Angina News

I discovered something very interesting about the history of angina, which I would like to share with you all. At present I'm studying at University College Chester for a Master's degree in Cardiovascular Rehabilitation. The course consists of modules, assignments and a research dissertation. One of the modules I studied set me the task to research and write about the diagnosis of stable angina pectoris, with particular emphasis on symptoms and investigative techniques.

I thought long and hard about this question and decided to research into the history of this condition and find the physician who gave the name 'angina pectoris'. I reached many dead ends by surfing the World Wide Web, but I eventually found a cardiology book that had all the information I needed. I discovered that William Herberden was the first physician to bestow the name 'angina pectoris' to the disorder that is described as a sensation of 'strangling and anxiety' in the chest. His discovery was described in lectures in 1768 and was later published in Commentaries in 1802. The published Commentaries gave the following account of the disorder of angina pectoris.

'Angina pectoris occurs whilst walking and more particularly when walking soon after eating. The sensation seems as if it would take their life away, if they were to increase or continue their activity. The sensations quickly vanish when standing still. This was thought to be the beginning of this disorder and after several months sensations took longer to cease upon standing still after walking. Further progressions of the condition also resulted in sensations whilst lying down or with the motion of being in a horse and carriage or crouching or going to stool and even speaking or a disturbance of the mind'. (Herberden, 1802, cited by Fuster et al, (2001). Hursts, The Heart. 10th ed. Maidenhead, McGraw Hill.).

In addition, Herberden noted that the disorder mainly affected men over the age of 50 who had short necks and were overweight. This is an interesting observation because being overweight, over the age of 50 and male gender are three major risk factors for coronary artery disease. Herberden also noted in 1768 that one of his patients set himself the task of sawing wood for half an hour every day, and was nearly cured of anginal symptoms. Was this the first Cardiac Rehabilitation Programme?!

Tim Grove

Have a Heart !

As February 14th approaches images of hearts bombard us from every angle - mostly in the hope of parting us from our money in exchange for cards, chocolates and over-priced roses. However, our hearts do more for us than beat a little faster at the glimpse of a loved one and sadly, heart disease remains the main cause of premature death in the UK.

It's never too early to start to care for your heart and good habits developed in childhood and adolescence will stand you in good stead for a lifetime. Prevention, as we know, is better than cure, however it is equally true to say it's never too late to start and significant benefits can be gained from positive lifestyle changes at any age.

Remember, your heart is a muscle and like all muscles, it needs to be kept active. The more you look after your heart, the better you will feel and the better it will work for you.

So how can you look after your heart? There are many different things that you can do to look after your heart. Some of these have been widely promoted and will no doubt come as no surprise to THROB members; they include:

Being a non-smoker

Eating a diet rich in fresh fruit, vegetables and "good fats" like those found in oily fish and olive oil.

Taking regular moderate exercise at least 3-5 times per week for up to 30 minutes at a time – expending enough energy to get slightly short of breath.

Having a moderate alcohol intake with no binge drinking.

Lifestyle changes have an added advantage over drug treatment, they are cheap ( yes, healthy food choices can be cheaper than junk food), have no unwanted side effects and best of all, they work.

What about some less well-known activities that can help you to stay quite literally "young at heart"?

Socialising is surprisingly good for you - an enjoyable time with family or friends reduces stress levels and encourages the production of brain chemicals, endorphins, that have a beneficial effect on your body.

Laughter can take years off you!! Laughter, along with an active sense of humour, may help protect you against a heart attack, according to a new study by cardiologists in the USA. The researchers found that people with heart disease were 40 per cent less likely to laugh in a variety of situations compared to people of the same age without heart disease.

Pets can extend your life. Stroking a pet has been shown to reduce heart rate and lower blood pressure and of course if your pet happens to be a dog it will need to be taken for regular daily walks!!

Cuddles might even lower your cholesterol. A small-scale research study appeared to indicate that rabbits that consumed a high fat diet and were given daily cuddles had less cholesterol build up in their arteries than a control group of rabbits that were left untouched.

Small scale studies cannot be regarded as proof but, hey, who's complaining about a hugging recommendation and maybe that St Valentine had something going for him after all, so make the most of February 14.

Lesley Richards

Exercise

We are living in a health and fitness era, bombarded by facilities, programs, equipment, information and options. Some fitness strategies focus on prevention, some on maintenance and others on recovery. Water exercise is the perfect answer to anyone's fitness needs or goals because it is adaptable to all personal conditions, illnesses, injuries and post operative problems. One can target specific body areas to exercise or combine several movements into a complete head-to-toe activity.

Water exercises are a proven way to increase participants' metabolism, build muscle tone and strength, improving balance coordination and range of motion, and relieve tension - all with pain-free, low impact movements. Both swimmers and non-swimmers can perform water exercises because they can choose their water depth. Due to these positive aspects of water exercise, water can be considered an ideal medium in which cardiac rehabilitation classes can be held. Research has shown that, as physical fitness improves, so does the mental, emotional and spiritual parts of one's life. Some of the observed benefits are enhanced feeling of well-being, better sleep patterns, quicker recovery from injuries, the slowing of ageing both mentally and physically.

Depending on your condition, you can exercise as slowly or as quickly as you desire. Your body is supported making exercises easier and less painful, while you are performing movements ranging from the simple to those nearly impossible on land. The buoyancy provided by the water helps to protect your joints from impact shocks associated with exercising on land. The resistance of the water (hydrostatic pressure) against your movement results in higher workout intensity compared to land exercises. A massaging effect is also created when your muscles are surrounded by water. Indoor pools permit year round exercise programs and a variety of exercise equipment is available to assist with resistance and flotation.

Whatever your reasons for starting a water exercise program a doctor's initial guidance is always advised and a qualified instructor must provide the exercise options for the individual's particular needs.

Massimo Vencato

My Pharmaceutical History

I have recently been researching my family pharmaceutical history and have discovered that I

can trace family involvement back to 1877.

My eldest uncle, Herbert, registered in 1902 and his three brothers, Frank, Albert and Frederick (my father), registered as chemists and druggists in 1911, 1912 and 1924 respectively. I qualified in 1961, overlapping on the Register with my father and the immediate Mills family has, to date, 208 years on the Pharmaceutical Register.

My eldest uncle's first wife, however, was also a pharmacist, who registered in 1903. She came from an established family of pharmacists from Ilkley in Yorkshire. Her father registered 1877, her uncle in 1884 and her brother in 1906, which brings the wider family total up to nearly 400 years on the Pharmaceutical Register.

My uncles were born in Bath, though Herbert left in 1907 to set up a pharmacy with his wife in West Dulwich. Both Frank and Albert worked in Bath and in 1915 took over an established business at 8, George Street. Though the premises were initially registered as AE Mills, in 1918 it was changed to Mills and Mills, under which name it was still trading in 1999 when it closed, though contact with my family stopped in the 1930s. My father worked first as an unqualified assistant, as he did not qualify as a Society of Apothecaries Assistant until 1920, and as a chemist and druggist in 1924. As soon as he qualified, he opened a pharmacy in Keynsham as junior partner to Albert. In 1930 the two brothers fell out and my father took over a bankrupt business in Uxbridge, Middlesex.

The course I entered at Chelsea in 1957 trained students to identify materials and to manufacture medicines. But in my working life I never found any need to use this skill, which stretched from useful botanical specimens to potential adulterants such as mouse droppings. However, one of my father's closest friends and a contemporary at the West of England School of Pharmacy, did use his knowledg of pharmacognosy in a Japanese Prisoner of War camp to provide medical preparations for fellow prisoners. When I first worked in my father's pharmacy in Uxbridge, the day would start with the the manufacture of Winchesters of various mixtures, many of which would be unknown to modern graduates: Mist Expect, Mist Tussis Nig, Mist Gent Alk, Mk, Rhei Co or Mist Mag Trisil Co. During the day we would dispense these as well as vast quantities of Benylin Expectorant, the most popular medicine. As a student, I worked at Gibbs and Gurnell on the Isle of Wight where all medicines were still wrapped in white paper and sealed with sealing wax. Labels were handwritten and though I am sure not all were legible, I think pharmacists had considerably better handwriting than doctors. I remember scripts being handed around the dispensary to take a consensus as to what was intended and the majority view was what was dispensed. Doctors obviously considered it was part of the pharmacists' professional training to be able to decipher their writing and did not approve of being asked to explain. Dispensing was further complicated by the units then used: liquids were dispensed in minims and fluid ounces, while powders and ointments were weighed in grains, scruples and ounces. This was further complicated by ounces being either Troy or Avoirdupois, where one was 480 grains and the other 437.5 grains.

In those days a pharmacy had an individual smell, which one noticed every morning on arrival, but this has now disappeared, like many of the products that were sold. When I first started work, the chemist's shop was the place that sold toilet rolls and lemon barley water, as well as other strange items. At Uxbridge, we had a major business in photographic chemicals and paper and chemistry materials such as test tubes, Bunsen burners and chemicals. We also sold brass nuts and bolts, though I have no idea why. When instant coffee first arrived we stocked that too! Self-service was an unknown concept at that time and stock was stored in cupboards and drawers, with little cards recording the price. These had to be remembered before being entered onto the old-fashioned mechanical tills. The dispensary was not the only part of the pharmacy where a facility for maths was necessary. All my working life it seems pharmacy has been at a crossroads and it is not surprising that, at the end of our careers, we complain that things aren't what they used to be. But then I suspect my great-uncle who started in 1877 complained about that too.

Roger Mills