"It was introduced as a remedy for dropsy; and, on the
applications which were made of it for the treatment of that
disease, a slowing action upon the cardiac movements was
observed, which led to its acquiring the reputation of a cardiac
sedative. Numerous observations were made on man by the
originators of its application, by Dr. Sanders and many other
physicians, in which special attention was paid to its effects
upon the circulation; but no further light was thrown upon its
remarkable properties, with the unimportant exception that in
some cases it was found to excite the circulation. It was not
until the experimental method was applied in its investigation,
in the first instance by Claude Bernard, and subsequently by
Dybkowsky, Pelikan, Meyer, Boehm, and Schmiedeberg, that the
true action of digitalis upon the circulation was discovered. It
was shown that the effects upon the circulation were not in any
exact sense sedative, but, on the contrary, stimulant and tonic,
rendering the action of the heart more powerful, and increasing
the tension in the blood-vessels. The indications for its use in
disease were thereby revolutionised, and at the same time
rendered more exact; and the striking benefits which are now
afforded by the use of this substance in most (cardiac) diseases
were made available to humanity."
Or take Sir T. Lauder Brunton's account of the action of nitrite of
amyl in angina pectoris:--
"The action of nitrite of amyl in causing flushing was first
observed by Guthrie, and Sir B. W. Richardson recommended it as
a remedy in spasmodic conditions, from the power he thought it
to possess of paralysing motor nerves. In the spring of 1867 I
had opportunities of constantly observing a patient who suffered
from angina pectoris, and of obtaining from him numerous
sphygmographic tracings, both during the attack and during the
interval. These showed that during the attack the pulse became
quicker, the blood-pressure rose, and the arterioles
contracted.... It seemed probable that the great rise in tension
was the cause of the pain, and it occurred to me that if it was
possible to diminish the tension by drugs instead of by
bleeding, the pain would be removed.
"I knew from unpublished experiments on animals by Dr. A. Gamgee
that nitrite of amyl had this power, and therefore tried it on
the patient. My expectations were perfectly answered. The pain
usually disappeared in three-quarters of a minute after the
inhalation began, and at the same time the pulse became slower
and much fuller, and the tension diminished."
Public-domain text, read in full here on John Shaqi.
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