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See Cancer in Foot. ...
AS far as we make circumstances guides and not limitations, t...
Dysphagia is the most frequent complaint in cases of esophag...
These are often performed in cases in which proper treatment o...
See Head, Soaping. ...
Probably most acute infections cause more or less myocarditis...
Have a piece of M'Clinton's soap, a good shaving brush, and a ...
The current is that moving electric essence which traverses t...
The Dissection Of The Oblique Or External And The Direct Or Internal Inguinal Herniae
The order in which the herniary bowel takes its investments f...
It is rarely, if ever, advisable to use alcohol. In certain ...
An infant's clothing should be soft, warm, and light in weight...
The most striking symptom of diphtheria is the growth of a sub...
This is usually a result of stagnation of food or secretion, ...
The Surgical Dissection Of The Deep Structures Of The Male Perinaeum The Lateral Operation Of Lithotomy
The urethra, at its membranous part, M, Fig. 1, Plate 53, whi...
A few of the anatomical details must be kept especially in mi...
The Form Of The Thoracic Cavity And The Position Of The Lungs Heart And Larger Bloodvessels
In the human body there does not exist any such space as cavi...
To Prevent Diarrhoea
Where it is prevailing as an _epidemic_, _Ipecac_ at night, a...
Eyes Spots On
These spots are of two different kinds, and yet they are very ...
Methods Of Obtaining Pure Water
Wise Planning and Spending of Money is Necessary. If our city...
How Nuts should be Used. Another form of fat is the meat of ...
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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