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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    Strophanthus.—The first of these is strophanthus, either in the form of the seed, or in that of its essential principle, strophanthin. It strengthens the heart action, slows the pulse, and, although to a much less extent than digitalis, increases the arterial tension. Most authorities credit it with a diuretic action, but in the author's opinion this is not at all marked. Occasionally it has a deleterious effect on the kidneys. Dujardin-Beaumetz records a case where it caused hematuria, and Lemoine has observed that it increases albuminuria in Bright's disease. Bright's disease is therefore a contraindication for its use, as is also, ac- cording to G. See, true angina pectoris. The author's experience does not confirm the latter statement. [Osier recommends strophanthus as a diuretic in acute Bright's disease, but states that it is not to be com- pared to digitalis when dropsy is present in heart disease.] Unlike digitalis, it produces no cumulative effect, so that it can be given for any length of time, unless stomach symptoms (nausea and vomit- ing) appear. It produces a noticeable effect on the heart muscle much more quickly than digitalis,—in 24 hours instead of 36-48 or even more. It is usually given as a tincture (1:10 alcohol), 6-10 drops 3 times a day alone, or 20-30 drops a day in a mixture. IJ Tinct. strophanthi gtt. xv-gtt. xx gtt. xv-gtt. xx Syr. aurantii 20.00 fv Aq. dest 180.00 Svi M. fiat mist. Sig.—1 tablespoonful every 2 hours. Or: IJ Tinct. strophanthi, Tinct. Valerianae aa 10.00 3iiss M. et sig.—»10—20 drops 3 times a day. The intravenous injection of strophanthin has been tried more re- cently with good results. The best form is a watery solution of stro- phanthin in doses of 1 mg. (1/64 gr.) in 1 cm.3 (15 min.) of water. The usual daily dose is %-l cm.3 (7 to 15 min.). Its action is very rapid. A single dose, at times, stimulates to action a heart that has almost failed to beat, increases diuresis for several days, and quiets a labor- ing heart. It must be used in smaller doses if the heart is much dam- aged; e.g., y3 to i/2 mg. (7192-7128 gr.). The technique of intravenous injection has been mentioned above. [Gibson considers strophanthus of real value when a rapid effect is required, and in dilated senile hearts. Yeo prefers strophanthus in cases of cardiac feebleness with gouty tendencies—with corpulency, flatulence, and dyspepsia—or following acute illness. He substitutes it for digitalis to avoid the latter's cumulative effect. He has also found it to succeed in producing diuresis after digitalis has failed. Patton recommends strophanthus, 7-12 drops of the tincture, in the minor degrees of ataxia of the heart exhibited by nervous excitable persons, and in controlling the dyspnoea and palpitation of mitral stenosis.