Treatment of internal diseases : for physicians and students / by Norbert Ortner ; ed., with additions, by Nathaniel Bowditch Potter ; tr. by Frederic H. Bartlett.

  • Ortner, Norbert, 1865-1935.
Date:
[1913], [©1913]
Catalogue details

Licence: Public Domain Mark

Credit: Treatment of internal diseases : for physicians and students / by Norbert Ortner ; ed., with additions, by Nathaniel Bowditch Potter ; tr. by Frederic H. Bartlett. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    We should also remember that it has toxic properties. Nausea, vomiting, diarrhoea, pain in the heart, giddiness, slowing or quickening of the pulse, early allorrhythmia (especially bigemina), arrhythmia, sometimes weakness of the pulse, diminution of the amount of urine, sleeplessness, and nightmare are generally the first symptoms of digitalis poisoning. In severer form it leads to fatigue of the heart muscle, a true '' delirium cordis, and a veritable therapeutic asystole (Dujardin). All these bad effects will disappear very soon after the drug is stopped. Therefore in prescribing it we should give only relatively small (not too small) doses, should use it only for a limited time, should sometimes decrease the dose, and should immediately stop giving it as soon as symptoms of intoxication appear, especially slowing of the pulse below 60, extra systoles, or gastric symptoms. The best form in which to administer digitalis is that by maceration: U Inf. digitalis 120.00 giv Sig.—Tablespoonful every 2 hours. The tincture may be employed, but it is not so effective or so sure as the preparation mentioned. We order 5-15 drops three times a day, or prescribe as follows: IJ Tinct. digitalis, Tinct. scillae aa 7.50 3ii M. fiat sol. Sig.—20-30 drops 3 times a day. Finally we may give digitalis as powder or in the form of pills. The latter is the least desirable form to administer, while either prepara- tion is liable to irritate the mucous membrane of the stomach and cause inflammation. The usual dose is 0.20 G. (3 gr.) of the powder up to 0.60 G. (9 gr.) per diem. For example: IJ Pulv. digitalis 0.10 gr. iss Sacchar. lactis 0.30 gr. v M. fiat pulv. Dent. tal. dos. no. x. Sig.—1 powder every 3 hours. Such doses should not usually be continued for more than 4 or 5 days. If the treatment is to be kept up longer, the medication should be reduced to two-thirds or one-half the original quantity after the first two days. The signs of a favorable action of digitalis are: the improve- ment in the patient's subjective condition; the slowing and strength- ening of the pulse; the increase in the amount of urine; and the dis- appearance of oedema. The author takes exception to the large doses often given. [Cushny, in a recent lecture before the Harvey Society, urges the use of the maximum doses.] Relative Intolerance for Digitalis.—If the patient cannot bear the infusion of digitalis, especially if it brings on stomach trouble, he may be given the powder or certain digitalis preparations may be substituted.