GASTRO-1NTESTINAL DISORDEE.S.—Ni troglycerin is advised by Humphreys against all kinds of vomiting, except that of pregnancy and of peritonitis. Reflex vomiting-, is especially amenable to its favorable influence.
Seasickness is often relieved with great promptness by nitroglycerin. It will re lieve the pain in gastralgia. Nitroglyc erin is of especial value in the algid stage of cholera. One or two drops of a 1-per cent. solution on the tongue dilates the peripheral blood-vessels, diminishes the diac and pulmonary dyspncea arc relieved by nitroglycerin, but, as in the use of the nitrites, great care should be exercised if the patient has a fatty heart. Bartholow has advised nitroglycerin in certain cases of anailnia.
Conclusions in regara to nitroglycerin are as follow: 1. It is only when deal ing with arteries in which there is no more than the normal tonicity of the walls that the drug is liable to produce disagreeable effects. Under this condi tion it should be administered with cau tion and in small doses. 2. In cases of arterial tension the drug can be used more freely than has been customary among practitioners, the dose being pro portioned to the degree of tension. 3. ln cases of arterial tension tolerance of the drug is rapidly acquired, and by a slight increase day by day very large doses can soon be tAkcii with safety, the constant guide being the degree of ten sion in the arterial w all. W. L. Arm strong (Med. News, Oct. 31, '96).
ln ang,ina pectoris nitroglycerin should be. used, and its dosage should be pushed to the requirements of the case. Nitrite of amyl is preferred to meet the parox ysms. Commencing with doses of nitro glycerin of '1„,, grain three times a day, they should be increased until the pa tient takes four or five or even more tinies as much three times a day--care being taken to select an active prepara tion, and being guided by the flushing of the face and throbbing of the head as to its activity. Osler (N. Y. Ided. Jour., Nov.-Dee., '96).
The vaunted efficacy of glonoin in all eases of sudden heart-failure is based on a misunderstanding of its physiological action. Where the heart is simply tired and nagging from overwork, glonoin is of value. In pneumonia and hypostatic congestion of the lun,,ris, where the right heart is unusually taxed. both in its capacity and in the work to be done, glonoin meets the condition. The effect, as some writer has said, is like bleeding a patient into himself, but it has this decided advantage over venesection: that the blood is left in the body for future use. In all conditions of sudden increase
1411..1-preFsure. and relieves the heart. N mtx ors DisoltDERS. — cases of liv“,.ro-epilepsy 7m, grain of nitroglyc er,n .1.1iiiiiiistered hypodermically will control the spasm. In epilepsy nitro glvcaiii is not so efficient to prevent the attack ilS ainvl-nitrite. In itaynaud's dis k.ase g,rt.at relief follows the t;un of ' doses of nitroglycerin thrt.c times daily. A large number of rtl,cllious cases of sciatica have been curtAl through the use of nitroglycerin plikhalkine and Krauss).
In migaine, with blanched face, nitro glycerin is strongly indicated. In mi grainous headaches, when the paroxysms are periodical, Gowers advises the admin istration of the remedy three times daily. In neuralgia of the trigeminal nerve due to insufficient blood-supply, nitroglycerin is a reliable remedy. In cephalalgia due to cerebral anmia it affords prompt re lief. It has also proved valuable in sci atica.
Under the influence of nitroglycerin two cases were radically cured of their sciatica, and in the third case marked improvement took place. The trinitrin was administered either in the form of a 1-per-cent. solution in alcohol, of which the patients took 3 drops daily, or in the following mixture:— 13 One-per-cent. alcoholic sol. trini trin, 11/4 fluiclrachms.
Tr. capsiei, 1 'A flnidracluns.
Aq. menth., 3 3/. fluidrachms.
Dose: Five to ten drops three times daily. Mikhalkine (Jour. de Med., Apr. 21, '95).
Seven eases in which nitroglycerin was used in the treatment of sciatica.
Of these seven patients, all received marked benefit from the very beginning of this mode of treatment. In the acute cases they recovered in from ten days to a month; in the chronic cases they im proved notably, and gained daily.
The drug was administered in the form of a 1-per cent. alcoholic solution, begin ning with the dose of I minim three times a day, and increasing up tO 4 Minhos if found necessary, or in the form of tablets containing grain given three times daily. Bitter tonics, codliver-oil, etc., and other measures for improving the general conditions were also employed.
The only discomforts arising from the use of the drug were congestive head ache and flushing of the face, sometimes following the first dose of the medicine, sometimes supervening only when the maximum doses were administered. To counteract these effects bromides may be given. Krauss (N. Y. Med. Jour., Feb. 29, '96).