Digitalis : its mode of action, and its use : an enquiry illustrating the effect of remedial agents over diseased conditions of the heart : the Hastings prize essay of the British Medical Association for 1870 / by J. Milner Fothergill.

  • Fothergill, John Milner, 1841-1888.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: Digitalis : its mode of action, and its use : an enquiry illustrating the effect of remedial agents over diseased conditions of the heart : the Hastings prize essay of the British Medical Association for 1870 / by J. Milner Fothergill. 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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    palpitation is steadied into the normal, quiet, effective con- traction ; the system is relieved; dyspnoea, the external witness of pulmonary congestion, is abated ; the deficient secretion of the urine, which tells us that the pressure on tho glomeruli of the Malpighian bodies is lessened, is im- proved, and free secretion takes its place : dropsy is thus often relieved. The general condition of cyanosis is abat- ed ; there is evidence of a better circulation throughout the system generally. Frequently, the gradually widening circle of troubles which are involving the patient’s exist- ence, gradually diminishes after an improvement is in- augurated in the circulation. The spell which bound the ■system in a load of ever-increasing fetters is broken by the administration of a drug whose action is unquestionably to produce better, more complete, ventricular contraction; and in that, and that only, I believe the magic lies. When we consider the extreme tendency there is for a condition of cardiac engorgement, or distension to result from any prolonged debilitating cause, or acute disorder, and that, too, especially in the right or truly venous side of the heart; when we consider how that again tells on every ex- cretory organ, from the lungs in front to the kidneys be- hind, and how that leads directly to non-excretion, and how blood-poisoning is engrafted on partial blood-stasis; how the left side of the heart is encumbered between the two burdens of poisoned blood and venous congestion— we can readily appreciate a drug which will enable these chambers to more completely empty themselves, and thus to direct better blood-propulsion, and can understand its extreme therapeutical importance. It is of the utmost importance that we really understand in the administra- tion of digitalis what we can fairly expect of it, what it may be fairly presumed to be able to do, and what experience