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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    while the altered condition hears more resemblance to the normal bladder capable of complete contraction, and con- sequently requiring longer time for distension. The heart in distension is incessantly at the point of over-distension, and is acting unnaturally quickly; the administration of digitalis, by producing more perfect contraction, relieves this condition of irritable, or, rather, irritated distended ventricle, while, at the same time, more complete con- traction produces more thorough aortic distension, and thus brings out more thorough arterial recoil or systole; that, again, gives relief generally to the systemic symp- toms, and also permanent benefit as an ulterior result. It must be borne in mind here that the contraction of the ventricle fills the vessels and distends them; the recoil of the elastic arteries completes the propulsion of the blood. The series of altered actions consequent upon increased contraction, run in the following order or sequences; and it may be desirable for the sake of lucidity to arrange them in a series of propositions, each depending on the one before, like a logical syllogism. The effects of in- creased contraction are, then :— 1. Increased arterial distension and tension, which give relief to the systemic symptoms, and further causes 2. Increased arterial recoil. This is the propelling power for the coronary arteries; and thus arterial recoil means 8. Increased or improved coronary circulation ; and that, in its turn, produces 4. Increased nutrition of the heart, which results in 5. Compensatory hypertrophy. In connection with these, we have also to consider 6. Atheroma and fatty degeneration of the heart- fibres.