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"An old man they call Peter Mines came to see George, and his heart has failed. Please hurry!" "Heart, eh?" said the doctor. "Well, wait a minute. No use to go about a bad heart without digitalis." He got up and put on his hat, told the men he would be back soon, and went to the nearest drug store. Kate followed. The men who had been in the office came also. "Doctor, hurry!" she panted.
If the left ventricle becomes dilated the mitral valve may become insufficient, when the usual lung symptoms occur, with hypertrophy of the right ventricle; and if it fails, the usual venous symptoms of loss of compensation follow. This lesion not infrequently causes epistaxis, hemoptysis and hematemesis. Digitalis is always of value in these cases, but it should not be pushed.
Even with some forms of angina pectoris, digitalis in small doses may reduce the frequency of the pain. This decrease of pain following the use of digitalis has in some cases been ascribed to the improvement of coronary circulation and resulting better nutrition of heart muscle. Of course under these conditions the action of digitalis must be carefully watched, and it should not be given too long.
If the patient is sufficiently ill to require the best action of digitalis, an active preparation should be obtained. It was long supposed that the infusion presented activities which could not be furnished by the tincture of digitalis. This seems not to be true.
His brother, about to leave for Vezins on vacation, was told of the specimens which he wanted to complete his collection; for although he had never set foot there since his first departure, he recalled, with remarkable precision, all the plants that grew in his native countryside; their haunts, their singularities, and the characteristics by which one could not fail to recognize them: as well as all the places which they chose by preference, where he used to wander as an urchin; the Parnassia palustris, "which springs up in the damp meadows, below the beech-wood to the west of the village; which bears a superb white flower at the top of a slightly twisted stem, having an oval leaf about its middle"; the purple digitalis, "whose long spindles of great red flowers, speckled with white inside, and shaped like the fingers of a glove," border a certain road; all the ferns that grow on the wastes, "amid which it is often no easy task to recollect one's whereabouts," and on the arid hills all the heathers, pink, white, and bluish, with different foliage, "of which the innumerable species do not, however, very greatly differ."
Then every affection of the heart was treated with digitalis. Within the last few years new remedies have been proclaimed in the shape of salicylic acid and its sodium salt.
In the morning the patient was better, and 0.5 gramme of digitalis was then given in infusion per rectum, and repeated on the following day, after which the patient remained comparatively well until a year and a half later, when a second attack of the kind just described was quickly cut short by similar treatment.
In such cases one cannot tell without trying whether digitalis will be of benefit or will cause more discomfort. 11 small dose of an active preparation should be given at first twice in twenty-four hours, and after a week once in twenty-four hours, its action being carefully watched and the decision as to whether the dose is too large or too small arrived at.
I am very tolerably well for me: and am said to look better. At the same time I am aware of being always on the verge of an increase of illness I mean, in a very excitable state with a pulse that flies off at a word and is only to be caught by digitalis. But I am better for the present while the sun shines.
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