844

ELEMENTS OF MAT Ell IA MEDICA.

of vegetable bitters (as infusion of gentian or calumba) with fox? 0 ’forms, I think, a valuable form of exhibition in many old dropsicalInfusion of common broom (Cytisus scnparius) might probably bevantageously conjoined with foxglove, where a powerful diuretic isquired. In old cases of general dropsy, in oedematous swellings ^debility, and in anasarca following scarlet fever, where, together " jweakness, there is still left an excited and irritable state of the a ^ er | t ]jsystem, clialybeates (as the tinctura ferri chloridi) may be conjoined wfoxglove, with the happiest effects (Holland, Med. Notes and R e r ep. 546). ^ ng>

4. In Hemorrhages . — In active hemorrhages from internal or ^ a ge .

accompanied with a quick, hard, and throbbing pulse, foxglove as adative is oftentimes serviceable. Epistaxis , haemoptysis, and IIlCI userhagia, are the forms of hemorrhage more frequently benefited by the 1of foxglove. _ . n

5. Diseases of the Heart and Great Vessels .—An important indicat 1 ^in the treatment of many diseases of the heart and great vessels i sreduce the force and velocity of the circulation. The most effect?means of fulfilling this indication are,—the adoption of a low' dl ’repeated blood-letting, and the employment of foxglove. There a ’perhaps, no diseases in which the beneficial effects of foxglove aremarked, than in those of the heart and great vessels. In aneurism of 1

great V csscis. aii uwcw/ w"' y

aorta , our only hope of cure is by the coagulation of the blood m ^ ^aneurismal sac, and the consequent removal of the distensive pressurethe circulation. To promote this, we endeavour to retard the move®of the blood within the sac, by diminishing the quantity of blood i n ^system generally, and by reducing the force and velocity with whic icirculates. Blood-letting and digitalis are, in these cases, very imp ()r .agents; and under their use cases now and then recover. Ag ain >simple dilatation of the cavities of the heart, our objects are to rein°' e ’,possible, the cause (usually obstruction in the pulmonic or aortic s ) ste f r .to strengthen the muscular fibres of the heart, and to repress any p renatural excitement of the vascular system. Digitalis is useful to u *.^attaining the latter object. In simple hypertrophy, or hypertrophy un ‘,dilatation, we have to reduce the preternatural thickness of the he aparietes, and this we do by removing, when it can be done, any obstr 1 ^tion to the circulation, by using a low' diet, by repeated blood-letting? aI ^by the employment of foxglove. No means, says Dr. Davies ( . , pgMed. Gaz. vol. xv. p. 790), excepting the abstraction of blood, dimi«i sthe impulsion of the heart so completely and so certainly as digd a ’“ I have been,” adds he, “ in the habit of using it for several )' ea gtfor these affections, and have rarely seen it fail in producing at j® a j_temporary relief.” “ The enlarged and flaccid heart,” observes Dr. \land (Med. Notes and Reflect, p. 574), “though, on first view, it 1111 ^seem the least favourable for the use of the medicine, is, perhaps, not s^At least we have reason to believe, that, in dropsical affections, • ^often connected with this organic change, the action of digitalis, aSdiuretic, is peculiarly of avail.” In some disordered conditions of * nW ^ration of the heart and great vessels —as in angina pectoris, nervous p apitations of the heart, and augmented arterial impulsion, foxglove is a ^at times beneficial. In patients affected with an intermittent or ot ie ^ 0wise irregular pulse, I have several times observed this medicine P r0Ll1