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Treatment. Early bleeding is requisite here, to be followed by active purgatives; after which, give one of the following powders every half hour: nitrate of potassa, two ounces; tartrate of antimony and pulverized digitalis, of each one and a half drachms; mix, and divide into eight powders. These should not be renewed. Cold linseed tea should be freely given.
Caffein is indicated if digitalis is contraindicated or does not act satisfactorily, and the patient is not nervously excited, but perhaps is stupid or apathetic, and also when diuresis is desired. Strychnin: This is a valuable stimulator and heart tonic when properly used. It promotes muscular activity of the heart much as it promotes all muscular activities.
"It's all right, M'sieur Barri," smiled Beale ruefully. "I was addressing myself oh, what a fool I've been!" He went down on his knees and examined the floor. "I want this tile, don't let anybody touch it," he said. Of course, van Heerden had stood because under his foot he had crushed the digitalis tablet he had taken from the phial, and for which he had substituted something more deadly.
"I am on night duty after a very strenuous day assisted the doctor with the instruments and material for 25 dressings, put up eight prescriptions myself, dressed the wounds of five Finns, spent some time in the ward, went over the soldier's money accounts, did an hour massage, slept one hour and tomorrow morning I am going to take the temperatures at 6 A.M., at seven put up a bottle of digitalis, at eight get into clean clothes, prepare the surgical dressing room for two dressings, give the instruments and material, and at half past eight or quarter to nine start with two soldiers for Petersburg one who is to be operated and the other who has been so ill for a week that they think it best to take him back as quickly as possible.
I see something not material make Jekyl into Hyde; and thank God, make Hyde over into Jekyl again, when birch rods and iron bars have no effect whatever. I have seen love do physical things which the mere intellectual convictions cannot make hearts beat and eyes sparkle, that would not respond even to digitalis and strychnine.
He also believes that when the heart in auricular fibrillation is increased the normal amount or more than normal, the prognosis is good. He still further advises in auricular fibrillation an injection of atropin before digitalis has been administered, and another after digitalis is thoroughly acting.
In the first place, I found that digitalis had been put in Marchant's tea." "They'll be here directly," I reported from the telephone, hanging it up and joining them again. "It couldn't have been an accident, as Karatoff said," went on Kennedy, rapidly. "The drug increased the blood pressure of Marchant, who was already suffering from hardening of the arteries.
The most satisfactory dose of digalen is from 5 to 10 drops once or twice in twenty-four hours. Digitalis should not be used when there is fatty degeneration of the heart; it should ordinarily not be used when there is arteriosclerosis, and very rarely, if ever, when it is decided that there is coronary disease.
The treatment is rest in bed and digitalis, but White found that in only four patients out of fifty-three so treated was the alternating pulse either "diminished or banished." In a word, the only treatment is that of decompensation and a dilated heart, and when such a condition occurs and is not immediately improved, the prognosis is bad, under any treatment.
The value of digitalis in doubtful instances will be evidenced by an improved circulation in the extremities, a feeling of general warmth instead of chilliness and cold, an increased output of urine, and less breathlessness on slight exertion. This is a name applied to pain in the region of the heart caused by a disturbance in the heart itself.
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