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Medical ArticlesRemoval Of Open Safety Pins From The Trachea And Bronchi
Removal of a closed safety pin presents no difficulty if it i...
Examination Of The Trachea And Bronchi
All bronchial orifices must be identified seriatim; because ...
Torpid Reaction Asthenic
The more violent the contagious poison, and the weaker the or...
Dysphagia is the most frequent complaint in cases of esophag...
We have had so much success in helping the deaf that we feel w...
Stings Of Insects
The effect produced by the sting of Bees, Wasps, and Hornets ...
Treatment Of Affections Of The Nervous Centres
In affections of the nervous centres, the _brain_, the _cereb...
The need for this is often indicated by irritability of temper...
Racks From Lifting
See Muscular Pains; Sprains. ...
Of Fungous Ulcer Of The Navel In Infants
It sometimes occurs that a little fungous sore exists upon th...
See Veins, Swollen, etc. ...
Strabismus Discordance Of The Eyes
If neither of the rectus muscles have been cut and cicatrized...
Pain Severe In Limbs
This is often not due to any trouble in the joint itself, but ...
In every person there is a certain amount only of force which i...
Blood Supply Of
To supply good blood in cases where it is lacking, either from...
The question of the advisability of strychnin is a constant s...
The cause of an irregularly acting heart in an adult may be o...
It is a mistake to try to force a foreign body into the stom...
Period Of Incubation Or Hatching
The time which passes between the reception of the contagious...
Although curative attributes were ascribed to the magnet in...
Auricular Fibrillation Diagnosis
Source: Disturbances Of The Heart
If the pulse is intermittent and there is apparently a heart block.
Stokes-Adams disease should be considered as possibly present, and
digitalis would be contraindicated and would do harm.
A scientific indication as to whether a heart is disturbed through
the action of the vagi or whether the disturbance is due to muscle
degeneration may be obtained by the administration of atropin.
Talley [Footnote: Talley, James: Am. Jour. Med. Sc., October, 1912.]
of Philadelphia shows the diagnostic value of this drug. It is a
familiar physiologic fact that stimulation of the vagi slows the
heart or even stops it. Stimulation of these nerves by the electric
current, however, does not destroy the irritability of the heart;
indeed, the heart may act by local stimulation after it has been
stopped by pneumogastric stimulation. It is also a well known fact
that anything which inhibits or removes vagus control of the heart
allows the heart to become more rapid, since these nerves act as a
governor to the heart's contractions. Under the influence of atropin
the heart rate is increased by paralysis of the vagi. Talley states
that a hypodermic injection of from 1/50 to 1/25 grain of atropin
produces the same paralytic and rapid heart effect in man. He
advises the use of 1/25 grain of atropin in robust males, and 1/50
grain in females and in less robust males, and he has seen no
serious trouble occur from such injections. 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.
The value of such an injection rests on the fact that atropin thus
injected will increase the normal heart from thirty to forty beats a
minute, and Talley believes that if the heart beat is increased only
twenty or less, if the patient has not been suffering from an
exhausting disease, it shows "a degenerative process in the cardiac
tissue which makes the outlook for improvement under treatment
unpromising." 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.
Comparison of the findings after these two injections will determine
which factor, vagal or cardiac tissue, is the greater in the
condition present. The patients with a large cardiac factor are the
ones who may be more improved by the digitalis treatment than those
in whom the fibrillation is caused by vagus disturbance.
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