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Alcohol may be of benefit. If syphilis is a cause of the condition, iodids are always valuable. If syphilis is not a cause and arteriosclerosis is present, small doses of iodid given for a long period are beneficial, although it may not much reduce the blood pressure or decrease the plasticity of the blood. Iodid is a stimulant to the thyroid gland, and therefore it is on this account valuable.
It should not be used, except if specially indicated, in broken compensation or in other myocardial weakness. Iodids: These have no immediate action. The vasorelaxation that often occurs from iodid is quite likely due to the stimulation of the thyroid gland by the iodin, and the thyroid gland secretes a vasodilating substance.
Alkalies, whether potassium or sodium citrate or sodium bicarbonate, are often of advantage in so changing and aiding metabolism, or perhaps reducing the irritation from hyperacidity or a mild condition of acidosis, that their administration causes a lowering of blood pressure. Of course, in syphilitic sclerosis large doses of iodids are indicated and are valuable.
For this reason iodids must always be used in connection with mercury or salvarsan if the disease itself is to be influenced. It is occasionally difficult to get patients to understand this after they have once taken "drops," as the medicine is often called. Otherwise the use of iodids in syphilis is of medical rather than general interest.
It has been stated that iodids are of no value except in syphilitic arteriosclerosis, but iodids in small doses are stimulant to the thyroid gland, and the thyroid secretes a vasodilating substance. Therefore, the use of either iodids or thyroid would seem to be justified in many instances of high blood pressure.
The sunken noses and roofless mouths are usually syphilitic yet if they are recognized in time and put under treatment, all these horrible things yield as by magic. There are few greater satisfactions open to the physician than to see a tertiary sore which has refused to heal for months or years disappear under the influence of mercury and iodids within a few weeks.
In these conditions camphor is better. Vasodilators. In various conditions of high blood pressure, arteriosclerosis and even during the sthenic stage of a fever, vasodilators may be indicated. The most important are nitrites, iodids and thyroid extracts. Alcohol, as stated above, may act as a vasodilator.
So remarkable is this effect that it gives the impression that iodids are really curing the syphilis itself. It has been shown, however, that iodids have no effect on the germs of syphilis, and therefore on the cause of the disease, although they can promote the healing of the sores in the late stages.
Cardiac Tonics: Digiralis, strophanthus, caffein, strychnin. 2. Cardiac Stimulants: Camphor, alcohol, ammonia. 3. Vasodilators: Nitrites, iodids, thyroid extract. 4. Cardiac Nutritives: Iron, calcium. 5. Cardiac Emergency Drugs: Ergot, suprarenal active principle, pituitary active principle, atropin, morphin, and also some of the drugs already mentioned.
The drugs that are mostly used to lower blood pressure are nitrites or drugs which are like nitrites, and these are nitroglycerin, sodium nitrite, erythroltetra nitrate and amyl nitrite, and the frequency of their use is in the order named. Other drugs used to lower blood pressure are iodids, thyroid, alkalies, chloral, bromids and aconite, the latter rarely.
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