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In sudden cardiac insufficiency, provided digitalis has not been given in large doses a short time before, strophanthin may be given intravenously once or at most twice at twenty-four-hour intervals. If, in this more or less serious condition of the heart weakness, there is great sleeplessness, a hypnotic must sometimes be given, and the safest hypnotic is perhaps 3 / 10 grain of morphin.
On the other hand, if the heart pangs or heart aches and the sluggish circulation are due to myocardial weakness without much actual degeneration, digitalis may be of marked benefit.
The strenuous measures that should he used to lower a high diastolic pressure are contraindicated when the diastolic pressure is already low, even if the systolic pressure 1s high. If a high systolic pressure begins to fall more or less rapidly the heart shows fatigue, and should be stimulated by digitalis or strophanthin.
Measles and rheumatics, confinements and bronchitis take up all our time, and when we get a man like poor Andrew your father, something out of the ordinary, appealing to us for healing, we give him digitalis or Epsom-salts for the elixir of life. We do our best, but it's bad very bad. When I talked to Kraill that day I kept thinking of your father.
Therefore the perfunctory use of such drugs as nitrite of amyl and the other nitrites may not be in the least indicated when, for example, the venous pressure depends upon inability of the right heart to perform its functions, and the drug needed may, for example, be digitalis.
He laughed, and called, "Digitalis put me on my feet like a flash." "He's got the most brains of any man in this party," I remarked to myself. The trail at this point is very winding, so that one can rarely see fifty feet in advance, and sometimes not ten. Owing to this, the first thing I knew I plumped round a curve on to a mule, which was patiently standing there.
"Never mind, I will give her digitalis. I am afraid that delirium will supervene. She perspires in the palms of her hands. What sin can we have committed in the sight of God? How quickly has all this misery come upon us! Hideous rapidity of evil! A stone falls. It has claws. It is the hawk swooping on the lark. It is destiny. There you lie, my sweet child! One comes to London.
She grew to think that she had a right thus to give her life for her love, to belong to Andras, to be the wife of that hero if only for a day, and to die then, to die saying to him: "I was unworthy of you, but I loved you; here, strike!" Or rather to say nothing, to be loved, to take opium or digitalis, and to fall asleep with this last supremely happy thought: "I am his wife, and he loves me!"
The conclusion to be drawn from their experiments is that when there is asphyxia, increased venous pressure, and also a rising blood pressure from the stimulation of carbon dioxid, strychnin is contraindicated. It should be recognized that digitalis very frequently not only does not raise blood pressure, but also may lower it; especially in aortic insufficiency and when there is cyanosis.
I continued the aperient medicine, and ordered a warm lotion to be applied, consisting of the liquor plumbi acetatis and infusion of digitalis. She improved from the first application of it, and in a few days was quite well. A fortnight afterwards the pain returned. The lotion was employed, but not with the same success. A seton was then applied.
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