CARDIAC DISORDERS.—In angina pec toris we note the presence of cardiac dis tress, associated with radiating muscular pain and increased arterial tension: a symptom-complex controlled and lieved by the exhibition of the nitrites.
Amyl-nitrite is generally preferred at the time of the paroxysm; the alkaline trites may be used in the intervals, as their action is more prolonged.
For prompt and immediate relief to the pain of angina, or breathlessness due to vasomotor and bronchial spasm, that so often accompanies the senile heart, there are two drugs of supreme impor tance,—nitrite of amyl and nitroglycerin, —the latter having the most persistent action, and being, therefore, preferable. The tablets containing / Ho grain are the most convenient. One or two of these may be taken on any indication of pain or spasm, and the dose may be repeated several times a day if required. Balfour (Edinburgh Med. Jour., June, '91).
[Grainger Stewart has pointed out that nitrite of amyl has a direct effect on nervous structures, and that it re lieves other forms of neuralgia. Patient personally seen, however, with his coun tenance purple and the vessels almost bursting from overengorgement, due to the influence of nitrite of ainyl, without experiencing the slightest relief to his anginal attack. Still, it is readily ad mitted that nitrite of amyl and its allies do relieve some anginal attacks, and to a certain extent, and in some cases, by the lowering of the vascular tension, without, however, admitting that there is a direct causal relationship between the anginal attacks and heightened ar terial tension. E. N. WHITTIER and E. M. GREENE, Assoc. Eds., Annual, '9-1.1 Sodium nitrite being stable, may re place the less stable amyl- and ethyl nitrites. It dilates all the arterioles rapidly, and thus soon relieves the heart.
Disagreeable s3-mptoms may be overcome by prescribing it with ammonia-water or spirit of chloroform and small doses ...I boor( lone It is most useful in an :01.11 affections and in irregular heart lo obtain most benefit from its iok It should be continued some time .ft,r s)itiptoins. hare passed °II. The ir um dose is .1 or at most 5 grains. atia gem rall;. 1 or 2 grains are enough.
I 1,40aSe Oil ld appear to be ag :no attd, and bronchitis anti asthma are ta,t nettled by its ipze. Cordon Sharp itioner, .May.
In ar(bac dyspncea the nitrites are lainable. caution. however, should be uot to exceed 5 minims of amyl ei!r:te bv inhalation where fatty degen tr,Ition is present. II. C. Wood recom in( nds the nitrites in aortic insufficiency with excessive hypertrophy and severe headache.
yncope and cardiac failure follow ing general anresthesia (especially chlo rof Tim), shock, etc., amyl-nitrite by in halation is strongly recommended by Ed ward Bice.
Case of girl, aged 7 years, who sud denly ceased respiration during tenotomy for squint under chloroform amesthesia. Dead and shoulders were lowered, and artificial respiration begun, but the child appeared quite dead.
Amyl-nitrite was poured on a piece of lint, and held over the nose and mouth; hut ior some time there was no response, so more and more nitrite was poured on the lint, till at last a sob was beard during the interval between the artificial respiratory movements. Still keeping these up, sure signs of life appeared, and the operation %NILS eoncluded. G. E. Walker 1 Brit, .Med. ,lour., Aug. 7, '97).