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Richmond times-dispatch. [volume] (Richmond, Va.) 1914-current, April 08, 1917, Image 47

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Masks .Made from Athletes' Faces
?t the Moment of Supreme Effort,
the Agonized Expressions Being
an Indication of the Strain Their
Hearts Are Undergoing. Such
Strain if Long Continued Results
in Permanent Enlargement of the
Heart and Thickening of Its
Muscles. (From Photograph Copyright by Dr. Mackenzie.)
By Wm. Brady, M. D.
MURM URS are adventitious sounds of a musical char
acter which not every heart can produce. A person
who is anemic is likely to have a beautiful murmur,
and a victim of goitre almost always owns one. In fact, a
great many people in whom we can pick no flaws by the
most delicalc tests of medical science harbor murmurs.
And, what is more discouraging, the most serious types of
heart disease present no audible murmurs. For instance,
a pronounced valvular leakage, with a dilated, failing
heart, commonly produces no murmur when conditions are
most alarming. If rest, and care proves successful in re
storing fairly competent, heart action, then, as the pa
tient's strength and efficiency return, back comes the
murmur, too. musical as ever, like a song of chcer.
So the presence of a murmur in or near the heart. In
stead of being a bad omen, is generally a favorable sign,
or else insignificant.
Suppose there is a leakage of a heart valve. The valve
leaflet has become slightly distorted as a result of the slow
contraction of a scar left in it by some former inflamma
tion?perhaps not recognized at the time it occurred. The
distortion prevents perfect closure of the valve at each
henrt beat, and so a little blood leaks back again into the
ventricle from the great artery (the aorta), or into the
auricle of the heart, from the ventricle, as the case may
be. In leaking back the blood passing over the iense
valve set^it vibrating just as the column of air sets the
reed of an organ pipe vibrating, and in this way an ad
ventitious sound, called a murmur, is produced, a sound
which intrudes upon the ordinary music of the heart.
It is a checrful sound because it is the sound of ef
ficiency; it signifies that the heart muscle, reacting to the
increased demand put upon it to compensate for the back
flow or leakage, has responded by increasing in bulk and
strength sufficiently to maintain a competent circulation
under ordinary conditions. A man with valvular heart
disease must have a stronger heart than one with undam
aged valves in order to be comfortable. Hundreds of per
sons with.valvular leakage of this sort are so comfortable
and feel so well in every way that they never suspect
:here is anything wrong with the heart, unless they hap
pen to be exposed to an insurance examination, or come
down with some severe illness like typhoid or pneu
monia, which places an unusual strain upon the circula
tion: or unless they attempt a mode of life which proves
too strenuous.
Heart failure is by no means the sudden, unexpected
or mysterious seizure popularly imagined. On the con
trary it always gives signals far in advance of an attack.
The victim too commonly ignores the signals or misin
terprets them by the aid of his friend in the corner drug
store, or a nostrum advertisement, or the weather, or busi
ness anxieties or other means of miscalculation. But no
victim of heart failure who succumbs can be said to have
been stricken unwarned; he goes down because he has
placed the mattev of personal health in a secondary posi
tion in his scheme, of life.
The most modern studies of pathology have taught us
that the earliest symptoms of heart failure are felt by the
patient long before the condition becomes manifest, to the
physician. The symptoms are produced by beginning ex
haustion cf the reserve power of the heart.
If you run some distance you grow short of breath, be
cause the exertion uses up the ordinary available energy
of the heart and calls upon the reserve. The reserve en
ergy is jealously conserved by nature and expended
grudgingly. But if you keep on running, supposing you
are sound and true, you will presently get your "second
wind" and find yourself able to run a long distance at
moderate speed without getting quite out of breath. You
arc using the reserve power. By practice, by training in
telligently, you may so increase the reserve power as to
withstand an extraordinarily big strain.
This is what happens when an athlete trains for a con
tost : ? The muscles of the whole heart, but principally the
vcntriclcs, undergo a process of hypertrophy or thicken
ing, just as the biceps may be increased in bulk by exer
cisc; and the right ventriclc, which pumps the blood
through the lungs, is"able to do much more work, keeping
the blood much better aerated in time of great physical
exertion. An athlete has a large heart. He must'have
enlargement of the heart in order to endure the great'
strain of a contest. If he keeps up moderate athletic
work the year round he will be comfortable, but if he sud
denly begins to loaf following the big contest, then that
big heart is likely to begin to bother him considerably,
like a powerful automobile engine with the clutch thrown
2 N
out. This
sort of trou
ble ? "Ath
lete's heart"
?is natural
ly more fre
quent in high
school lads,
and it is the
best of rca
s o n s why
f o o t. b a 1 1
should be ab
solutely pro
hibited in
high schools.
One of the
early signs of
heart failure
The Diagram (X) Shovrs How Liko the Action
of the Heart Is to That of a Force Pump. On
the Left, the Condition During the Resting Period Between
Beatn When Blood Is Flowing In; on the Right, the Condi
tion When Blood Is Being Pumped Out. Below?A View of
the Valves of the Heart, Showing Right Auriculo-Ventri
cular Opening, Closed by the Tricuspid Valve; Left Auri
culo-Ventricular Opening. Closed by the Mitral Valve;
Fibrous Rings; Aortic Opening and Valves, and Pulmonic
Opening and Valves; Muscular Fibres.
is shortness of breath, not ncccssarilv very rapid breathing
or panting, but inability to "get your wind" on moderate
exertion. But heart failure, remember, does not mean
the awful end the coroner too often mentions in his renort
when the actual cause of death is a matter of surmise.
It means a gradual loss of efficiency in a heart damaged
by disease of any kind, such as valvular distortions result
ing from former tonsillitis, quinsy, so-called "rheuma
tism," or neglected teeth, or a fatty degeneration of the
heart muscle from prolonged indulgence in alcohol, for
A man subject to heart failure is always aware that he
has lost his former "pep," that, he is no longer able to do
his former physical or mental work without being
abnormally fatigued, that his health is below par, that he
has "dyspepsia" or "gas" or some other more or less
constant trouble which a healthy man has no business
entertaining. If disaster finally overtakes him?and it
certainly does not in the majority of eases of heart dis
ease?it is only because he has failed to undergo an annual
physical examination.
It was just observed that heart disease does not prove
fatal in the majority of cases. Ninety per cent of all
victims of heart disease die like the rest of us, from every
day preventable diseases like pneumonia, Briglit's disease
and typhoid fever. And the very few who do succumb
suddenly are far outnumbered by the victims of sudden
death from apoplexy, uremia, shock and poison. Many a
coroner's case of "heart failure" would prove to be one
of these conditions if the truth were sought by a complete
post-mortem investigation.
A deplorable circumstance which has much to do
with the subject of the death rate from heart disease is
the popular use of patent medicines and "ethical" or
medically prescribed nostrums for the temporary allevia
tion of symptoms in reality due to a failing heart, but
misinterpreted as "nervousness." "neuralgia." "head
ache," "run down condition," "overwork." "need of a
Ionic." "dyspepsia," "bronchial trouble," "insomnia"
and Ihe like.
Worse still, many of the popular nostrums taken for
the relief of such symptoms contain, as a "kicker," quan
tities of acetanilide, phenaeetin (neetphenetidin) and
other coal-tar derivatives which do bring relief to pain,
fatigue and nervousness, for the time being, but at, the
same time break down red blood corpuscles, seriously
impair the functional strength of the heart, and, if
frequently used, soon start a habit which is ruinous.
There are several simple physical tests by which an
individual may determine for himself whether the
machinery needs expert care. These tests do not specific
ally indicate just which part is worn or defective; they
simply prove that there is something radically wrong with
engine, cooling system or transmission. It. is for the
medical expert to locate nnd remedy the. particular defect.
Sit at rest for an hour or so ami try how long you can
hold your breath. A healthy adult can hold his breath
thirty-five or forty seconds by the watch. Then comes
tho breaking point and he must come up for air.
If the blood and tissues are inadequately supplied
with oxygen, that is, if the proportion of combustion
products (carbon dioxide and other acids) in the blood
and 1 issues be excessive, then it is impossible to hold the
breath so long. One with an impaired circulation cannot
stand out much more than thirty seconds, or, perhaps,
even less. When a patient is unable to hold his breath
more than twenty-five seconds, no matter what his illness,
the advisability of giving an anesthetic for any operation
Copyright, 1917, by tha Star Company.
How To Keep^four
. Heart from Breaking
Diagrammatic Scctional
View of (ho Heart. (A)
Tricuspid Valve. (B)
Semilunar Valves. (C)
Eustachian Valve (1)
Pulmonary Artery (2)
Aorta (3) Vena Cava
.Superior (4) Vena
Cava Inferior. The Ar
rows Show the Course
?f the Blood
Through the Heart
Science Explains
Why This Vital
Organ Often
Fails and Shows
How You Can
Detect When
Wrong with Its
Method of Recording the Heart's Beat by
Means of Sinoke Rings on a Paper Tape, and
Some Actual Records of the Heart's Action
Under Different Conditions.
is always questionable.
That the test indicates the presence of
excessive amounts of carbon dioxide and
other products of combustion in the
blood and tissues (acidosis, as doctors
now call it), is made evident by a further
test. Having determined your breaking
point ? say thirty-five seconds ? just
breathe a trifle more than usual, but not
faster than sixteen times a minute, and
not forcibly at, all, for two minutes. Then
hold the breath. You will now easily last
a minute, perhaps a minute and one-hnlt.
or even longer without another breath. You have-satur
ated the blood with an excess of oxygen for the time bring.
A Yale student breathed in this way for five minutes,
then took a few whiffs of pure oxygen from a tank, and
held his breath right minutes. A Lcland Stanford man
tried it and held his breath for thirteen minutes.
Here is a second test: Count your pulse after you have
been lying at rest for an hour or so. Then sit up and
Groat Britain Rights Reserved.
*1 r your circulation is good your pulse
will resume its normal rate within
three minutes after standing up and
then squatting like this twenty times in
moderately quick auccesaion."
count it. Then stand up ant! count
it?a minute each time. The aver
age normal adult has a pulse of,
say, 66 per minute when lying at
rest, 70 when sitting up, and 74
when standing erect. But if the
circulation is inefficient the com
parative increase upon assuming
the upright positions will be con
siderably greater.
Next count the pulse after you
have been at rest an hour or so.
Then stand up and make twenty
deep knee flexions (squatting) at a moderate rate. The
pulse will become quite rapid and remain rapid for some
time. If the circulation is good, however, the pulse will
return to its normal rate after three minutes of rest in the
?sitting posture. Should it. fail to do so, the chances are
that you have either a defective circulation or tl^at you ar?
subject to nervous exhaustion. Tn either case, your ma
chine needs the attention of a skilled human mechagia.

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