A textbook of medical treatment, diseases and symptoms / by Nestor Tirard.

  • Tirard, Nestor Isidore Charles, Sir.
Date:
1900
Catalogue details

Licence: In copyright

Credit: A textbook of medical treatment, diseases and symptoms / by Nestor Tirard. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    ENDOCARDITIS o Quininae Sulphatis . Ammonii Carbonatis Potassii Bicarbonatis Tragacanthae . Aquae Chloroformi . gr- J. gr- ij- gr. xx. gr. iv. Caton 1 advocates continuous counter-irritation combined with prolonged rest. When, in a case of acute rheumatism, a bruit is heard at the mitral or aortic valve, or even when the premonitory assourdissement is perceptible, he applies a series of small blisters, each the size of a florin, along the course of the third, fourth, fifth, or sixth intercostal nerve, in front and at the sides. Only one blister is applied at a time, hut the blistering is repeated at different points. He gives at the same time sodium or potassium iodide in 8 or 10 grain doses thrice daily, and he keeps his patients in bed for about six wTeeks. He claims for this treatment a very considerable reduction of the liability to chronic valvular mischief after acute rheumatism with endocarditis. The special symptoms likely to arise in connection with endocarditis are those of ansemia, palpitation, and pain. The first may be greatly benefited by the administration of perchloride of iron. Palpitation may be controlled by the employment of digitalis, either the infusion or the tincture, while some cases appear to improve greatly during the ad- ministration of stimulants. In endocarditis it is necessary to watch the pulse closely while giving stimulants, and to check their administration if the pulse gains in rapidity and loses in force. For the relief of pain different preparations of opium may be used, and of these the compound ipecacuanha powder is often preferred. When given at night this powder will frequently promote sleep by reducing cardiac discomfort. In some cases of more chronic type, benefit appears to result from the employment of iodide of potassium, or of sodium. During convalescence from rheumatic endocarditis, it is necessary to warn the patient to avoid muscular exertion and cardiac strain. There are good grounds for believing that carelessness at this period is liable to be followed by increased cardiac distress. When the progress of the case is estimated by the 1 Brit. Mecl. Journ. Jan. 25, 1896.
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