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Caffein or coffee is here indicated, and the patient should be kept warm lest he lose necessary heat. The stomach should be emptied by an emetic, often best by apomorphin hypodermically, unless the pulse is excessively weak. Strychnin may also be given, and digitalis, hypodermically, if it seems indicated. Camphor is another cardiac and cerebral stimulant that is valuable in these cases.
If none of these symptoms is present, though a patient has received digitalis for broken compensation, a tachycardia occurring might not contraindicate digitalis, as much of the digitalis on the market is useless; and a patient may not actually have been obtaining digitalis action.
Sometimes he would pray for courage; sometimes, cracking suddenly, he would pray for digitalis and send Marcella often at midnight with a pleading note to the doctor to give him the drug and a little soothing for his heart that was running away with him.
CARDIAC TONICS.-Digitalis: There is no drug that can take the place of digitalis in loss of compensation in chronic valvular disease. It acts specifically for good, and it has its greatest success in the valvular lesions that cause enlargement of the left ventricle, on which it acts the most intensely. It also acts for good on the right ventricle. It has but little action on the auricles.
Other pelories are terminal and quite regular, and occur in some species of Linaria, where I observed them in Linaria dalmatica. The terminal flowers of many branches were large and beautifully peloric, bearing five long and equal spurs. About their origin and inheritance nothing is known. A most curious terminal pelory is that of the common foxglove or Digitalis purpurea.
Paroxysmal tachycardias are certainly caused by these substances, and the conditions of auricular fibrillation and auricular flutter may be found frequently present if such hearts are carefully examined with cardiographic instruments. The condition may be stopped by relieving the heart and circulation of all possible toxins and irritants, and by the administration of digitalis.
The explanation of this no doubt was that I had forgotten to take my dose of digitalis before starting. Being in the jungle I was under great disadvantages from having to shoot through the underwood, and, though I knocked over the tiger, and there was plenty of blood to prove it, we lost him.
Poppies gleamed here and there amongst the wheat; the ditch was edged with flowers, brambles, nettles, sweet-brier, long prickly stems, broad shining leaves, blackberries and purple digitalis, all of which mingled their colours and various foliage and uneven branches, and crossed their shadows on the grey dust like the meshes of a net.
The leading symptom is tetanic spasm. 5. =Poisons Affecting the Heart.= These kill by sudden shock, syncope, or collapse. They comprise prussic acid, dilute solution of oxalic acid and oxalates, aconite, digitalis, strophanthus, convallaria, and tobacco. 6. =Poisons Acting on the Lungs.= These have for their type carbonic acid gas and coal gas.
The irregular pulse in auricular fibrillation is more or less distinctive, being generally rapid, from 110 upward. Occasionally the pulse rate may be much slower, if the heart is under the influence of digitalis.
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