We say the mind is depressed by grief and excited by joy. In the same manner emotions of sadness or grief so depress the heart’s action that it beats with great feebleness, or its motion is almost arrested, causing that condition known as fainting. Joyous emotions, on the other hand, so excite the heart that the frequency of its beats is often doubled.
The heart, says Fernard Papillion, is no more the seat of the sentiments than the hand is the seat of the will; but it is a reactive, which is modified by the sentiments, with the utmost nicely and with infallible certainty.
Not only does the heart betray by the very disturbances of its normal rhythm the nature of the initial brain excitation, but it also produces throughout the whole organism disordered actions, the sum of which constitutes, as it were, the physical image, the palpable externals of passion. But it produces this disordered action only by reacting on the brain, which is the organ of all the demonstrations and of all the movements in the nerves, and consequently, of the muscles.
It is disbelieved by some, even at this day, that emotional influences can cause long-lasting functional disorder of the heart. Much less is it thought that they may cause structural changes in that organ.
In this connection,
THE STATISTICS OF INSANITY
are suggestive, if nothing else. Dr. Wilkie Burman, who has lately investigated the relations of heart disease with insanity, says: “Examination of the heart in the living and the dead shows that diseases of the heart are very frequent in persons suffering from mental diseases. In 500 cadavers, 36 per cent. gave a diseased state of the valves and apertures of the heart and aorta; 14 per cent, showed hypertrophy, without valvular disease; 30 per cent. showed hypertrophy, fatty degeneration, and other heart diseases of minor importance; only 20 per cent. gave perfectly sound hearts. Of 680 male patients, 44 per cent. had heart disease. The average weight of the heart is, in both sexes, when suffering from mental diseases, heavier by one ounce than in persons of sound mind. This increase may be ascribed to the valvular morbid states, or to the hypertrophy which is seen in chronic and recurring mania, and in consecutive dementia, often without valvular disease, and most frequently attacking only the right ventricle.”
Heart diseases are most frequently observed in patients with hypochondriac melancholy; with the so-called “melancholy with suspicion,” causing a suspicious morose disposition, and it appears that the heart disease has some relation to it, whereby the subjective sensations offer a prolific foundation for illusions and delusions. In chronic cases and for advanced mental disease it shows an essential asthenic type, also feebleness in the circulation, cold livid extremities, and a weak, small pulse.
THE CONCLUSIONS.
If these statistics show anything, they show (1) that the presence of heart disease during mental disorder is too common to be an accidental coincidence; (2) that, in a proportion of the cases, the heart disease must have been caused by the mental; (3) that the coincidence of heart disease with melancholy is pretty conclusive that mental depression causes cardiac depression, a condition which leads to certain forms of structural changes in the heart. I admit, be it remembered, that diseases of the heart may and do cause many cases of insanity. But I must affirm my belief that emotional shocks, or mental influences, may and do cause not only functional but organic heart diseases.
Take, for example, the influence of
FRIGHT, SUDDEN GRIEF, or other sad and painful emotions. They suddenly diminish the rapidity of the heart’s beating, and thus increase the amount of blood discharged from that organ at each diastole; hence the contractions by which it drives the blood into the vessels are very laborious and protracted. In some cases the shock (as from fright, terror, or the sight of blood), may at once stop the motion of the heart, and as the blood is no longer discharged into the vessels, fainting occurs. This fainting may not simulate death, but may actually cause it, by rupture of the heart or tetanic and persistent contraction of its cavities. But, if recovery occurs, the heart has received such a strain that it may take that organ weeks and months to recover, or it may not recover at all, but end in structural disease, for it is admitted now by all the best authorities that many functional cardiac disorders may, if persistent for a long time, end in organic disease.
Among the diseases of the heart which may be caused by mental emotions and psychical disorders may be enumerated; 1. Cardiac irritability, angina pectoris, cardiac myalgia, palpitation, and weakened heart; among the purely functional. 2. Hypertrophy with dilatation, and with enlargement, certain valvular diseases, rupture and aneurism; among the organic.
HOW EMOTIONS ACT.
Right here it may be of interest to inquire, Through what media do emotions act upon the heart? The recent discoveries of M. Cyon afford us a basis for the most probable explanation of the phenomena. The following embodies the results of his researches.
The heart is provided with a number of little, self acting nerve-ganglia without relations to the brain, from which spring, under the influence of the blood, a certain number of motor impulsions. These ganglia govern the usual normal action of the cardiac apparatus; but the rhythm and force of the beatings are every instant modified by excitations having their origin in the brain. The brain sends out to the ganglia of the heart two sets of nerves; the retardator (pneumogastric) and accelerator nerves. Excitation of the former diminishes the frequency and augments the force of the heart’s movements. Excitation of the latter produces the opposite results, increasing the number and lessening the force of the heart’s contractions.
Now it is evident that the emotions, according to their quality and intensity, must affect these two sets of nerves either separately or together. Our next inquiry will be, then,
CAN WE CLASSIFY THE EMOTIONS
and arrange them in such a way as to show those which affect these sets of nerves in a special manner, either to excite or depress.
After considerable study of the action of the various emotions, and guided by such authorities as Tuke, Winslow, Carpenter, and Maudsley, I have ventured to arrange them as follows: (1) Emotions which excite mainly the retardator nerves: Joy, rapture, ecstasy, hope (with faith), pride, courage, love, adoration, wonder, and astonishment, to which we may add anger, rage, and wrath. (2) Emotions which excite mainly the accelerator nerves: Grief, sadness, discontent, disappointment, melancholy, despair, remorse, fear, fright, horror, anxiety, and wonder.
It may be said, in criticism of this arrangement, that we rarely find one emotion acting exclusively at one time. This is admitted, and it is the one chief element of uncertainty that prevents a perfectly satisfactory classification of the emotions. Suppose, for example, that we have joy and anxiety acting at the same time upon the brain. The result would be an excitation of both sets of nerves, causing an increased force with accelerated action of the heart. Again, astonishment from pleasurable causes would act altogether on the retardator nerves; but, if from unpleasant causes, on the accelerators.
Apparently, the most opposite emotions cause similar head- symptoms, but when we analyze the nature of the effects, they will be seen to be widely different. Thus joy and terror both cause palpitation, but the former causes increased cardiac action with augmented vital force, the latter produces an irritative frequency with deficient power. It may be asked, How can
JOY AND FRIGHT
both cause death? The action of an emotion is like the action of a drug. In small and repeated doses, quinine causes a continuous augmented action of the heart, not injurious unless too long continued; while a massive dose acts suddenly, causing cardiac spasm and fatal symptoms. So joy, moderate and continuous, increases the vital manifestations of physical and mental life, but sudden and great joy kills by causing persistent cardiac spasm. Fright or terror may also kill suddenly, either by causing immediate cardiac failure, if the emotion is overwhelming, or destroy life more slowly by producing an irritative frequency which will end in gradual cessation of the contractions of that organ.
Enough has been said to show that we must study the effects of the emotions as closely and in the same manner as we study the effects of drugs on the human organism. We ought, some time, to have carefully arranged pathogeneses of the emotions, not only that we may use their influence as remedial agents for the removal of similar disorders.
THE TREATMENT.
We come now to the treatment of those disorders of the heart caused by the emotions. What is the first principle which should guide us in selecting the medicine, after we have prescribed the proper hygienic rules? The tenets of our school of practice give us the following laws, namely:
Hale wrote Lectures On Diseases Of The Heart, Materia medica and special therapeutics of the new remedies Volume 1, Materia Medica And Special Therapeutics Of The New Remedies Volume 2, Saw Palmetto: (Sabal Serrulata. Serenoa Serrulata), The Medical, Surgical, and Hygienic Treatment of Diseases of Women, New Remedies: Their Pathogenetic Effects and Therapeutic Application, Ilex Cassine : the aboriginal North American tea, Repertory to the New Remedies with Charles Porter Hart, The Characteristics of the New Remedies, Materia Medica and Special Therapeutics of the New Remedies, The Practice of Medicine, Homoeopathic Materia Medica of the New Remedies: Their Botanical Description etc.