EPITOME OF CURRENT MEDICAL LITERATURE

1922 BMJ (Clinical Research Edition)  
coeur, des vaisseaux et du sang, April, 1922) refers to his formner publication (with DUMONT and Joos) in La Polyclinique (Brussels, March, -1921) of a series or cases of persistent auricular fil)rillation. In lhalf the cases the cardiac rhythm was restored, as shownl by electrocardiograms, but the reCtoration of normnal rhytlhm is not a cure, the patient retuLrns to his former condition, and the brealkdown of compensation is only delayed. "Since then, the remedy has been use(d regularly at the
more » ... Bruissels Polyclinic; the positive results andl thie controls have nmaintained an analogous ratio, and( yet, without the test of experience, we cannot at pres-ent differenjtia-te between those cases which react favourably and others." He now continues the administration of quinidine for some weelks after the restoration of normal rhythml, because fibrillation is apt to recur, especially -when some sliglht inifection supervenes--for example, coryza or transient enteritis. He coininences with a moderately large dose-1.25 to 1.50 gram]s per diem for three or four days. If the beat becomes regular 1 gram per dliem is given for one to two weeks. Then digitalis (infuision of 1 graini of powdered leaves) and quinidine are given alternately, eaclh for a period of four or five days. He describes the case of a miian wlho had suffered for seven month.s fromprecordial paill, dyspnoea Ion exertion, and violent palpitation. Blood pressure = 130 to 100 m mi. Hg approximnately. Both si(les of the heart were muecll hypertroplhied; heart sounds were normal, but action very rapi(l. Digitalis infusion (= 1 gram of pow(dered leaves in forty-eight hours) was prescribed and continue(d for seventy-two hours longer. Heart action becanme slightly slower. Thlen 1.5 grams quinidine sulphate were given (laily for twodays. On tho third day the pulse was quite regular --9o per minute. The patient -was much easier and free froml pain. Quini(line was given regularly for ten days more, when the pulse was regular and lha(l fallen to 76. Four days after, the pulse, still regular, hacl risen to 156 per minute. The author gives three cardiograms which
doi:10.1136/bmj.2.3209.e1 fatcat:h64zgdvt2bflfgnxfdyqfyaz7e