Plenty of fresh air, and mild exercises in the open air all tend to increase the pressure. Graded walking, climbing, or other more interesting exercises are advisable, as all tending to raise the pressure, provided that at no time are they carried to the point of exhaustion.
Forced feeding may be useful. Cool sponging in the morning, if there is proper reaction, is often of benefit. Iron may be indicated; bitter tonics may be indicated. Digitalis and strychnin are often of advantage. Caffein may be used as a drug as well as given in coffee and tea. Atropin may be of value in some forms of hypotension.
At times with a low systolic pressure, but a relatively high diastolic pressure, nitroglycerin is valuable.
More or less actite hypotension may occur in hot weather or with overheating, often termed heat exhaustion. Such patients should, if possible, go to a cooler region, whether to the seashore or to the mountains is unimportant. The treatment of dangerous sudden low blood pressure, as shock, will be discussed elsewhere.
PERICARDITIS
ACUTE PERICARDITIS
As this inflammation is generally secondary to some other condition, its treatment cannot be positively outlined. Furthermore, it is often a terminal condition, and in such instances the results of treatment are of necessity nil. The most frequent terminal cause is nephritis; other terminal causes are pulmonary tuberculosis, adjacent abscesses, cancer or other growth.
The most frequent infectious cause is rheumatism; other infectious causes are cerebrospinal fever, typhoid fever, acute miliary tuberculosis, pneumonia and Sepsis. Accidental causes are traumatism and an adjacent inflammation of the pleura.
The result of an inflammation of the pericardium may be a fibrous exudate, or an exudate which is both serous and fibrous, or one in which pus is present in considerable amount.
The onset of pericarditis may be more or less acute, or it may commence insidiously. For this reason, during severe illness, and especially in those diseases which are known to have pericarditis often as a sequence, frequent examination of the heart should be made as a routine procedure.