The action and uses of digitalis in cardiac failure : a clinical lecture delivered at the Hospital for Consumption and Diseases of the Chest, Brompton / by J. Mitchell Bruce.

  • Bruce, J. Mitchell (John Mitchell), 1846-1929.
Date:
1906
Catalogue details

Licence: In copyright

Credit: The action and uses of digitalis in cardiac failure : a clinical lecture delivered at the Hospital for Consumption and Diseases of the Chest, Brompton / by J. Mitchell Bruce. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    to demonstrate to you the observations thus recorded, and to discuss them serially and as a whole. The case itself was full of interest pathologically, but I will not dwell on this aspect of it, except so far as is necessary to illustrate certain points in the action and uses of cardiac remedies. The patient was a man of 27, a ’bus conductor, who was under my care in Charing Cross Hospital from November, 1903, to February, 1904, suffering from failure of the heart with dropsy in connection with valvular disease of rheumatic origin. The valvular lesions were mitral incompetence, mitral stenosis and aortic incompetence, with well-marked physical signs, including the charac- teristic murmurs, in addition to which a tricuspid systolic murmur was also audible. On admission, November 23, the patient was cyanosed and suffered from orthopnoea, praecordial distress, and extensive oedema; the pulse was extremely irregular in force and rhythm, 94 beats reaching the wrist per minute ; the liver enlarged and pulsating. You will observe that in every respect the case was an ordinary one, and I need only add that the evidence was that the heart had failed in consequence of exposure and exertion. This was the second occasion on which compensation had broken down within a few years. The patient was at once put on what may be called our routine treatment for cases of the kind. He was in bed, and properly nursed ; he had a somewhat dry, solid diet, including fish, chicken, bread and butter, and light pudding ; and to this was added from 1^ ounces to 3 ounces of brandy per