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364 Cardiac Stimulants. the apex, unassociated with enlargement or persistent murmur. There is little muscular element in the first sound. There may or may not be a slight basic systolic murmur, or at the apex a systolic whiff, once or twice during each respiratory cycle. The nervousness of the apex sounds is quite recognizable. The auscultatory signs are valuable in these functional cases, because the patient nay not voluntarily confess his wrong-doing, and yet it is useless for him to swallow drugs without reforming his habits. It is better that for a time the special indulgence should be wholly stopped, both because total abstinence is more likely to be attained than is temperance, and because even a small amount of tobacco, for instance, will keep the already nicotized heart in its diseased state. Alcoholic excess often affects the heart in the way just described, but the other bodily effects are usually too evident for one to need to auscult the heart in order to recognize the nature of the case, and besides arterial and myocardial degeneration may be present, so that the prognosis and treatment are not those of functional disturbance. In the purely functional cases, bromide and a tonic usually bring immediate subjective improvement, and make it easier for the patient to abstain from the exciting cause. If there be anemia, iron is useful; otherwise, I am apt to prescribe compound tincture of cinchona. Nux vomica and strychnine are usually regarded as physiologicrdly incompatible with the bromides, but in this class of cases 10 or 15 grains of bromide of sodium and 5 or xo minims of tincture of nux vomica seem to me an efficient combination. An analogous experience is the favorable effect upon some cases of enuresis when the belladonna, which has been used in vain, is combined with nux vomica and the enuresis ceases. Clinical facts are sometimes like Wilkie Collins's heroine, "superior to logic. " Tincture of strophanthus in a dose rarely exceeding 5 minims, three times a day, has a good effect upon nervous palpitation. Cases of general and nervous debility sometimes have excessive cardiac weakness out of proportion to the other symptoms. The heart impresses one as thin and flabby. It may be somewhat dilated and there may be innocent murmurs. The condition is not devoid of danger. There may be sudden collapse, with pulmonary congestion and death. At the same time the mind has considerable influence upon the disturbance, so that assurances that there is no valvular disease and that with returning bodily vigor the heart will become strong, contribute to the cure. About two years ago, a gentleman who had returned from a scientific expedition to Mexico with neurasthenia, and whose condition was causing his family much anxiety, allowed me to show him to a class of medical students as an unusually fine illustration of multiple inorganic murmurs. He recovered rather rapidly after a sea-voyage, and is now well and actively engaged in his profession of civil engineer. For this neurasthenic state there is no specific remedy.
Object Description
Rating | |
Fixed Title * | NCHH-19: North Carolina Medical Journal [1878-1899] |
Document Title | North Carolina Medical Journal [1878-1899] |
Subject Topical | Medicine -- North Carolina -- Periodicals. |
Subject Topical Other | Medicine -- North Carolina -- Periodicals. |
Publisher | Wilmington; Charlotte : The Journal?, 1878-1899. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1895 |
Identifier | NCHH-19-036 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 36 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-19/nchh-19-036.pdf |
Document Sort | all; group-e; nchh-19 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-19-036 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-19 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1318861 |
Revision History | done |
Description
Fixed Title * | Page 264 |
Document Title | North Carolina Medical Journal [1878-1899] |
Subject Topical | Medicine -- North Carolina -- Periodicals. |
Subject Topical Other | Medicine -- North Carolina -- Periodicals. |
Publisher | Wilmington; Charlotte : The Journal?, 1878-1899. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1895 |
Identifier | NCHH-19-036-0280 |
Form General | Periodicals |
Page Type | all; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolinamed361895jack_0280.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 36 |
Issue Number | 9 |
Page Number | 264 |
Health Discipline | Medicine |
Full Text | 364 Cardiac Stimulants. the apex, unassociated with enlargement or persistent murmur. There is little muscular element in the first sound. There may or may not be a slight basic systolic murmur, or at the apex a systolic whiff, once or twice during each respiratory cycle. The nervousness of the apex sounds is quite recognizable. The auscultatory signs are valuable in these functional cases, because the patient nay not voluntarily confess his wrong-doing, and yet it is useless for him to swallow drugs without reforming his habits. It is better that for a time the special indulgence should be wholly stopped, both because total abstinence is more likely to be attained than is temperance, and because even a small amount of tobacco, for instance, will keep the already nicotized heart in its diseased state. Alcoholic excess often affects the heart in the way just described, but the other bodily effects are usually too evident for one to need to auscult the heart in order to recognize the nature of the case, and besides arterial and myocardial degeneration may be present, so that the prognosis and treatment are not those of functional disturbance. In the purely functional cases, bromide and a tonic usually bring immediate subjective improvement, and make it easier for the patient to abstain from the exciting cause. If there be anemia, iron is useful; otherwise, I am apt to prescribe compound tincture of cinchona. Nux vomica and strychnine are usually regarded as physiologicrdly incompatible with the bromides, but in this class of cases 10 or 15 grains of bromide of sodium and 5 or xo minims of tincture of nux vomica seem to me an efficient combination. An analogous experience is the favorable effect upon some cases of enuresis when the belladonna, which has been used in vain, is combined with nux vomica and the enuresis ceases. Clinical facts are sometimes like Wilkie Collins's heroine, "superior to logic. " Tincture of strophanthus in a dose rarely exceeding 5 minims, three times a day, has a good effect upon nervous palpitation. Cases of general and nervous debility sometimes have excessive cardiac weakness out of proportion to the other symptoms. The heart impresses one as thin and flabby. It may be somewhat dilated and there may be innocent murmurs. The condition is not devoid of danger. There may be sudden collapse, with pulmonary congestion and death. At the same time the mind has considerable influence upon the disturbance, so that assurances that there is no valvular disease and that with returning bodily vigor the heart will become strong, contribute to the cure. About two years ago, a gentleman who had returned from a scientific expedition to Mexico with neurasthenia, and whose condition was causing his family much anxiety, allowed me to show him to a class of medical students as an unusually fine illustration of multiple inorganic murmurs. He recovered rather rapidly after a sea-voyage, and is now well and actively engaged in his profession of civil engineer. For this neurasthenic state there is no specific remedy. |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-19/nchh-19-036.pdf |
Document Sort | all; group-e; nchh-19 |
Article Title | Cardiac Stimulants |
Article Author | Vickery, Herman F. |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-19-036 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-19 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1318861 |
Revision History | done |
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