TREATMENT OF PSEUDO-ANGINAS
The treatment of these pseudo-angibas depends, of course, on the diagnosis of the cause, and the cause should be eliminated or modified. If the heart shows real disturbance from this reflex cause, the treatment aimed toward it depends on whether the heart action is weak or strong and the circulation poor or good. If the circulation is poor, digitalis in small doses may be needed, either 5 drops of an active tincture twice a day, or 8 or 10 drops once a day. If digitalis is not indicated, strophanthus sometimes is valuable. While strophanthus has been shown not to be a real cardiac tonic like digitalis, still there seems to be a nervous sedative action when it is given by the mouth, and it often does good in these cases. The dose is 5 drops of the tincture, in water, three times a day, after meals. Strychnin in small doses may be needed, but in these patients, who are generally nervous, it is usually better not to give it.
One of the best sedatives to a heart that is irregular in its action and not acting strongly is lime; a good way to administer it is in the form of calcium lactate, and the dose is 0.3 gm. (5 grains), in powder or capsule, three times a day, after meals.
If the circulation is good and the heart is strong, and yet these irregular pains and irregular contractions occur, the bromids act favorably and successfully. This is probably on account of their ability to quiet the central nervous system, to quiet and soothe the irritability of the heart, and to relax the peripheral blood vessels. The dose should be from 0.5 to 1 gm. (7 1/2 to 15 grains), in water, three times a day, after meals. It is not necessary or advisable to continue the bromid very long. Whatever general tonic or eliminative treatment the patient, requires should be given. The value of hydrotherapy, massage and graded exercise should not be forgotten.