OCR Text |
Show FOXGLOVE. FOXGLOVE. employed to promote absorption should so powerfully re the motion of the heart and circulating fluids, that the irritating morbid action of the extremities of the blood-vessels, and secretion as its immediate effect, should be considerably diminished, if not altogether suspended, another most salutary purpose would be accomplished. ‘To the cautious and continued use of digitalis, Sir, I looked for these consequences, though whether I should be able to render them sufficiently permanent to promote a cure, was necessarily a matter of great doubt. It was my wish also, as I have mentioned above, to eflect these 2s without any previous sickness, concluding, that should » able gradually to depress the circullation, nausea, as alink in the chain ofeffects, might be excluded, and absorption, togeth a suppression of morbid action and secretion, still be th the result. is a well-known fact, and probably arising from an indis« soluble association between the stomach and the heart, that the pulse generally sinks in consequence of nausea; and as subse» quent to the retardation of the action of the heart, absorption frequently occurs, it has been supposed that nausea, a diminution of arterial motion, and absorption, are mutually and necessarily related to each other, and that were thefirst of these phenomena abstracted, the latter, viz. absorption, would not be produced. It has therefore been usually attempted to promote pulmonary absorption through the medium of this affection of the stomach, whence the prescription of emetics, of sailing at sea, and of swinging, to induce vertigo and sickness; and the digitalis has been hitherto exhibited with this view. ‘The cases annexed, however, will prove that the circulation may be safely, and therefore immediately diminished the « the interval between the 22d of June and the 17th of the dose of the di lis had in this period gradually its maximum, not the least sickness occurred, ptom that could lead to apprehension. a considerable intermission of the pulse nued for better than a fortnight, though without occasi the patient the smallest uneasy sensation. In Mr. Grime the dose of tincture was pushed to ninety-six drops without convenience, and his pulse fell to forty, yet no intermission felt; nausea, however, and vomiting after his meals supervened the dayafter this quantity had been taken; these continued four orfive days, and were only alleviated by the omission of the digitalis. re therefore, in one instance, one } other ninety-six of the saturated tincture, were, by creased es, safely introduced into the tated patients, bef« r sickness or irregularity of tl lation appeared ; moment, as the first was speedily removed, duced no inconvenience. During this per of irritation and fever, co j » pain, and dyspnoea daily better, and at length altogether retired. On the quantity and quality of the expectorated matter, the digitalis soon exerted a most remarkable effect, either promoting its absorption, ordiin a rapid manner, whilst at the sametime it deprived it ofits fcetor. What, however, I consider as of mos and to which, perhaps, w powerfully, and perhaps more permanent ly retarded, independent of.anyaffection of the stomach, and that absorption as certainly follows a depression thus procured, as when sickness has ushered for weeks together, by the useof thi case the pulse never rose beyond 17th to October it in. ; The preparation of digitalis best adapted to my purpose, appeared to be the saturated tincture; and in the first case I com- curative intenti menced with but fifteen drops twice a day, in the second twenty. Mr. Marris gradually increased the dose oftincture until he took one hundred drops: this quantity was first ordered on the 12th of July, when the pulse beat but fifty strokes in the minute, and was continued for nine days, when his pulse dropped to forty. Beyond this depression I thought tt unsafe to proceed, letter allow me to expatiate further on tl Subject; I shall only add, it the theory laid down, and the facts now given, will, if L mistake not, mutually illustrate each other, One circumstance ofdi 3 as to the ope-~ |