On the influence of digitalis on the weak heart of typhus fever / by Thomas Wrigley Grimshaw.

  • Grimshaw, Thomas Wrigley, 1839-1900.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: On the influence of digitalis on the weak heart of typhus fever / by Thomas Wrigley Grimshaw. 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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    This patient got no alcoholic stimulants; infusion of digitalis was given to the amount of every third hour from the tenth to the fifteenth day, when, as the pulse tracing had resumed its normal form, the dose was reduced to On the seventeenth day the tracing had the pointed character denoting sudden and quick contraction of the ventricle. The digitalis was discontinued when the pulse, though small, assumed the usual healthy form (No. 20, Plate II.). It will be seen from the pulse tracings, in Plate II., from this case, that the tension had fallen very low, and the pulse became almost undulatory in its character on the tenth and eleventh days, but soon recovered under the continued use of digitalis, falling in tension only on the thirteenth day, when the bronchital complication arose. Case VIII.—Mary Walsh—the pulse tracings from this case are shown in plate II.—aged forty-nine, married, has had thirteen children, three of whom are in hospital, cases IX. and X., and a little girl with a mild febrile attack—is a fat soft woman, with arcus senilis around cornea. Admitted on sixth day of disease; first seen on seventh day, when temperature was 102°'2 Fahr. (see Diagram VIII.), and pulse 110. No tracing was taken, but the pulse was small and weak; the heart sounds were distinct, but first sound weak. The patient was in great anxiety about her son and daughter who were sick; the bowels were confined; tongue white, with red edges and tip; ordered castor oil and infusion of digitalis §1 every third hour. On eighth day.—Heart sounds weaker, the first sound being nearly absent; tongue brown; other symptoms nearly the same; maculated; ordered digitalis as before, and whiskey §1 daily, in divided doses. 9th day.—Spots unusually large and dark, but not numerous ; first sounds of heart lost; says she is going to die ; slept well; first sound of heart absent; add 51 liquor strychnias to digitalis, and give dose every second hom\ Tenth day.—Heart sounds improved ; first sound audible; slept badly. Eleventh day.—Slept a little; some subsultus; no tracing of pulse could be obtained; tongue brownish, but moist. Twelfth day.—Heart sounds failed again, but recovered under tempo- rary administration of gl of extra whiskey, and on the thirteenth day the heart sounds were again distinct. On the fifteenth day bronchitis appeared, which was preceded by a rise in temperature on the two previous days. The spots began to fade on same day, and the bronchitis soon became better, the patient being convalescent on the twentieth day. On the thirteenth day the pulse tracing assumed the character which I am accustomed to associate with fatty heart, and this character was maintained during convalescence, namely, a tendency to squaring of the
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