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Source: Disturbances Of The Heart
Anything which tends to increase the acidity of the tissues and to
diminish the alkalinity of the blood, whether from starvation or
outer causes, seems to pro-duce endocardial and myocardial
irritation, if not actual inflammation. Therefore in a disease like
rheumatism, which seems to be made worse by anything which increases
the acidity, alkalies are obviously indicated, and it is probable
that an increased alkalinity of the blood tends to prevent
endocardial irritation, and may soothe an inflammation already
present. Until we have some positive knowledge to the contrary,
alkalies should be freely administered during endocarditis,
especially during rheumatic endocarditis. Potassium citrate in 2 gm.
(30 grain) closes, in wintergreen water, should be given every three
to six hours, depending on how readily the urine is made alkaline.
This may be given with the salicylic acid treatment, and also when
the salicylic acid has been stopped. It may be well, if sodium
salicylate is being used, to give also sodium bicarbonate, the
sodium bicarbonate often preventing irritation of the stomach from
the sodium salicylate, the dose being equal parts of the sodium
salicylate and the sodium bicarbonate administered in plenty of
water. If some other form of salicylic acid is preferred,
novaspirin, which is methylene-citryl-salicylic acid and contains 62
percent of salicylic acid, is perhaps the least irritant to the
stomach of the salicylic preparations. This drug is decomposed in
the intestine into its component parts, salicylic acid and
methylene-citric acid. If this drug is combined with sodium
bicarbonate, the disintegration into its component parts would be
likely to occur in the stomach.
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