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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    ventricular valve, and thus overloads the venous system behind. The pulmonic system and the right ventricle undergo compensatory changes of dilatation with thicken- ing ; the power of the pulmonic system, in fact, is generally increased; the blood pours into the left ventricle on its diastole, under great pressure, and thus distension of it follows, with hypertrophy or dilatation as its usual con- comitants ; the usual question of restorative power of the system deciding whether. The consequence of this change is one little to be expected by any one who has not given the subject of compensatory changes its proper considera- tion. It is this; that, in spite of the regurgitation of a considerable amount of blood, it (the ventricle) remains capable of filling the aorta (Niemeyer). That it does so with more or less success is evidenced by the irregularity of the pulse—not irregularity in time, but irregularity in volume, sometimes nearly the whole amount of blood passing forward, and then again a great portion passing backwards. But to achieve this change in the left ventri- cle, increase of growth behind the lesion is unavoidably necessary; without the opposition of the blood in the pulmonic system, and the hypertrophied right ventricle, this would be unattainable. Thus we see that muscular change is compensatory in regurgitant disease behind, as well as obstructive disease before. Sir Dominic Corrigan considered the advantage of ad- ministering digitalis (and the fact of relief being afforded by it is unquestionable, however defective the explana- tion) to he in its rendering ventricular action slow. Thus in aortic obstruction it allowed the ventricle more time to perfectly empty itself into the aorta ; that is, compensation took place by more time being allowed for the passing of the blood into the aorta through the narrowed orifice.
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