Medical ArticlesAuricular Fibrillation Pathology
Schoenberg [Footnote: Schoenberg: Frankfurt. Ztschr. f. Patho...
The Guidance Of The Body
THE literature relating to the care of the human body...
The Surgical Form Of The Male And Female Axillae Compared
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Ulcers Case Xxviii
Mrs. U. aged 60, has been subject to ulcerated legs for sever...
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Of Punctures Etc
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Punctures Case Xiii
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Wounds And Bruises
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The Circumstances Of Life
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Take A D current, of very mild force. Place P. P. at the feet...
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Acute Dilatation Of The Heart In Acute Disease
It has for a long time been recognized that in all acute prol...
Continued coldness of the feet gives rise to many more serious...
will often cure malignant ulcers both of the breast and uteru...
Malignant disease of the esophagus is rarely seen early, bec...
As mentioned above, bronchial aspiration is often necessary....
Stokes Adams Treatment
Source: Disturbances Of The Heart
The treatment of true Stokes-Adams disease is unsuccessful. If
general arteriosclerosis is present, that condition should be
treated. Digitalis would seem almost invariably contraindicated,
although it is of value in extrasystoles without heartblock, or in
conditions which are not Stokes-Adams disease; but if this disease
was considered present, digitalis would probably do harm. Sometimes
strychnin is of benefit.
Atropin has sometimes caused stimulation of the heart to more normal
rapidity. Its benefit is generally only temporary, as most patients
cannot take atropin regularly without having it cause a disagreeable
drying of the throat and skin, a stimulation of the brain, and an
undesired raising of the blood pressure, to say nothing of its
action on the eyes.
The only value of the nitrites is when the blood pressure is high
and the nitrite action is desired on that account.
Coffee or caffein often causes these hearts to become irritable; it
certainly raises the blood pressure, and therefore is not generally
advisable. Both tea and coffee should generally be prohibited.
During the acute faint attack, camphor is one of the best
stimulants. 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
An excellent stimulant to the heart is thyroid secretion or thyroid
extract. Theoretically thyroid extracts should be the treatment for
a slow-acting heart. It sometimes seems of benefit to these
patients, but it often causes such nervous excitation and
irritability as to preclude its use. The dose of thyroid for this
purpose would be small, about one-fourth to one-half grain of the
active substance three times a day. To be of any value, the
preparation must be good.
Epinephrin has been shown by Hirtz [Footnote: Hirtz: Arch d. mal. du
coeur, February, 1916] to overcome experimental heart block. It is
not clear just how it acts, but it could well be tried in heart
block when the blood pressure is not too high. A few drops of an
epinephrin solution 1:1,000 may be placed on the tongue, and
repeated three times a day, or from 5 to 10 minims of a weaker
solution may be given hypodermically.
The usual precautions against overeating, overdrinking, severe
physical exercise, sudden movements, overuse of tobacco, etc.,
should all be urged on the patient. The disease is sooner or later
fatal, although the patient may live some years. Death is generally
It is understood that this disease must he separated from the
condition of bradycardia inherent in a few persons who have a slow
pulse throughout their life, without any untoward symptoms.
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