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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    diem. After an immediate dose of 3 grains of calomel, followed by white mixture, he was given half a drachm of compound jalap powder every morn- ing, and he took 10 minims of tincture of digitalis with potassium acetate and tincture of nux vomica every four hours. A proper record was kept of the daily observations made in connection with the case, and those which were expressed numerically wrere represented in the form of a chart, which I will now show you, omitting the temperature curve, which does not concern us now. The two curves which you see represent respectively the pulse-rate and the volume of urine passed ; and it is by these curves that I wish to order my discussion of the action of the remedies employed. The first striking feature of the urine curve is its low range for the first week. It starts, you will observe, at 16 fluid ounces on the man’s admission, reaches a maximum of not more than 30 fluid ounces on the fifth day of treatment, and falls again to 23 fluid ounces on the seventh day. This was a most disappointing result. After a whole week of thorough treatment with the remedies which I have mentioned there was no diuresis. It is true that, as you will see by the other curve, the pulse-rate had begun to fall, so that the digitalis appeared to have begun to act upon the heart, but so far no impression was made on the kidneys. I have called this a disappointing- result, for our experience is that diuresis as the effect of digitalis in cardiac failure occurs by the middle of the first week of treatment. Howrever, this dis-