A systeme of anatomy, treating of the body of man, beasts, birds, fish, insects, and plants illustrated with many schemes, consisting of variety of elegant figures, drawn from the life, and engraven in seventy four folio copper-plates. And after every part of man's body hath been anatomically described, its diseases, cases, and cures are concisely exhibited. The first volume containing the parts of the lowest apartiments of the body of man and other animals, etc. / by Samuel Collins ...

CHAP. XIX. Of the Pathology of the Motion of the Heart.

HAving given a History of the Motion of the Heart, Mechanically performed by the Contraction of various ranks of fleshy Fibres, associated with many Tendinous and Nervous Fibres; My design at this time is to speak of the Pathology of its Motion, as it is after a manner abo∣lished, diminished, or depraved.

The two first irregular Motions of the Heart may be comprised in a Syn∣cope, * 1.1 and Lipothymy, which do not formally or essentially differ, but only gradually, secundum Magis & Minus, as the first is higher than the latter; So that they being both symptoms attending the Motion of the Heart are near akin to each other as proceeding from the same causes, as affected with higher or lower degrees, vid. From the defect of Blood, or too great a quantity, or from its grosness or Concretion, or from Corruption, or lastly, by the de∣fect or fault of the Animal Spirits.

The defect of Blood in the Heart, * 1.2 may proceed from a weak concoctive faculty of the Stomach, derived from a want of due Ferments and kindly heat in Chronick and acute diseases; whereupon a small quantity of Chyle (the Materia substrata Sanguinis) is produced.

Another cause of the defect of Blood in the Heart, * 1.3 may be deduced from an obstruction of the ascendent Trunk of the Vena Cava, caused by some Fleshy substance, or by some concreted Blood intercepting the current of Blood into the right Cistern of the Heart, or by the same causes in the Pul∣monary Vessels, giving a check to the motion of Blood out of the Lungs into the left Ventricle.

An Instance may be given of the hindred circulation of Blood, produced from its Coagulation in the Trunk of the Vena Cava, in a Maid of Four∣teen years old, who after she had been highly afflicted for a day with a great heaviness, and a vertiginous indisposition and frequent Syncopes, took her farewell of her Friends and her miserable life; and afterward she being opened to inspect the cause of her death, the Brain was found to be free from any disaffection, and the Vena Cava to be filled with concreted Blood, which rendred the right Ventricle empty of it, which proved satal to this young Virgin.

Another cause of a Lipothymy or Syncope (often attended with a fatal stroke) may arise out of so great a torrent of Blood, * 1.4 carried into the Ven∣tricles, that the Heart is not able to discharge it out of the right into the Pul∣monary Artery, nor out of the left into the Aorta; whereupon a suddain

Suffocation the Heart immediately ensueth, and the motion of the Blood wholly taken away.

Sir Robert Fen, a worthy Gentleman, * 1.5 and Servant of King Charles the First, of most blessed Memory, being subject to great Passion, was so highly surprized with Fear, upon the occasion of a conceived imminent loss, that he fell down dead in a moment, which was (as I humbly conceive) cau∣sed by a great sourch of Blood suddainly impelled into the right Ventricle, and Suffocated the Heart.

A third cause of a Lipothymy or Syncope, * 1.6 may be deduced from a gros∣ness or concretion of Blood, proceeding from an over-fibrous disposition, that is, from numerous Films and Vesicles containing gross Atoms of Blood full of fixed Saline Particles, Coagulating the Blood in the Ventricles, often producing a Polypus, inducing these ill accidents of the Heart.

These symptoms may also be caused by some fleshy Excrescence filling up either of the Ventricles; So that they are not receptive of Vital Liquor; * 1.7 whereupon the Heart loseth its use and motion, as being designed by Nature to transmit Blood into all parts of the Body.

A Woman of great Honour and Birth, was frequently tortured with a pain of the Heart, and great Fainting Fits, which could not be taken away by the power of Art, and at last the pain and Lipothymies growing more and more afflictive, Death became the best remedy. And afterward her Body being opened, and her Heart inspected, a black Flesh substance some∣what resembling a Medlie in figure, was discovered in the left Sinus of the Heart.

Another cause of these ill symptoms of the Heart, * 1.8 may be taken from a Purulent Matter flowing from an Ulcer of the Heart, tainting and distoning the mass of Blood passing through the Ventricles; whereupon the Fibres of the Heart grow faint, and at last lose their Contractions proceeding from a vitiated dispirited corrupted Blood, received into their inward Compage, whence follow Lipothymies, Syncopes, and Death it self.

A Citizen long afflicted with a high Hypocondriacal passion, and an acute Fever, accompanied with Lipothymies and Syncopes, determining in a hap∣py departure, as the period of pain and misery, his Body being Dissect∣ed, the Cavity of the Thorax was found full of a thin, red, faetide humor, which was also lodged in the left Ventricle of the Heart, flown from an Ulcer.

These severe accidents of the Heart do often arise out of the Ulcers of the neighbouring parts, as the Lungs, Pleura, Mediastine, Midriff, Liver, * 1.9 Spleen, Pancreas, which being oppressed by Ulcerous Matter, do transmit it by smaller branches of Veins peculiar to the said Viscera, into the as∣cendent Trunk of the Cava, and from thence into the right Ventricle of the Heart, whereby its Fibres are highly discomposed by Pus imbibed in∣to them with the Blood.

These most troublesom accidents of the Heart perverting the Oeconomy of its Motion, * 1.10 are often produced in Malignant Fevers, by Venenate Steams corrupting the native disposition, and distoning, and destroying the Spirituous parts of the Blood, whereupon it groweth Concreted in the great Vessels, and Ventricles of the Heart; So that the poysonous steams being received with the Blood into the substance of the fleshy Fi∣bres, do weaken, if not take away their Contractions, whence ensue Li∣pothymies and Syncopes, the forerunners of Death.

Another cause of these dreadful Symptoms may be derived from the indisposition of the Brain, * 1.11 either not generating a sufficient quantity of Nervous Liquor to invigorate the Nerves of the Heart, or else if it be ge∣nerated, cannot be transmitted to the Cardiack Nerves, caused by some ob∣struction of them, whereupon the Fibres are not able to play their parts in the scene of repeated Motions, as not impregnated with Animal Spirits, which may be one cause of Lipothymies and Syncopes, speaking a conclu∣sion to Life.

And the motion of the Heart is not only lessened in Lipothymies, * 1.12 and abolished in Syncopes, but depraved also in Palpitations, which are sometimes so great, that the Cone striketh the left side near the Pap with so great a violence, that it may be plainly seen, felt, and heard too at some distance.

The Mechanick cause of an erection of the Heart whereby it striketh the Breast, * 1.13 proceedeth very much from the oblique situation of the Heart and disposition of the Fibres, which are obliquely and spirally wreathed and brought round from the right toward the left side of the Heart, and this posture of the Fibres is very much assisted by the conformation of the Heart, as the left Wall is more short and less Carnous, and crooked, in the left Ventricle of the Heart than in the right, which is encompassed with two Walls, as Learned Borellus hath observed: Unde (ait ille) in Systole erigi debet Cordis mucro versus sinistram partem pectoris, eam{que} percutere potest pro gradu violentiae, qua erigitur. Hoc salvari quo{que} potest, vel adjuvari ab erectione Cordis obli{que} jacentis, vel à situatione, & dispositione Fibrarum, quae obli{que} spiraliter circumducuntur à parte dextra basis Cordis versus sinistram par∣tem Verticis, unde in inflatione Fibrarum anterius versus sinistram partem, & sic percussio fieri potest.

The erection of the Heart, perverting the Oeconomy of Nature (where∣in the Mucro of the Heart maketh violent strokes upon the left side) is called Palpitation, * 1.14 which may be derived from many Causes, one may arise from too great a quantity of Blood, which the Heart being unable wholly to discharge in every Systole, is so oppressed, as to make strong and frequent Contractions of its Fibres, (wherein the Cone of the Heart being elevated, maketh strong Appulses upon the left side) to discharge the exuberant Blood by most brisk Vibrations.

A second cause of the Palpitation of the Heart, * 1.15 may be fetched from an undue fermentation of the Blood, as consisting of unactive, and too much depressed Elements, hindring the Intestine motion of the Vital Juyce, which is often found in Cachectick bodies in the Scorbutick Distempers of Men and Women, wherein the dispirited mass of Blood is apt to Coagulate in the Ventricles of the Heart; So that the Heart is forced to make many brisk and often repeated Systoles, and erections of the Cone against the left side.

A third cause of this Disaffection may take its rise from the great effervescence of the Blood, proceeding from a high Fermentation of it, * 1.16 as composed of too much exalted saline and sulphureous Particles often found in Hypocondriacal and Hysterical Distempers. Wherein the Fibres of the Heart, being highly aggrieved with the fiery heat of overmuch fermenting Blood, do produce vigorous Constrictions of the Ventricles, and strong Vibrations of the Cardiack Cone against the Thorax.

The fourth cause of this disorderly Convulsive motion of the Heart, * 1.17 may be derived from the indisposition of the Cortex of the Brain, in which an ill Animal Liquor is generated, as partly consisting of exalted Saline and Oyly Particles, produced from ill Blood, whose Albuminous part is the Materia Substrata of Nervous Juyce, which is transmitted through the Fibrous parts of the several processes of the Brain, into the Origens of the eighth pair of Nerves, and from thence into the Cardiack branches, whereupon numerous Nervous Fibrils (inserted into the Carnous Fibres) being highly irritated by an ill Succus Nervosus, do draw the Fibres into violent irregular Convulsive motion; So that the elevated Cone of the Heart maketh many impetuous strokes against the Thorax.

As to the Cure of the Palpitation of the Heart arising from too great a quantity of Blood clogging the Heart, * 1.18 and putting the Fibres upon irre∣gular Contractions; it denoteth a free mission of Blood which will speak an Alleviation to great Vibrations of the Heart.

An instance may be given of this disaffection in a Knight, a Pensioner of his Majesties, who being endued with a Plethorick constitution, was of∣ten afflicted with a great Palpitation proceeding from an exuberant quantity of Blood (evidenced in a high Pulse) oppressing the Heart, and was im∣mediately freed from this troublesome Distemper, in opening a Vein, by which a large proportion of Blood was immediately discharged, and the Pa∣tient relieved.

The irregular motions of the Heart (derived from the want of Fer∣mentation of Blood, * 1.19 produced by improper Ferments) do indicate bit∣ter Medicines, which Corroborate the Stomach, and Anti-Scorbutick Me∣dicines mixed with Chalybeates, which rectifie the fixed saline and sulphu∣reous parts of the Blood, and endue it with proper Fermentative Prin∣ciples.

A Mercers Wife in Covent-Garden, endued with a thin Body, a weak Pulse, and an ill Concoction of Stomach, was often highly afflicted with Palpitations of the Heart, proceeding from the defect of a good Intestine motion of the Blood, whereupon it grew depauperated, and the Patient liable to fainting Fits, and a great difficulty of Breathing, which were much alleviated by bitter Decoctions, Pearl Julaps, Spirit of Hartshorn, and Chalybeates given in Apozemes made of opening Roots, Sarsa Parilla, Pine and Fir, and at last by the drinking Tunbridge Waters.

The Palpitation of the Heart arising out of the Blood (over acted with too high an Intestine motion of the Blood, * 1.20 produced by exalted saline, and sulphureous parts) doth denote Testaceous Powders, as Pearl, Crabs Claws, Crabs Eyes, Coral, and the like, which do dulcifie the mass of Blood, given with temperate Diuretick Apozemes, and discharge the fixed saline Particles by Urine, and attemper the hot Atoms of Blood: In this case also Chalybeates mixed with temperate Anti-Scorbuticks, may be given with good success.

Dr. * 1.21 Huit, a Person of great Vertue, Learning, and most eminent Loy∣alty (for which he was Murdered in the time of Usurpation) was affect∣ed with a hot Scorbutick habit of Body, and highly discomposed with great Palpitations of the Heart, taking its rise (as I humbly conceive) from too great a Fermentation of the Blood, as consisting of active Heterogeneous Elements, whereupon I advised him to take Testaceous Powders, taken with cooling Julaps, and temperate Cordials, mingled with Pearl, as also Chalybeate Syrups, taken with Diureticks and temperate Anti-Scor∣butick Apozemes, by which the Patient (God be praised) was perfect∣ly recovered.

The fourth kind of irregular motion of the Heart being Convulsive, * 1.22 (as produced by an ill Succus Nervosus, transmitted into and irritating the Cardiack Nerves) doth denote proper Medicines to refine the Al∣buminous part of the Blood, the Materia Substrata of Animal Liquor, and also Cephalick Medicines to Corroborate the Brain, and Nerves of the Heart.

Palpitations of the Heart are accompanied also with Convulsive mo∣tions of the Nerves seated in divers parts of the Body, * 1.23 and chiefly about the Base of the Heart (which is backed by the Sentiments of Learned Dr. Willis) encircling the Trunks of the Aorta, and Vena Cava to hin∣der the immediate flux and reflux of the Blood, and its great efferves∣cence and Stagnations, produced by vehement passions of Anger, Fear, Sorrow, and Joy, which highly disorder the various Nerves inserted into the Coats and make irregular motions in the Arteries, and especially in the Aorta near the Heart, whereby its Nerves are drawn into Consent, and are productive of Convulsive Motions.

Another cause of the unkindly motion of the Heart may proceed from the frequent Pulsation of the Arteries, caused by the Carnous Fibres, * 1.24 irri∣tated by the Convulsive motion of the great company of Nervous Fibrils, implanted into the fleshy Fibres of the Trunks relating to the Arteries, which renders their repeated Contractions very violent, whereupon the Blood is impetuously moved first through the Arteries, and then through the smaller and greater branches of the Vein into the right Ventricle of the Heart; So that the Carnous Fibres are highly sollicited to make many irre∣gular Motions, which are in truth Convulsive in order to discharge the great torrent of Blood into the Pulmonary Artery, which being highly aggrieved by impetuous streams of Purple Liquor, doth make irregular Con∣tractions (to discharge the exuberant source of Blood into the Pulmonary Vein) which draweth the Heart into a Sympathy, as the Orifice of the Pul∣monary Artery is implanted into the right Ventricle of the Heart.

A fourth cause of the inordinate motion of the Heart may be deduced from the Nerves, * 1.25 animating the Carnous Fibres of the Arteries which do interrupt the equal and natural course of the Blood, by reason the Cavities of the Arteries are very much narrowed by the Convulsion of the Nerves inserted into the Carnous Fibres; whereupon the impulse of Blood is stop∣ped, as in the disorder of the Nerves in great passions of Anger, Fear, Sorrow, and the like, which cause great consternation and confusion: So that it is probable that the Trunk of the Aorta being very much lessened by the Convulsion of the Nervous Fibril drawing the Carnous (seated in the Coat of the great Artery adjoyning to the left Chamber of the Heart) much hinder the motion of the Blood out of the Heart into the Aorta; whereupon the Ventricle of the Heart being highly distended by overmuch Blood, will cause many violent Pulsations or Convulsive Contractions, to discharge the exuberant quantity of Blood into the Orifice of the great Artery.

Persons subject to immoderate passion of Anger, Grief, Joy, and those that are much afflicted with Hypocondriacal, and Scorbutical Diseases, are very obnoxious upon every light occasion, and sometimes without any pro∣vocation to passions and convulsive motions of the Heart, called vulgar∣ly the Palpitations of it, as having the Cardiack Nerves affected with a gross Succus Nutricius, proceeding from ill humors in a Cachectick body op∣pressed with Acide Ferments of the Blood, acted also with gross saline Par∣ticles. Palpitations of the Heart also proceed from a great quantity of Blood, ready to suffocate the Heart, and put the Fibres of the Heart into inordi∣nate

Motions, as well as the Nerves highly irritated by an exuberance of Blood, compressing of the Heart, and thereby hindring the passage of the Nervous Liquor in the Interstices of the Filaments often productive of Convulsive motions afflicting the Heart; These irregular motions are al∣so generated in the origen of the Nerves, when they are disordered with some Acrimonious Matter vellicating the Fibres seated in the ambient parts of the Brain.

As to the Cure of these Convulsive Motions producing a great exube∣rance of Stagnant Vital Liquor in the Heart, it denoteth frequent opening of a Vein, to sollicite the motion of Stagnant Blood to abase its quantity.

And in reference to the cause of Convulsions (seated in the Nerves) producing the palpitation of the Heart, Cephalick Apozemes, Electuaries, Spirit of Hearts Horn, Spirit of Amber Succinated, &c. may be of great use.

Notes

• * 1.1

  The Syncope and Lypothy∣my of the Heart, do dif∣fer gradually.
• * 1.2

  The first cause of defect of Blood.
• * 1.3

  The second cause of the Penury of Blood.
• * 1.4

  A second cause of a Ly∣pothymy.
• * 1.5

  An instance of this cause.
• * 1.6

  A third cause of a Lipothy∣my.
• * 1.7

  These symp∣toms may pro∣ceed from an Excrescence filling up ei∣ther Ventri∣cle of the Heart.
• * 1.8

  A Syncope and Lipothy∣my may come from Puru∣lent Matter, or Ulcer of the Heart.
• * 1.9

  These symp∣toms may a∣rise out of Ulcers of the adjacent parts.
• * 1.10

  A Syncope and Lipothy∣my coming from Malig∣nant steams of the Blood in Pestilential Fevers.
• * 1.11

  The symp∣toms may come from the indisposi∣tion of the Brain.
• * 1.12

  The Palpita∣tion of the Heart.
• * 1.13

  The cause of the Heart striking the lest side.
• * 1.14

  The Palpita∣tion proceed∣ing from too great a quan∣tity of Blood.
• * 1.15

  The second cause of the Palpitation may be taken from an un∣due fermenta∣tion of the Blood.
• * 1.16

  A Palpitation of the Heart arising out of an efferves∣cence of the Blood.
• * 1.17

  The Palpita∣tion of the Heart pro∣ceeding from the indisposi∣tion of the Brain.
• * 1.18

  Blood-letting is good, in a Palpitation of the Heart flowing from an exuberance of Blood.
• * 1.19

  Bitter Medi∣cines are pro∣per in a Palpi∣tation of the Heart.
• * 1.20

  Testaceous Powders are good in an un∣due fermen∣tation of the Blood.
• * 1.21

  An instance of the Cure of the Palpita∣tion of the Heart derived from an ill fermenting Blood.
• * 1.22

  Cephalick Medicines are proper in the Convulsive motions of the Heart.
• * 1.23

  A second cause of the Con∣vulsive mo∣tions of the Heart.
• * 1.24

  A third cause of Cardiack Convulsions.
• * 1.25

  A fourth cause of Convulsive motions in the Heart.