Medical ArticlesFirst Stage
The spatular end of the laryngoscope is introduced in the ri...
IN climbing a mountain, if we know the path and take it as a ...
The Inward And The Outward Current
I have already said that when the conducting-cords are of equ...
The Relation Of The Internal Parts To The External Surface Of The Body
An exact acquaintance with the normal character of the extern...
Purple Spots On Skin
These arise first as small swellings. The swellings fall, and ...
Deformities Of The Prostate Distortions And Obstructions Of The Prostatic Urethra
The prostate is liable to such frequent and varied deformitie...
Foreign Bodies In The Larynx
Laryngeally lodged foreign bodies produce a wheezing respirat...
Small Pox - Variola
This disease begins with pain in the head and back, chilly se...
The treatment under Glands, Swollen, should be followed. But b...
We feel urged, in first considering this sore and very common ...
Eyes Spots On
These spots are of two different kinds, and yet they are very ...
Rules For Endoscopic Foreign Body Extraction
1. Never endoscope a foreign body case unprepared, with the...
Nursing Sore Mouth
Sore mouth of nursing women, as the name of the disease indic...
See Digestion; Nourishment. ...
It should be understood that especially in acute conditions...
REST, fresh air, exercise, and nourishment, enough of each in...
The Care Of The Heart-pump
The Effect of Work upon the Heart. Whatever else in this body...
Enemas Cold Water
Prejudice often exists against cold treatment of any kind, but...
As so many times repeated, real pain must be stopped, and mor...
These are of two kinds, the one purely imaginary, the other wh...
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.
Next: Cardiovascular Renal Disease
Previous: Stokes Adams Disease Heart Block