Cardiac Drugs

Whether any drug should be used which acts directly on the heart is

often a question for decision. As endocarditis is generally

secondary to some acute disease, the patient has become weakened

already, and the circulation is not sturdy; therefore such a drug as

aconite is probably never indicated. The necessary diminished diet,

catharsis, hypnotic, salicylic acid and alkalies all tend to quiet

the circulation and diminish any strenuosity of the heart that may

be present. Unfortunately, during fever processes, digitalis in

ordinary doses rarely slows the heart; and while it might slow the

heart if given in large doses, it would also cause too powerful

contractions of the ventricles. Digitalis is inadvisable if there is

much endocardial inflammation, and especially if there is supposed

or presumed to be acute myocardial inflammation. If a patient had

already valvular disease from a previous endocarditis, and during

this attack insufficiency of the heart was evidenced by pendent

edemas, digitalis Should be administered; but it probably should not

be given to other patients during the acute period of inflammation.

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