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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.
It is atropin, atropin" and her wild laugh. Did she know, or was she guessing or bluffing? It hurt him, hurt him inconceivably to think that she might have deceived him thus; might have broken the wrong bottle, and then deliberately have kept him in darkness with the very remedy at hand. That would seem the refinement of cruelty. But he must be fair.
"Until you obtained the remedy?" "Probably for always. One must not let glaucoma run or it becomes chronic. It's God's own luck that I have this stuff with me it's the pilocarpin I told you of. The other stuff atropin would blind me for sure!" He thrust forward the three bottles. "Here," he urged. "If you had not the remedy this what-you-call pilocarpin, what would you do?"
If our patient on the Island has taken his overdose so recently, and it seems still worth while to act by antidote, we shall be obliged to get over the difficulty presented by his stomach's lack of retention by administering our belladonna in the form of atropin in solution as a hypodermic injection.
It will whip up a flagging heart, more or less increase the blood pressure, cause cerebral awakening, and may often be of value. If there is any idiosyncrasy against atropin, if the throat and mouth are made intensely dry, or if there is serious flushing or cerebral excitement, the dose should not be repeated. Morphin: This would rarely be considered as an emergency drug in cardiac weakness.
If there are weakening perspirations, atropin should be given, especially as it is also a circulatory stimulant. Calcium in almost any form seems to be of value in the majority of heart conditions. It is a sedative to the nervous system, and is certainly indicated in acute myocarditis. Calcium lactate is perhaps the best salt to administer, in doses of 0.25 gm.
If the blood vessels are dilated and the perspiration profuse, atropin is indicated, both as a cardiac stimulant and contractor of the blood vessels and as a preventer of too profuse sweating. The dose should be from 1/200 to 1/100 grain for an adult, given two or three times in twenty-four hours, depending on its action and the indications.
Then he spoke to Cazi Moto in a vibrating voice. "Bring me the chest of medicines. Now," he went on to Winkleman, when this command had been executed, "kindly read to me the labels on all these bottles; begin at the left. All, please." He listened attentively while Winkleman obeyed. The pilocarpin was present; the atropin was gone. "You have not deceived me?" he cried sharply.
The throat is of course dry, and the eyesight interfered with for a day or more, but Talley has not seen even insomnia occur, to say nothing of nervous excitation or delirium. Theoretically, however, before such atropin dosage, an idiosyncrasy against belladonna should be determined.
In the second type, where there was normal auricular activity, but where the ventricular contractions were decreased, atropin affected an increase in the number of ventricular contractions, but did not completely remove the heart block. He adopted atropin where the heart block was associated with auricular fibrillation.
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