful management, because it is hard for a person to understand that he must not get up for any purpose whatsoever. The under-lying principle is that the heart,. under rest, gradually works with less and less stress, and finally reaches a point where it can recuperate. Any exertion neutralizes, for a long time, the benefits of the rest; and recuperation does not begin again for some time. So a patient resting a while, and then jumping up, is often no better off than a patient who is up all the time so far as concerns the curative power of complete rest.