But the opposite happened. From the first mouthfuls (I naturally eat very little) the pain became more tolerable and the pulse less frequent. After lunch, everything became normal again; the pain ceased, the pulsations slackened (78-80 per min.) and became much more regular. Intermittence was rare, and I several times counted 100 regular beats in succession. I remained absolutely conscious during the whole crisis, and what chiefly pleased me is that I felt no fear of death, which I was expecting at every moment. It was not only reasoning which made me understand that it was better to die now, whilst my intellectual powers had not yet gone from me and I had evidently accomplished all of what I was capable; I resigned myself also in feeling, and quite serenely to the catastrophe which was coming upon me and which would be far from unexpected.
My mother, who had suffered from heart attacks during a great part of her life, died at 65. My father died of apoplexy in his 68th year.
My eldest sister succumbed to an œdema of the brain; my brother Nicholas died at 57 of angina pectoris.
Undoubtedly my cardiac heredity is a bad one. Already in my youth, I suffered from my heart. At 33 I had such cardiac pains that sometimes I had to rest after walking a few paces. At 34, I had much giddiness and a feeling of heaviness in the head. I could not read a few lines, a poster even, without a painful sensation. In 1881, during relapsing fever, I had severe cardiac intermittence, very fatiguing and only relieved by small doses of digitalin.
I afterwards had periodical attacks of intermittence but never any tachycardia, at least none that lasted more than a few seconds. A little tincture of strophanthus used to relieve me during intermittence. I ended by consulting Dr. Vaquez, but the treatment he prescribed gave me no relief. As I attributed my condition to poisoning by the toxins of intestinal microbes, I resolved to give up raw food and to purge myself now and then with Carabaña water. The success of this treatment was indisputable, and in 1897 the intermittence ceased. In the autumn of 1898 I was beginning to suffer from polyuria; I consulted Albaran, who counselled Contrexéville water, but this cure caused the appearance of albumen in my urine. In 1898 I consulted Norden at Frankfort and Leube in Paris during the Exhibition of 1900. Neither found anything alarming. Norden had told me that I had symptoms of arterio-sclerosis inherent to my age (53). I adopted a mixed diet; I took, regularly, sour milk prepared with cultures of the Bulgarian lactic bacillus, and, during some years, my health was quite satisfactory.
It was only after my journey to Russia in 1909 that a notable aggravation supervened. I felt acute pains in the chest, along the sternum, especially after eating or walking.
In 1911 the intermittence reappeared. In January 1911, I consulted Dr. Heitz in order to know whether I could undertake an expedition in the Kalmuk steppes, where hygienic conditions are very unfavourable. Dr. Heitz found my heart hypertrophied, some slight galloping noise, the blood-pressure (Pachon’s apparatus) 17-16-15. He said, however, that I might undertake the journey, but added, “People die suddenly with less the matter than that with their hearts.” The journey went well, though I suffered from frequent intermittence and pains along the sternum when I walked.
After my return, my heart was fairly satisfactory.
What consoles me especially is that I have preserved my activity, my passion for work, and my intellectual powers. But, naturally, I am ready to die at any moment.
At the beginning of the summer I was sounded by Dr. Manoukhine and Professor Tchistovitch; both thought the heart-sounds satisfactory, but Manoukhine was rather struck by the weakness of the first aortic sound whilst the second was very strong. I had frequent intermittence, but with intervals of normal pulsations. Latterly I have felt better in that respect, and the pain along the sternum only occurred in exceptional cases.