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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    Thus in a distended heart, only a longer time is requisite, and, of course, the cause of the original distension must be overcome; so that the conditions are scarcely equal, and longer time and an artificial compensatory hyper- trophy is necessary to maintain the balance thus tempor- arily restored. When this condition of distension is only of short duration, as seen in people who have been over- worked and overtaxed for a short period only, but pre- sents all the appearances, signs, and symptoms of cardiac dilatation, the restoration of the natural balance by digi- talis may be quick and withal permanent. Certainly I have seen such cases. The experiments of W. T. Gaird- ner on Groux, the man without a sternum, show that the ventricular chamber undergoes a certain amount of ex- pansion under passing circumstances, a normal distension in fact; for distensibility without abolition of function is a peculiar property of involuntary muscular fibre; but when distension is excessive, or the tissue degenerate, however, abolition of function may, and certainly does, take place. The experiment may be tried on any thin muscular man—viz., place the tip of your finger on the exact apex-beat, and bid him hold his breath ; the right ventricle dilates until the apex-beat is lost behind the dis- tended ventricle, which acts like a water-cushion between the left apex-beat and your finger. Still keeping your finger in its place, tell the man to breathe again; the dis- tended condition passes away, and soon no trace of it re- mains. Now, all the time the heart has been beating* away, and there has been no abolition of function. Claude Bernard has gone so far as to suggest that a normal dis- tension of the heart takes place through the action of the depressor nerve of the heart of Cyon and Ludwig, and that the heart can undergo a certain amount of accom-